Appearance of a Newborn
Your infant's appearance at birth may surprise or even shock you. How a newborn looks in reality is not usually how we picture her beforehand. For infants, a misshapen head, peeling yellow-tinged skin, swollen eyes and bright red birthmarks are common and nothing to worry about. All of these conditions will likely clear up in the first weeks of your baby's life. On this page, we'll describe some of physical traits that many newborns exhibit.
A newborn looks very different from older babies and children. Whereas her head is relatively large, measuring one fourth of her entire length, her legs are only one third of her length. Clearly, in humans, brain development takes precedence over development of the rest of the body.
Aside from being large, your newborn's head may look misshapen and even a little bruised. The bones of the skull are separated rather than fused as they are in adults. This separation allows the bones to slide over each other as the head passes through the narrow birth canal. Also, this mobility is essential to accommodate an infant's rapid brain growth.
When you caress the top of her head, you can feel the soft spots, or fontanels, in the skull. Here the bones are widely separated, but the brain is covered by a tough membrane and scalp. You won't hurt your baby by gently touching these areas. The anterior fontanel, located in the midline on top of the head, usually closes between 9 and 18 months after birth. Behind it is the smaller posterior fontanel, which closes by four months after birth.
Hair. The amount of hair on a baby's head varies. Any amount is normal. Most of this hair falls out and is replaced. The color and texture of the new hair may be quite different from those of the hair she was born with.
Inside the womb, the baby's body was covered with fine, downy hair called lanugo. Unless your baby was premature, most of this body hair has disappeared, except for some fuzz on the back. Even this residual lanugo disappears in a few weeks.
Eyes. Your baby's eyelids may be red and swollen from pressure during the delivery. In most hospitals, antibiotic drops are applied to the newborn's eyes. The drops may cause mild, temporary inflammation.
As your baby studies your face, you may notice one eye wanders or the two eyes don't move together smoothly. Unless one eye seems to be almost fixed in position (cross-eyed or wall-eyed), this wandering is normal and is corrected as the baby gains strength and coordination in the muscles that move the eyes.
Ears. The cartilage in the outer ear is very flexible in the newborn. If an ear looks folded, don't worry -- it will probably straighten out. If the problem continues, talk to your doctor.
Nose. At birth, the nose and mouth are often filled with mucus. After the delivery, your caregivers suction the baby's airways with a rubber syringe to clear them and help your baby breathe. Her own sneezing helps clear her nasal passages and is not necessarily the sign of a cold.
Mouth. An occasional baby already has one or more teeth at birth, which usually fall out. Your doctor may want to extract these teeth so your baby doesn't later choke on them.
If your baby did a lot of sucking in the womb, blisters may be present on the upper lip, as well as on the fingers, hands, or forearm.
Your baby's skin is wonderfully soft. It may not, however, appear as flawless as the complexion of an older infant. The newborn's skin often has a ruddier hue. For the first few days, the hands and feet may appear to be tinged with blue. Soon, the baby's circulation improves, and the skin color is more uniform.
Jaundice. More than half of newborns have some degree of jaundice in the first week of life. In most cases, this condition is due to the immaturity of the liver and is not a threat to the baby. The liver is the organ that helps to clear bilirubin, a waste product of broken-down red blood cells. Since the liver is not completely mature at birth, babies often are not able to excrete bilirubin as well as adults do. The deposition of bilirubin in the skin and the whites of the eyes gives them a yellowish tinge.
Jaundice first appears on the face and spreads downward as the bilirubin level increases. Normal newborn, or physiologic, jaundice usually is first visible between the second and fifth days of life, peaks between the fifth and seventh days, and clears within one to two weeks. In some breast-fed babies, jaundice may last a bit longer.
Unless your doctor determines the bilirubin level is too high, you can probably manage your baby's jaundice at home. The mainstay of home treatment is frequent feedings at breast or bottle. Bilirubin is eliminated in the urine and feces; the elimination can be accelerated by increasing fluid intake. Bilirubin is broken down in the skin, and light stimulates the action. The wavelength of light that hastens bilirubin breakdown in the skin passes through glass and plastic. Because this is so, sometimes just placing the baby near a sunny window for short periods of time is beneficial.
Your doctor may follow your baby's progress by checking the bilirubin level with a simple blood test. If the level rises excessively, the baby will require hospitalization for phototherapy treatment (exposure to light at a wavelength similar to that of ultraviolet light) and to determine whether the jaundice is due to something more serious than immature liver function.
In most babies, the jaundice resolves spontaneously. If your baby has jaundice, your doctor will tell you what to do to speed its disappearance.
Birthmarks. Birthmarks are a fairly common skin condition of the newborn. Babies of darker-skinned parents may have what are commonly called mongolian spots, a bluish pigmentation under the skin over the lower part of the back and the buttocks. Stork bites (also called angel kisses) are red, flat birthmarks usually located on the bridge of the nose, the upper eyelids, or the back of the neck. They usually disappear by the second birthday but may reappear with crying. Sometimes the spots on the nape of the neck persist into adulthood.
Rashes. Rashes often develop within the first few days of a newborn's life. Although parents tend to worry about these skin blemishes, most of these conditions are completely harmless and go away on their own. Milia are small white pimples on the face, caused by maternal hormones. They go away in several days without treatment. Erythema toxicum -- a rash of red bumps with yellow centers and a generally flea-bitten appearance -- occurs in half of all newborns. It is harmless and disappears on its own in about a week or so.
The skin of most babies peels a little after birth. Peeling is most noticeable on the palms and soles. It is more marked in babies born after more than 40 weeks of pregnancy. You might also notice a flaky condition on the scalp known as cradle cap. This flaking goes away by itself. Daily washing with soap and water is helpful. Click here for instructions on treating cradle cap.
Your baby breathes at a faster rate than you do. The normal newborn breathes between 30 and 50 times a minute. The rate is often irregular. If you watch closely, you may see a faint motion of the heart beating against the left chest wall. The pulse in new babies is also fast -- 130 to 160 beats per minute.
You may also notice your baby's breasts are enlarged. This enlargement, caused by exposure to high estrogen levels while in the uterus, is temporary.
Genitals. Exposure to maternal hormones may also cause swelling in the baby's genitals, especially the labia in girls. In the first few weeks, girls may have a white, blood-tinged, mucous discharge from the vagina due to withdrawal from those hormones.
In boys, the foreskin that covers the penis is not easily retractable. Don't try to force it back, as this may hurt your baby.
Abdomen. After the umbilical cord has been cut, a stump remains. If it is kept clean and dry, it falls off within ten days. Many hospitals recommend you gently clean the base of the stump with a cotton ball and rubbing alcohol. For directions on the care of your newborn's umbilical stump, click here.
Your baby's first bowel movements are sticky and greenish-black. This tar-like substance is called meconium. After your baby drinks breast milk or formula for a few days, her bowel movements appear yellow to brown.
Arms and Legs. Your baby can move all four extremities quite well. She prefers to keep them flexed and close to her body. Their exact position may resemble her posture during the last few weeks in the uterus. The legs often flop open at the hips, giving her a frog-legged look.
Extending her arms and legs makes her feel insecure. When she frets, you may be able to make her more comfortable by wrapping her snugly in a blanket and holding her close to you.
Despite some of the unusual physical characteristics of your baby, you undoubtedly believe that she's the most beautiful thing you've ever laid eyes on. During the first days of cuddling your baby and gazing into her eyes, you might wonder how much you baby is seeing and understanding. In the next section, we will explain your newborn's reflexes and responses.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.