When you picture a newborn, you might imagine a rosy-cheeked, soft-skinned bundle of perfection. But let’s be honest—most newborns come into the world looking a little… funny. Cone-shaped heads, puffy eyes, flaky skin, and even some funky hairdos are all part of the charm.
Don’t worry—it’s totally normal! Babies have just finished an incredible (and squishy) journey through the birth canal or endured the rigors of a surgical birth, and their appearance reflects that. In this post, we’ll dive into all the quirky features your little one might sport in their early days, why they happen, and when you can expect things to settle into that classic baby cuteness.
Head: Unless you've had a cesarean, the skull of your newborn baby will probably be affected by molding, wherein the bones in the skull have been compressed or overlapped from their passage through the birth canal. This can give your baby’s head a squashed, elongated or “cone-head” look. You may also notice some bruising that was sustained during birth. Both of these phenomena will usually disappear over the course of the first few days.
Fontanels: Your baby has two fontanels, commonly called “soft spots” on their skull where the bones have not grown together yet and are protected by a tough membrane. The purpose of the soft spots is to make room for the brain which grows very quickly during their first year. Soft spots are usually flat but may also bulge when your baby cries or strains and it is normal to see and feel a pulse beating under a soft spot. The anterior fontanel is located in the top front part of your baby’s head. It is diamond shaped and about 2 inches wide. The anterior fontanel starts to close with bone at six months and is usually completely closed off by 18 months. The posterior fontanel is located toward the back of the head and shaped like a small triangle. It is about one-half inch round and may be difficult to find. The fontanel is usually closed with bone by the third month. It is ok to gently touch and wash your baby’s soft spots.
Face: Your baby might arrive with a flattened ear, a squashed nose or even a crooked jaw, but don’t worry, all of this is temporary. Compressed facial features are a result of positioning in the uterus and are entirely normal. You might also find that there may be a bit of puffiness to baby’s face. This is from fluid accumulation (especially if you’ve been on IV fluids for a long time), that will also disappear within a few days.
Hair: Some newborns come into the world with a fine coat of hair called lanugo covering their back, shoulders and neck. This hair is usually shed in the uterus, and its function is to anchor the vernix to the baby's body in-utero. It also provides lubrication for birth and contributes to thermoregulation, prevention of water loss, and innate immunity. Without the lanugo to anchor the vernix caseosa, these functions would be compromised. The lanugo will usually shed within a few days, if not a few hours.
Skin: A newborn’s skin can be mottled or even blue due to temperature change, which can be especially alarming to new parents. Mostly the mottling is due to the pressure from the journey through the birth canal and will go away. You might also see that your baby has some scratches or contusions, but like the rest, it will heal up within the first week or two. You'll notice your newborn baby’s feet and hands will often be blue, which is a normal response to your baby's underdeveloped circulatory system.
Dry skin is normal for newborns and this is a period when the baby’s skin learns to adapt to the outer environment. Applying moisturizer won't help because some of the outer layers of skin dries up and flakes off naturally in the first couple of weeks. Babies skin only needs to be washed with soap about once a week, but you can bathe them daily in warm water, as well as run their bottoms under the sink instead of always using wipes (even Water Wipes contain Grapefruit Seed Extract which can be irritating to babies' super delicate skin).
Newborn skin can also be affected by several other conditions of which the most common are:
Jaundice: 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 gets rid of older red blood cells. But it may indicate a problem, especially if it worsens. Always let a pediatrician evaluate your baby if the skin tone starts becoming yellow. In most cases, feeding the baby frequently and making sure the baby gets lots of daylight will be enough as prevention and treatment, but in some cases the newborn jaundice becomes more severe and the baby will need supervision and treatment in hospital, like phototherapy (sunbathing under blue lights)
Baby Acne: A skin condition affecting many babies during their second month of life. Usually, doing nothing is the best treatment and the acne will clear on its own.
Cradle Cap: This affects at least 40% of all babies and usually disappears at some point during the baby’s first 12 to 18 months. Cradle cap is yellow and greasy, and you’ll most likely find it on your baby’s skull, forehead, eyebrows, or behind the ears.
Milia: Milia are tiny, white, bumps on a newborn's nose, cheeks, chin and forehead. Milia form from oil glands and disappear on their own within a month or so. When these occur in a baby's mouth and gums, they are called Epstein pearls. As tempting as it may be, don't try to pop them!
Erythemia toxicum: Erythema toxicum is a red rash on newborns. It's often described as flea bites. The rash is common on the chest and back, but may be found all over. About 50% 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.
Birthmarks:
Café au lait spots: These are flat skin patches that are a light brown or tan colors. Café au lait spots look like small puddles of coffee and cream. This is a common birthmark that babies may get anywhere on the body. The spots may get smaller as your baby grows.
Moles: Moles are also called nevi (neev-eye) and are dark-brown or black. They may also be on your baby’s skin when he is born or may form later on. Most moles are harmless and do not need to be removed.
Congenital dermal melanocytosis (CDM): These spots are commonly seen on the buttocks, backs, or legs of dark-skinned babies. CDMs may be green, blue, or gray colored and may look like bruises. CDMs are harmless, and usually go away by the time your child is school aged. The prevalence of CDM varies among different ethnic groups and is most common in Asian babies. They've also been reported in 80% of East African children, in 46% of Hispanic children, and in 1-9% of white children.
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 linked to more serious problems. There are 3-5 cases per 1000 babies.
Stork Bite: A stork bite is a common birthmark, especially on light-skinned babies. Stork bites are flat, irregular patches that may be light or dark pink and can usually be seen on the eyelids, lower forehead, or bridge of the baby’s nose. They may also be found on the back of the baby’s head or neck. Most stork bites fade and go away by your baby’s first birthday. Even after your baby’s stork bites fade, they may darken for a short time when he cries or strains. Present in about 1/3 newborns.
Strawberry Hemangioma: 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 slowly fade. Nearly all strawberry hemangiomas completely disappear by age 9. Affects 2 of every 100 babies born.
Belly: Don’t worry if it seems that your baby’s stomach appears to be quite full, as though he or she has eaten something quite large. This slightly barrel-chested look is normal, as is the site of your newborn’s skin pushing between striations of muscle tissue on the chest. This goes away within a few months.
Cord: The cord stump should dry up and fall off in about two to three weeks. While your baby has his cord stump, fold their diaper down under it to prevent irritation. As the stump dries, it turns hard and dark. Never try to pull off the cord stump, even if it is only hanging on by a thin piece of tissue.
Arms and legs: Some new parents are concerned about the fact that their baby’s limbs are cramped and a bit bowed. This is simply the result of being confined in the womb, as are their clenched fingers and toes. Before you know it, this stage will be a memory! Also, newborn baby’s arm movements can make you start wondering if something is wrong with your baby. The arms flay out without control and may even start shaking almost as if the baby has a mild seizure, these are normal “newborn movements” and they disappear quickly.
Chest: It is not a concern if you notice that your baby, male or female, has disk-shaped lumps on their chest that resembles breasts and may even lactate. This is just a by-product of living in their mother’s uterus and being exposed to estrogen for an extended period of time.
Swollen genitals/discharge: 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.
Eyes & Vision: Newborns are born nearsighted, which means they can’t see things that are far away. Their vision is best in a range of 8-10 inches from their face. The baby’s ability to see smaller and finer detail improves over the first 3 months and continues to improve over the next few years. Newborns can recognize their own mother’s face as early as four hours after birth. Newborns prefer abstract patterns, light and dark contrasts, complex patterns over simpler and less-detailed patterns, curling rather than straight patterns. They also love human faces (especially their parents') and can also get bored with viewing the same picture for long periods of time.
Newborn Hearing: Sound travels through the womb and before-birth babies’ sense of hearing is well developed. Newborns have the ability to look toward the source of sound. They will respond to all sorts of sounds but they especially like the sound of their parent’s voice.
Newborn Sense of Touch: The sense of touch is activated well before birth, babies are surrounded and caressed by the warm fluid and tissues from the beginning of fetal life. After birth they continue to like closeness, warmth, and tactile comforting. The skin is the largest sense organ in the body and touch is important in a baby’s development. Touch has been demonstrated to increase the production of growth hormones and aid in the immune system.
Newborn Taste: Taste cells start to appear as early as 7-8 week’s gestation. Infants show pleasure in sweetness and displeasure in salty, acidic, or bitter liquid.
Newborn Sense of Smell: Newborns distinguish and recognize different smells. By day 2 of life breast-fed babies will recognize the smell of their own gestational parent.