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Parents often dream of what their new baby may look like, thinking about a pink, round, chubby-cheeked and gurgling wonder. It may be surprising for many parents to see their newborn the first time—wet and red, with a long head, and screaming—nothing at all like they had imagined.
Newborns have many variations in normal appearance—from color to the shape of the head. Some of these differences are just temporary, part of the physical adjustments a baby goes through. Others, such as birthmarks, may be permanent. Understanding the normal appearance of newborns can help you know that your baby is healthy. Some of the normal variations in newborns include the following:
A baby's skin coloring can vary greatly, depending on the baby's age, race or ethnic group, temperature, and whether or not the baby is crying.
When a baby is first born, the skin is a dark red to purple color. As the baby begins to breathe air, the color changes to red. This redness normally begins to fade in the first day. A baby's hands and feet may stay bluish in color for several days. This is a normal response to a baby's underdeveloped blood circulation. Blue coloring of other parts of the body, however, isn't normal.
Some newborns develop a yellow coloring of the skin and whites of the eyes called jaundice. This may be a normal response as the body rids older red blood cells. However, it may indicate problem, especially if it worsens.
Molding is the irregular shape of a baby's head from the birth process. Normal shape usually returns by the end of the first week.
This is a white, greasy, cheese-like substance on the skin of many babies at birth. It protects the baby's skin during pregnancy.
This is soft, downy hair on a baby's body, especially on the shoulders, back, forehead, and cheeks. It's more noticeable in premature babies. It will gradually disappear.
Milia are tiny, white, bumps on a newborn's nose, cheeks, chin and forehead. Milia form from oil glands and disappear on their own. When these occur in a baby's mouth and gums, they are called Epstein pearls.
Stork bites or salmon patches
These are small pink or red patches often found on a baby's eyelids, between the eyes, upper lip, and back of the neck. The name comes from the marks on the back of the neck where, as the myth goes, a stork may have picked up the baby. They're caused by a concentration of immature blood vessels and may be the most visible when the baby is crying. Most of these fade and disappear completely by age 18 months.
Congenital dermal melanocytosis
Congenital dermal melanocytosis (formerly called "Mongolian spots") are blue or purple-colored splotches on the baby's lower back and buttocks. Over 80% of African-American, Asian, and Indian babies have these marks, but they occur in dark-skinned babies of all races. The spots are caused by a concentration of pigmented cells. They usually disappear in the first 4 years of life.
Erythema toxicum is a red rash on newborns that's often described as "flea bites." The rash is common on the chest and back, but may be found all over. About half of all babies develop this condition in the first few days of life. It's less common in premature babies. The cause is unknown but it's not dangerous. Erythema toxicum doesn't require any treatment and disappears by itself in a few days.
Acne neonatorum (baby acne)
About 20% of newborns develop acne in the first month. It usually appears on the cheeks and forehead. They usually disappear within a few months. Gently wash the areas with mild soap.
This is a bright or dark red, raised or swollen, bumpy area that looks like a strawberry. Hemangiomas are formed by a concentration of tiny, immature blood vessels. Most of these occur on the head. They may not appear at birth, but often develop in the first 2 months. Strawberry hemangiomas are more common in premature babies and in girls. These birthmarks often grow in size for several months, and then gradually begin to fade. Nearly all strawberry hemangiomas completely disappear by age 9.
Port wine stain
A port wine stain is a flat, pink, red, or purple colored birthmark. They are caused by a concentration of tiny dilated blood vessels called capillaries. They usually occur on the head or neck. They may be small, or they may cover large areas of the body. Port wine stains don't disappear over time. Port wine stains on the face may be associated with more serious problems.
Newborn breast swelling
Breast enlargement may occur in newborn boys and girls around the third day of life. In the first week, a milky substance, sometimes called "witch's milk," may leak from the nipples. This is related to the mother's hormones and goes away within a few days to weeks.
Premature baby girls may have a very prominent clitoris and inner labia. Full-term girls have larger outer labia. Girls may have a small amount of whitish discharge or blood-tinged mucus from the vagina in the first few weeks. This is a normal occurrence related to the mother's hormones.
Premature boys may have a smooth, flat scrotum with undescended testicles. Boys born later in pregnancy have ridges in the scrotum with descended testicles.
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