Subcutaneous fat necrosis (SCFN) is a rare complication, usually occurring in otherwise healthy full-term infants who have experienced some level of trauma that causes ischemic injury to adipose tissue. Tissue injury usually occurs in areas of the body that are exposed to excessive pressure as during delivery. Tissue injury has also been described secondary to therapeutic cooling. This case study presents an infant who received whole body cooling for hypoxic ischemic injury and later developed severe hypercalcemia at one month of age without the skin lesions consistent with SCFN. The differential diagnosis for hypercalcemia and how it relates to SCFN is presented, as well as clinical presentation, treatment, and prognosis.

COVID-19 continues to spread across the United States with a continued increase in reported infections and deaths. How this virus effects pregnancy, particularly mothers and their infants around and after delivery, is of particular concern for health care workers. Moreover, concerns for compassion fatigue in the health care worker, as they attempt to provide comprehensive care to this population, is a documented concern that could have long-term effects on workers' ability to provide care. This article will describe the current concerns for the transmission of COVID-19 from the mother to the infant and how that has affected recommendations from several national and international organizations around maternal/infant testing, isolation, breastfeeding, and the infant requiring neonatal intensive care. Effects that changing recommendations may have on health care workers and care delivery, and how these may contribute to compassion fatigue, will also be discussed.

Aplasia cutis congenita (ACC) is a rare condition that presents at birth as an absence of skin that does not usually involve underlying structures. Occurring in 3/10,000 live births, ACC is evenly distributed between males and females; the risk of ACC increases to 7 percent in consanguineous marriages. Up to 86 percent of lesions are found on the scalp in the midline vertex position. Lesions can also be found on the trunk and limbs, as with Adams-Oliver syndrome or accompanying epidermolysis bullosa. ACC is associated with chromosomal abnormalities and 35–50 percent of the time with trisomy 13 (Patau syndrome). This case study presents an infant with multiple ACC lesions of the scalp. The pathophysiology, treatment, potential long-term complications, and nursing considerations are discussed.