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Your Newborn's Appearance

WHAT YOU NEED TO KNOW:

What do I need to know about my newborn's appearance?

Your baby may look different than you expect. Some of his body parts may look a certain way because he was in your uterus for many months. As he grows, many of these features will change.

What do I need to know about my newborn's head?

  • Your newborn's head may not be perfectly round right after birth. Labor and delivery may cause his head to have an odd shape. The head may have molded into a narrow, long shape to go through your birth canal. It may have a bump on one side. Your baby may have bruising or swelling on his head because of the birth process. This is usually normal. His head should look rounder and more even in 1 or 2 weeks.
  • Fontanels are soft spots on the top front part and back of your newborn's skull. They are protected by a tough tissue because the bones have not grown together yet. Your baby's brain will grow very quickly during his first year. The purpose of the soft spots is to make room for his brain to grow. Soft spots are usually flat, but they may bulge when your baby cries or strains. It is normal to see and feel a pulse beating under a soft spot. You may be more likely to see the pulse if your baby has little hair and is fair-skinned. It is okay to touch and wash your newborn's soft spots.
  • Your baby may be born with a little or a lot of hair. It is common for some of your newborn's hair to fall out. By the time he is 6 months old, he should have grown more hair. Your baby's hair may change to a different color than the one he was born with.
  • At birth, one or both of your newborn's ears may be folded over. This is because he was crowded while growing in the uterus. Ears may stay folded for a short time before unfolding on their own.

What do I need to know about my newborn's eyes?

  • Your newborn's eyelids may be puffy. He may have blood spots in the white areas of one or both eyes. These are often caused by the pressure on your newborn's face during delivery. Eye medicines that your baby needs after birth to prevent infections may cause your newborn's eyes to look red. The swelling and redness in your newborn's eyes will usually go away in 3 days. It may take up to 3 weeks before blood spots in your newborn's eyes are gone.
  • Most light-skinned babies are born with blue-gray eyes. The eye color of light-skinned babies may change during the first year. Dark-skinned babies usually have brown eyes that do not change color. If your baby will not open his eyes, the lights in the room may be too bright. Try dimming the lights to encourage your baby to open his eyes.
  • It is common for newborns to cry without making tears. A newborn baby's eyes usually make just enough tears to keep his eyes wet. By 7 to 8 months old, his eyes will develop so they can make more tears. Tears drain into small ducts at the inside corners of each eye. A blocked tear duct is common in newborns. A possible sign of a blocked tear duct is a yellow sticky discharge in one or both eyes. Your newborn's pediatrician may show you how to massage the tear ducts to unplug them.

What do I need to know about my newborn's nose?

  • Your newborn's nose may be pushed in or flat because of the tight squeeze during labor and delivery. It may take a week or longer before his nose looks more normal.
  • It may seem like your baby does not breathe regularly. He may take short breaths and then hold his breath for a few seconds. Your baby may then take a deep breath. This irregular breathing is common during the first weeks of life. Irregular breathing is also more common in premature babies. By the end of the first month, your baby's breathing should be more regular.
  • Babies also make many different noises when breathing, such as gurgling or snorting. Most of the noises are caused by air passing through small breathing passages. These sounds are normal and will go away as your baby grows.

What do I need to know about my newborn's mouth?

  • When you look inside your newborn's mouth, you may see small white bumps on his gums. These bumps are usually fluid-filled sacs called cysts. They will soon go away on their own. You may also see yellow-white spots on the roof of his mouth. They will also go away without care.
  • Your baby may get a lip callus (thickened skin) on his upper lip during the first month. It is caused by sucking and should go away within your baby's first year. This callus does not bother your baby, so you do not need to remove it.

What do I need to know about my newborn's skin?

At birth, your newborn's skin may be covered with a waxy coating called vernix. As the vernix comes off and the skin dries, your newborn's skin will peel. Babies who are born after their due date may have a large amount of skin peeling. This is normal. Peeling does not mean that your newborn's skin is too dry. You do not need to put lotions or oils on your newborn's skin to stop the peeling or to treat rashes. At birth or during his first few months, he may have any of the following:

  • Erythema toxicum is a red rash that may appear anywhere on your newborn's body except the soles of the feet and palms of the hands. The rash may appear within 3 days after birth. No treatment is needed for this rash. It usually goes away in 1 to 2 weeks.
  • Milia are small white or yellow bumps that may appear on your newborn's face. Milia are caused by blocked skin pores. Many milia may break out across your newborn's nose, cheeks, chin, and forehead. Do not squeeze or scrub milia. Creams or ointments may make milia worse. When your baby is 1 to 2 months old, his skin pores will begin to open. When this happens, his milia will go away.
  • Newborn acne may appear when your baby is 3 to 5 weeks old. Your newborn's cheeks may feel rough and may be covered with a red, oily rash. Wash your newborn's face with warm water. Do not use baby oil, creams, ointments, or other products. These will only make the rash worse. Keep your newborn's fingernails short to keep him from scratching his cheeks. No treatment will clear up newborn acne. Like milia, newborn acne should go away when skin pores begin to open.
  • Scrapes or bruises are common during the birth process. If forceps were used to deliver your baby, they may leave marks on his face or head. He may have bumps and bruises from going through the birth canal without forceps. A fetal monitor may also have left marks on your newborn's scalp. Scrapes and bruises should be gone within 2 weeks. Lumps and bumps, especially from forceps, may take up to 2 months to go away.
  • Lanugo may cover your newborn's shoulders and back. Lanugo is a fine coating of soft hair. It can be light or dark. This hair should rub or fall off your baby within the first month. Lanugo is more common in premature babies.

What do I need to know about birthmarks?

It is common for a newborn's skin to have birthmarks. Birthmarks come in different sizes, shapes, and colors. Some birthmarks shrink or fade with time. Other birthmarks may stay on your baby's skin for his entire life. Ask your newborn's healthcare provider to check birthmarks you have questions about. Your baby may have any of the following:

  • Café au lait spots are flat skin patches that are light brown or tan. They may be found anywhere on your newborn's body. The spots may get smaller as he grows.
  • Moles are dark brown or black. They may be on your newborn's skin when he is born, or they may form later. Most moles are harmless and do not need to be removed.
  • Mongolian spots are commonly seen on the buttocks, back, or legs. These spots may be green, blue, or gray and look like bruises. Mongolian spots are harmless, and usually go away by the time your child is school-aged.
  • Port wine stains are large, flat birthmarks that are pink, red, or purple. A port wine stain is caused by too many blood vessels under the skin. A port wine stain may fade in time, but it will not go away without surgery.
  • A stork bite is a common birthmark, especially on light-skinned babies. Stork bites are flat, irregular patches that may be light or dark pink. Stork bites can usually be seen on the eyelids, lower forehead, or top of a newborn's nose. They may also be found on the back of a newborn's head or neck. Most stork bites fade and go away by the first birthday.
  • A strawberry hemangioma is a rough, raised, red bump caused by a group of blood vessels near the surface of the skin. Right after birth, it may be pale or white, and may turn red later. It may get larger during the first months of a baby's life, then shrink and go away.

What do I need to know about my newborn's breasts?

Your newborn boy or girl may have swollen breasts after birth for a few weeks. This is caused by hormones that are passed to your newborn before birth. Your newborn's breasts may be swollen longer if he is being breastfed. This is because hormones are passed to him through breast milk. Your newborn's breasts may also have a milky discharge. Do not squeeze your newborn's breasts. This will not stop the swelling and could cause an infection.

What do I need to know about my newborn's genitalia?

  • Female: A girl's external genitalia may look swollen and red. Your baby girl may also have a clear, white, pink, or blood-colored discharge from her vagina. Hormones passed from mother to baby before birth cause this. This discharge should go away within 1 to 4 weeks.
  • Male:
    • The rounded end of your boy's penis is called the glans. The foreskin is the skin that covers the glans. Right after birth, your newborn's glans and foreskin are attached. This is normal. Do not try to pull back the foreskin. With time, the foreskin will slowly start to come apart from the glans. If your baby had a circumcision, ask his healthcare provider how to care for it.
    • It is common for a baby boy to have an erection of his penis. He may have an erection during diaper changes, when breastfeeding, or when you are washing him. He may also have an erection when his diaper rubs against his penis.

What do I need to know about my newborn's toes and fingers?

Your newborn's fingernails are soft, and they will grow quickly. You may need to trim them with baby nail clippers 1 or 2 times each week. Be careful not to cut too closely to his skin because you may cut the skin and cause bleeding. It may be easier to cut his fingernails when he is asleep. Your newborn's toenails may grow much slower. They may be soft and deeply set into each toe. You will not need to trim them as often.

When should I contact my newborn's pediatrician?

  • Your newborn has a fever.
  • Your newborn's eyes are red, swollen, or have a yellow sticky discharge. This may mean that he has an eye infection, which needs treatment.
  • Your newborn has redness, discharge, or swelling from the umbilical cord. Call if the area around the cord stump is red and your newborn cries when you touch it.
  • Your newborn boy's penis is red and swollen after circumcision. Also call if his circumcision site has yellow or green drainage that smells bad. His penis may be infected.
  • Your newborn is not waking up on his own for feedings. He seems too tired to eat or is not interested in feedings.
  • Your newborn's abdomen is very hard and swollen, even when he is calm and resting.
  • Your newborn coughs often during the day or chokes often during each feeding.
  • Your newborn is very fussy, crying more than he normally does, and you cannot calm him down.
  • Your newborn has a rash that gets worse or his skin turns yellow.
  • You have questions or concerns about your newborn's condition or care.

Care Agreement

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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