Skin and Birthmarks
Acne of the newborn - More than 1/3 of newborns develop acne of the face, mainly small red bumps. This neonatal acne begins at 3-4 weeks of age and may last until 4-6 months of age, though it usually lasts a shorter period of time. The cause appears to be the transport of maternal hormones just before birth. Since it is temporary, no treatment is necessary. Extra cleansing is unnecessary and may make the condition worse.
Erythema Toxicum-This will affect more than half of newborn babies. It will appear to look like insect bites, specifically like flea bites. The nose and cheeks are most often involved. Despite its name, they are harmless and resolve by 2-3 weeks of age.
Milia - Milia are tiny white bumps that occur on the faces of ½ of newborn babies. The nose and cheeks are most often involved. They look like small, firm, pearly pimples but are not infected. No ointments or creams should be applied to them.
Mongolian Spots - A Mongolian spot is a bluish-gray flat birthmark found in most of Native American, Oriental, Hispanic and African American babies. Mongolian spots occur most commonly over the back and buttocks, although they can be present on any part of the body. They vary greatly in size and shape. Most fade away by 2 to 3 years of age.
Scalp Hair - Most hair at birth is dark. This hair is temporary and begins to shed by one month of age. The permanent hair will appear by 6 months and may be an entirely different color from the newborn hair.
Molding- Molding refers to the long, narrow cone-shaped head that results from passage through a tight birth canal. The molding may lead to ridging of the skull where the bones that form the skull overlap one another. The head returns to normal shape in a few days.
Caput- This refers to swelling on top of the head or throughout the scalp caused by fluids squeezed into the scalp during the birth process. Caput is present at birth and clears in a few days.
Swollen Eyelids - Eyes may be puffy because of pressure on the face during delivery. This usually clears within a few days.
Subconjunctival Hemorrhage - A small hemorrhage on the white of the eye (sclera) is not uncommon. It is caused by birth trauma and is harmless. The blood is often reabsorbed within 2-3 weeks.
Crossed Eyes - Your baby's eyes should look straight at you when he is alert and awake. One may turn in or out slightly when he is particularly tired, but both eyes should work together most of the time. If crossed eyes persist, mention it at your baby's 2-month checkup. If one eye turns out most of the time, that should be mentioned by 1 month of age.
Vision - Newborn babies can focus on objects 8-12 inches away from them. Eye-to-eye contact may be brief at first but will increase during the early weeks after delivery. Babies may follow a face or an object from side to side. Babies can see at the distance adults do at around 4 months of age.
Folded-Over Ears – The ears of newborns are commonly soft and floppy. Sometimes one of the edges is folded over. The outer ear will assume normal shape as the cartilage hardens over the first few weeks.
Ear Pits – About 1% of normal children have a small pit or dimple in front of the outer ear. This minor congenital defect is generally unimportant unless is becomes infected.
Epithelial Pearls – Little cysts containing clear fluid or shallow white ulcers can occur along the gum line or on the hard palate. These are the result of blockage of normal mucous glands. They disappear after 1-2 months.
Breast Engorgement – Swollen breasts are present during the first week of life in many male and female babies. They are caused by the passage of hormones across the mother’s placenta. Breasts are generally swollen for as long as 4-6 months, but they may stay swollen longer in breastfed and female babies. Never squeeze the breast because this may cause infection.
Vaginal Discharge – As maternal hormones decline in the baby’s blood, a white or clear discharge can flow from the vagina during the latter part of the first week of life. Occasionally the discharge will become pink or blood tinged. This normal discharge should not recur once it stops.
Hydrocele – The newborn scrotum can be filled with clear fluid. The fluid is squeezed into the scrotum during the birth process. This painless collection of clear fluid is called a hydrocele. It is common in newborn males. A hydrocele may take 6-12 months to clear completely.
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