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When babies are first born they can have a variety of physical characteristics which may be surprising to parents who are not expecting them.

Typically, babies are not born with clear skin and perfectly shaped heads. Instead, it takes time for their bodies to adjust being outside the womb. It helps to remember that the physical appearance of newborns will change over time and there are many changes you won’t need to worry about.

All of the physical features described below are normal for newborn babies to have and generally not a cause for concern.

Soft Spots

Most parents will notice 1 or 2 soft areas on their baby’s head where the skull bones have not yet connected. These soft spots are called fontanelles. These gaps allow your baby’s brain to grow rapidly in the first couple of months.

While you want to be gentle with your baby’s soft spots, you don’t need to worry about typical daily handling being harmful to your baby’s head. Sometimes, you may see the soft spot pulsating along with your baby’s heartbeat.

Moulding

Some babies’ heads will look elongated after birth, giving their head a cone shaped appearance. This results from moulding: the ability of skull bones to overlap so a baby’s head can fit more easily through the birth canal. Some babies will also have a little swelling or bruising on the scalp after delivery.

Sometimes parents can even feel the ridges where bone plates overlap on their baby’s skull. Over the next several weeks, your baby’s head will grow round and the skull bones will naturally resume their correct alignment.

Skin Color

When babies are first born their skin is often dark red to purple in color. This color quickly lightens to red once they begin breathing. Their hands and feet may be bluish for a couple days from immature circulation. But if your baby’s body is blue anywhere else, alert your physician because that is not normal.

A yellow coloring to your newborn’s skin is called jaundice. Typically, this is a normal reaction to the body getting rid of extra red blood cells. However, jaundice can also develop into a serious condition.

To test for jaundice, gently press on your baby’s chest or forehead and watch for what kind of color returns. If your baby has a yellow color on the first day and it worsens, speak with your physician about whether extra tests need to be run.

Vernix

Vernix is a greasy, white substance that may cover your baby’s skin at birth. This substance protect your baby’s skin from amniotic fluid during pregnancy and is created from your baby’s oil glands.

Vernix does not need to be removed and is often absorbed into your baby’s skin in the first day or two. Babies born after 41 weeks may not show any signs of vernix.

Lanugo

Lanugo is the soft, downy hair on a baby’s body. It is not usually found on babies born late, and is most noticeable on premature babies.

Port Wine Stain

This is a flat, pink, red, or purple-colored birthmark caused by a concentration of capillaries (tiny, dilated blood vessels). They may be any size, and are often found on a baby’s head or neck. Port wine stains do not disappear over time, nor do they change color if you gently press on them.

Port wine stains may become darker over time and bleed when your child is older. Facial port wine stains can indicate a more serious problem and will need to be monitored by your baby’s pediatrician.

The most effective treatment for removal is a type of laser. This operation could be performed by a plastic surgeon when your baby is older.

Erythema Toxicum

This is a red rash that looks similar to flea bites. It can be found anywhere, but is commonly found on the chest and back.

About half of all babies have this condition in the first few days of life, but it is less common in premature babies. Erythema Toxicum is not dangerous and will disappear naturally after a few days.

Stork Bites

Stork bites are small red or pink patches that can be seen on a baby’s eyelids, upper lip, between the eyes, or back of the neck. The marks are caused by a concentration of immature blood vessels. Sometimes they become more noticeable when a baby cries. Most stork bites will disappear as your baby ages.

Mongolian Spots

These blue or purple-colored splotches appear on a baby’s bottom and lower back. They are caused by a concentration of pigmented cells. Mongolian spots appear in over 80 percent of Asian, African-American, and Indian babies, and are more common in dark-skinned babies. They usually disappear before a baby is 4 years old.

Strawberry Hemangioma

Strawberry Hemangioma looks like a strawberry: it is a dark or bright red, raised bumpy area, usually found on the head. It is caused by a concentration of tiny, immature blood vessels. Some babies do not have hemangiomas when they are born, but develop them later, within two months of birth.

Some hemangiomas grow for a few months and then fade over time. Often, they are completely gone by the time a child is 9. They are more common in girls and premature babies.

Baby Acne

A mother’s hormones can cause acne in about one-fifth of newborns. Pimples will often appear on the cheeks and forehead, but will disappear on their own within a few months. Refrain from squeezing or breaking open the pimples, which could start an infection.

Milia

Milia are white, tiny, hard spots that may appear on your newborn’s nose, chin, or forehead. Similar to pimples, they are from oil glands and disappear on their own with time. Sometimes you can find these spots in your baby’s mouth or on the gums.

Swollen Genitals/Discharge

A newborn’s genitals will look different depending on his or her gestational age (number of weeks or pregnancy) at birth. A premature baby boy may have a flat, smooth scrotum with undescended testicles. A full term or postmature baby boy may have ridges in the scrotum with descended testicles.

Premature baby girls may have a very prominent inner labia and clitoris. A full term baby girl may have a larger outer labia. It is also common for baby girls to have a small amount of blood-tinged mucus or whitish discharge from her vagina in the first few weeks.

Breasts

Both male and female babies may get enlarged breasts around the third day of life. Sometimes, a milky substance may leak from their nipples in the first week. This is caused by the mother’s hormones and will disappear within a few days or weeks. Refrain from squeezing your baby’s nipples or breasts, which could lead to infection.

Umbilical Cord Color

A newborn’s umbilical cord stump will turn yellow and then brown or black, before it eventually falls off on its own.

Odd Movements

A newborn baby cannot control their movements very well during the first few months. Most of their movements are controlled by reflexes. When your baby is crying, his chin, arms, or legs may seem shaky and this is normal.

Rapid Breathing

Adults only take 12 to 18 breaths a minute, while a healthy newborn takes around 40 breaths a minute. Sometimes, a baby’s breathing will pause for up to 10 seconds and then they will resume breathing normally.

While most of the physical attributes covered here are perfectly normal and may even disappear with development, if you have any concerns about your baby’s appearance speak with your doctor. He or she will be able to monitor a physical attribute and perform further tests, if necessary.

Karen K. Meyer, MD

Methodist Physicians Clinic Hawthorne Court (178 & Q)

Dr. Meyer answers your questions about child development and parenting. Dr. Meyer decided to become a doctor when she was in school and learned about the body's systems and the miracle of how they all work together. She likes talking to children and helping them feel better. Dr. Meyer believes that children are not little adults and they need to be treated in a way that will help them understand why they aren't feeling well and what they can do to get better. She also works to build tru ...

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