Your Baby's Appearance

Every new baby is unique and beautiful. Don’t be surprised, however, if your baby doesn’t look like the babies you see on television commercials or in magazine advertisements. Your baby may have lumps on his head, puffy or crossed eyes, a flat nose, a small chin, dry skin, or a rash.

And don’t be alarmed if your baby jerks occasionally while sleeping, has mild nasal congestion, breathes unevenly, sneezes, hiccups, and spits up occasionally. Such characteristics are normal and only temporary unless your doctor tells you otherwise.

Skin color in newborns can vary greatly — from a pink,white, yellowish, or even red tone to shades of tan or purplish blue depending on ethnicity.

• Rash. Babies skin often reacts to their new environment. Scattered, pinhead-sized, or somewhat larger pimples surrounded by a mild red zone may appear in various areas of the body when your baby is about two days old. These will disappear over time. The cause is unknown, and the rash requires no treatment. Some babies may have a rash called pustular melanosis [PUHS-chu-ler meluh- NOH-sis] with small pus-filled blisters that heal to dark spots on the skin. The spots eventually disappear. This rash is common in babies with darker skin and requires no treatment.
• Acrocyanosis. A blue color of the hands and feet is called acrocyanosis [ak-roh-sahy-uh-NOH-sis]. It is caused by a decrease in the circulation of blood to the skin of the hands and feet. This condition frequently occurs during the early hours of life. However, a baby should never be blue around the face and lips. If you notice that your baby’s face and lips have a blue color or if she has dusky or blue skin, this may indicate a serious problem and requires immediate medical attention.
• Mottling. A new baby’s skin can also look blotchy or mottled. This is especially noticeable if the baby is uncovered or cold. Mottling can also occur if your baby is ill. If your baby’s skin color becomes pale or mottled and their temperature is higher or lower than the normal range, call your baby’s doctor.
• Cradle cap. Cradle cap is a scaly patch of skin that develops on the scalp. Brushing your baby’s hair daily and washing it frequently — every time you bathe him or 2 to 3 times per week — may help prevent cradle cap. If cradle cap occurs, call your baby’s doctor.
• Milia. The whitish, pinhead-size spots, mainly on and around the nose or the newborn’s chin, are called milia [MIL-ee-uh]. Although they appear as tiny pimples, it is important not to disturb, break them or to put acne medicine on them. Doing so could produce a rash or cause the skin to scar. Milia are normal in newborns and usually disappear within a few weeks.
• Stork bite marks. These “birthmarks” occur in as many as half of all newborns, especially in those with fair complexions. This is a fanciful term for the areas of pink or red often present in the newborn on the upper eyelids, forehead, and back of the neck. They usually fade by the end of the baby’s second year.

Newborn babies rarely have nice round, perfectly shaped heads. Here are a few of the variations you may notice with your newborn’s head and face:

• Forceps marks. If your baby was delivered using forceps, marks left from the pressure of the forceps may be noticeable on your baby’s face, usually on the cheeks and jaws. Be assured that the marks will disappear quickly, usually within a day or two.
• Molding. Molding of the skull bones as the baby moves down the birth canal is a common cause of temporary lopsidedness of the head. Usually the head will return to its normal shape by the end of the first week. Molding is not usually present after a cesarean or breech delivery.
• Cephalohematoma. Cephalohematoma [sef-uh-loh-hee-muh-TOW-muh] is a collection of blood in the baby’s scalp tissue. You will notice this as a bruise on top of your baby’s head. Cephalohematoma is not usually present until several hours after birth. It may take 2 weeks to 2 months for the baby’s body to reabsorb the excess blood and for the bruise to go away.
• Facial asymmetry [ey-SIM-i-tree]. Your baby’s face may appear lopsided if crowding in the uterus caused the head to be held for some time in a sharply flexed position (with the shoulder pressed firmly against the jawbone). This unevenness disappears by itself in a few weeks or months.

The “soft spots” on your baby’s skull are called fontanels [fon-tn-ELS]. Most babies have two of them, one on the top of the head and one a little farther back. These areas are where the bones of your baby’s skull haven’t yet grown together. The rear fontanel usually closes within four months, while the front one doesn’t close until the child is at least a year old.

Don’t be afraid to touch these spots gently — they’re covered with a tough membrane to protect your baby’s brain.

Eyes

You’ll likely spend a lot of time looking into your newborn’s eyes. Babies can focus best at a distance of 8 to 14 inches — about the distance from her eyes to yours as you nurse or feed her. Babies also notice movement, light, patterns, and shapes. And as the first weeks go by, their ability to see and focus improves.

• Eye color. Babies aren’t born with their final eye color. Eyes at birth are usually grayish-blue in lighter-skinned infants and grayish-brown in infants of darker-skinned races. Pigment is slowly distributed to the eye and produces the final eye color of the baby by 6 to 12 months.
• Tear ducts. The tear ducts in a newborn are small and do not function at birth. Tears are usually not produced with crying until the baby is one to three months old.
• Cross-eyed. Many newborns appear to be cross-eyed because the upper eyelids of the newborn often show folds. This — in combination with the wide, flat bridge of the nose — can create this illusion. The can be tested by looking at the reflection in the baby’s pupils to see if both eyes are focused on the same object. This condition tends to disappear with further development of the facial structures.
• Eye movements. Uncoordinated eye movements are common in newborns. At times, it might seem that the eyes are operating independently. This is normal. Coordination of eye movements gradually occurs as the nerves and muscles of the eye develop. Fairly good eye coordination is usually apparent by the third or fourth month. In newborns, random and jerky movements are also normal.