Despite this the majority of neonates with junctional EB is able to suck a nipple or teat. However, the nipple or teat must be moistened because a dry nipple or teat can stick to the blisters. Often there are wounds in and around the nostrils which lead to crustation. The child will then have to start breathing through the mouth which leads to a dry mouth and dry mucous membranes. Because of this the child may sometimes find it difficult to suck a bottle or nipple and will therefore have to be fed with a spoon.
Blisters often burst spontaneously after which the wounds start to heal.
In the course of time the condition of the pharynx deteriorates because of the recurring blisters. Swelling under the vocal cords can cause restriction of the larynx which may lead to a serious shortness of breath in children. The effects of junctional EB on the pharynx are always life-threatening and this is the main cause of death in this group of children. The mouth and throat problems may cause a serious disruption of nutritional intake. Because of this the child barely grows or not at all while there is a higher need for nutrients because the body loses proteins along with the wound exudate and has to sustain the normal metabolism, too.