Care practices that affect the fragile infant with skin breakdown, wounds and ostomies in the Neonatal Intensive Care Unit (NICU) present major dilemmas for care providers. Not only are there issues of pain management and developmental support, but also best practice issues with regard to care and product use. Even with modern technological advances skin, wound and ostomy care can be challenging for the neonate, inconsistent among caregivers, and often ineffective. As a result parents and staff consistently report anxiety around the acute and long-term care of the fragile infant with skin, wound or ostomy challenges. Expert neonatal skin, wound and ostomy care was identified as an unmet need in our unit. The result was the creation of a Neonatal Skin, Wound and Ostomy Nurse (NSWON) position and a program to provide evidence-based, age-appropriate, developmentally supportive, neonatal skin, wound and ostomy care with a multi-disciplinary approach. As a result staff and parents are receiving the most up-to-date, consistent information for skin, wound and ostomy care with an emphasis on diminishing stress, discomfort and developmental risk. Provision of individualized, relationship-based rehabilitative care empowers the family with knowledge of how to care for their fragile infant while staff is more comfortable and consistent in their practice. The benefit to this underserved, fragile population, and their caregivers through this Neonatal Skin, Wound and Ostomy Program (NSWOP) and the possible development of similar programs is far reaching. True evidence-based, neonatal wound and ostomy care has not yet been established. The documentation within this NSWOP will lend itself to much-needed comprehensive research in neonatal skin, wound and ostomy care. I challenge other NICU's to support a NSWOP in their hospital, encourage WOCN certification, and join me in the very best of neonatal care.