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Your Newborn

My Baby Looks Weird:


A Guide to A Normal

Newborn's Appearance


by Rita Templeton

.
You spend nine months picturing the moment of delivery and the blissful newborn stage: you see yourself cuddling a tiny, round, pink, and perfectly dimpled cherub of an infant, basking in the glow of new parenthood.  But when the moment finally arrives, your illusions are shattered by a baby that looks more like a plucked turkey than a descended angel.


Don’t worry; regardless of appearance, you’ll still think your baby is beautiful – but there are some things that may look alarmingly strange, both at the time of birth and for the first few weeks (or even months).  What’s worse is that, since babies don’t come with detailed instruction manuals, you may be unprepared and even frightened to see some of the bumps, lumps, and rashes that pop up spontaneously.  It’s okay – here’s a guide to some of the weird things you might notice about your newborn.

 

Adjusting to life outside the womb,

babies are prone to all sorts of splotches, blotches, dots & bumps.


The angelic baby you've spent so long

picturing may look nothing like the baby

placed in your arms after delivery.


So... What's normal when it comes to

your newborn's appearance?

 Let’s get a “head” start.
 
Your baby’s head may be an odd shape if she was delivered vaginally.  Babies’ skulls are designed to form to the shape of the vaginal canal in order to make delivery easier, so more than likely, your baby will come out resembling the Coneheads from Saturday Night Live.  This is called molding and isn’t permanent; her head will round out and take on a more normal shape within a couple of days.  If you’ve had a C-section, your baby has an advantage in this department – no trip down the vaginal canal, no cone head!  
 

Sometimes, pressure on the head during delivery causes swelling on the top of the head or all over the scalp.  It’s called caput and is due to fluid being squeezed into the scalp during the birth process.  Though it may look serious, it isn’t, and it’ll disappear pretty quickly.  Again, C-section babies are generally exempt from this particular condition.

 

If your baby has an odd lump on his head, chances are it’s a cephalohematoma.  The name sounds ominous, but it’s just a collection of blood on the outer surface of the skull, beneath the skin.  It usually comes along with birth trauma (most commonly from vacuum-assisted deliveries), but it can happen with any type of delivery.  A cephalohematoma will appear on one side of the head, around the second day of life, and can be quite hard.  This one takes a while to go away; around two or three months.  The middle will generally disappear first, followed by the edges, which can leave the spot feeling – at least for a little while – like a crater.  Eventually it will disappear completely, so be patient.

 

The soft, mushy area on the top of your baby’s head is the fontanel, more commonly known as the “soft spot.”  If you look closely enough, you will see it pulsate with each heartbeat (creepy!).  It seems frighteningly fragile, as if you’d cause major damage if you so much as ran a finger over it, but it’s safe to touch (although poking your finger in it isn’t a good idea), so there’s no need to invest in a tiny helmet for protective purposes.  The fontanel is there to allow for the rapid growth of the brain that occurs within your baby’s first year.  Within twelve to eighteen months, the bones of the skull will fuse together and the soft spot will be history.

 

Your baby’s hair might be one of the biggest surprises at birth.  It isn’t uncommon for a baby to have a completely different hair color than expected.  If you’re a light blonde, for example, you may be shocked when your child emerges with a head of jet black fuzz.  But a newborn’s hair color – and even texture – has little bearing on what her hair will look like as she grows.  Also, you may notice your baby’s hair falling out a few weeks after birth.  This, too, is perfectly normal – hair has two phases: the growing phase and the resting phase.  It falls out after the resting phase.  In newborns, all of the hair follicles enter the resting phase at once, so it stands to reason that all that hair will fall out at approximately the same time.  Changing hormone levels can cause the resting phase to “kick in” … so don’t be alarmed at your temporarily bald baby.  By the time the baby is six months old, the permanent hair will have grown in.

 

Have you ever been holding a perfectly contented baby, only to realize that her ear has been folded double against your arm?  Ouch.  It looks painful – but newborns’ ears are soft and floppy because the cartilage hasn’t hardened yet.  Because of this, the edges of your baby’s ear may be folded over.  But the outer ear will assume its normal shape within the first few weeks when the cartilage begins to harden.  Another occurrence, appearing in 1% of babies, are earpits.  This is a small dimple (or pit) in front of the outer ear.  It’s a congenital defect, meaning that it is permanent, but it’s unimportant – it doesn’t affect your baby in any way (unless it becomes infected, which is fairly uncommon) – and barely noticeable.

Face facts.

Ever heard the expression “a face only a mother could love?”  That’s because newborns’ faces often aren’t at their peak level of attractiveness.  Nine months of being squished in a womb, several hours of being squeezed down a tight birth canal, and a whole bunch of surging hormones can make for a face that, well, wouldn’t exactly win a beauty contest.
 

Pressure during delivery can cause your baby’s eyes to look puffy and swollen.  They may also be irritated from the silver nitrate drops or erythromycin ointment commonly administered after delivery (as a precaution against eye infections from bacteria picked up on the trip through the birth canal).  As the fluids settle in the baby’s body, the irritation and swelling will go down.

 

A subconjunctival hemorrhage is the breaking of small blood vessels in a baby’s eye, leaving a flame-shaped red mark in the white of the eye (the sclera) or a band of red around one or both irises.  This is also a result of pressure, and will go away in two to three weeks.  It’s relatively common and won’t do permanent damage.

 

If your baby’s eye is consistently watery, crusty, and matted with gunk, he may have a blocked tear duct.  The channel that is responsible for carrying tears from the eye to the nose is clogged.  You can remedy this with gentle massage and a warm cloth, but even if you do nothing for the condition, the plugged duct will up by the time your baby is a year old; you’ll just have to contend with a bunch of “eye boogers” until then.

 

Your baby’s nose may be misshapen – flattened or pushed to one side.  Don’t worry; it’s not the result of a bad gene passed down from your not-so-attractive Uncle Harry.  It’s from being smushed up against the placenta and the ensuing squeeze down the birth canal, and it will resolve itself within your baby’s first week.

 

You’ve heard of being “tongue-tied” … well, your baby may be just that.  The medical name for the condition is ankyloglossia, and it’s used to describe a baby with a short lingual frenulum (better known as “that piece of skin that connects your tongue to the floor of your mouth”).  It’s normal for the movement of a newborn’s tongue to be restricted, but the condition will improve as the band stretches with time and growth.  It’s not medically necessary to do something about it unless the tongue-tie is severe and impedes your baby’s ability to eat or lasts more than a year (most pediatricians agree that the condition will right itself within the first twelve months).  In those severe cases, a simple surgery called a frenulotomy is performed.

 

If you’re poking around inside your baby’s mouth for some reason, you may find epithelial pearls.  These are little fluid-containing cysts or shallow white ulcers that occur on the hard palate or along the gumline.  They are the result of blocked mucus glands and will disappear in one or two months.

 

Rarely (but certainly not impossibly), a baby may be born with a tooth – or even a few teeth.  90% of those are normal teeth that have erupted prematurely.  The other 10% are extra teeth with no root structure.  An x-ray can be used to distinguish between the two.  If the teeth are just extras with no root structure, they’ll need to be removed by a dentist.  If they have a normal root structure, and have just poked through early, there’s no need to do anything about them unless they become loose or cause sores on your baby’s tongue.

 

Your baby may have a hard, white callus in the center of her upper lip; this is called a sucking callus and it occurs because of the constant friction experienced during feedings (either breast or bottle).  It’ll disappear once your baby begins drinking from a cup.  These calluses may also appear on the thumb, the wrist … wherever your baby prefers to suck.

Skin deep.

They say "beauty is only skin deep." The problem is, sometimes that skin isn’t very beautiful.  Newborn skin is prone to all kinds of dots, bumps, and strange marks.  At first, immediately following birth, your baby’s skin is covered with a white, waxy substance.  It’s called vernix and it’s actually a protective coating that shields the skin from the amniotic fluid.  It can be wiped out of the creases, and the rest will absorb within a few minutes.  If your baby was premature, her skin may look thin and you’ll be able to see the veins through it.  This is very normal for a baby born too early.  Also common in premature babies (and even in some babies carried to term) is the presence of lanugo, a very fine covering of hair that will fall off within a week – so no, your baby girl won’t grow up cursed with hairy shoulders.
 

Your baby may also have little white pimple-like bumps, called milia, on his face.  They’re caused by immature oil glands and dead, sloughed-off skin trapped in the pores.  They’ll go away within the first few weeks, but they may be replaced by infant acne.  These are pimples, tiny whiteheads caused by hormones – not the baby’s, as will happen later on during puberty, but Mom’s hormones still circulating through baby’s system.  It’s unfortunate that infant acne normally occurs during the first six weeks, when people are clamoring for visits and pictures.  After that six-week period, it will clear up, no medicated lotions or creams needed.

 

Crusty, scaly patches may develop on your baby’s scalp or face due to overactive oil glands beneath the hair and skin.  This condition is called cradle cap.  It looks like it might be itchy, but it isn’t … it’s just unattractive.  It can be helped by washing with a mild baby shampoo every few days, or rubbing a little baby oil or lotion into the spots.

 

Eczema is an itchy red rash caused by irritation from anything from allergens to detergents to baby’s own drool.  According to the American Academy of Dermatology, ten to twenty percent of all babies will have a case of eczema before they turn a year old.  It typically affects a baby’s face, but can appear anywhere, especially in moisture-retaining creases such as the crooks of the arms or the folds of the neck.  A steroid cream is usually prescribed for babies with eczema.  If your baby seems prone to it, limit baths to just twice a week or so, and only use water or non-drying soap; afterward, moisturize the baby well. 

 

Your baby may be born with a temporary birthmark of sorts.  One variety is called Mongolian spots, which is more common in babies with African, Asian, Indian, or Mediterranean heritage.  They’re bruise-like spots that appear on baby’s bottom or back, but they usually go away by the first birthday.  Another possible skin discoloration is a strawberry hemangioma – a soft, raised, reddish patch caused by immature blood vessels.  They can appear up to a few weeks after birth, and although they aren’t permanent, they do last longer, about nine or ten years.  Stork bites are blotchy-looking red patches that appear on the face (usually the forehead or between the eyes) or the back of your baby’s neck.  The legend that goes along with the marks is charming; the patches are left on the place where the stork picked your baby up.  (If you’ve just been through hours of labor and delivery, you’ll wish that the stork had brought the baby!)  They may be more noticeable when your baby cries and her face flushes.  One-third of all babies have stork bites, and they tend to disappear around eighteen months of age.

And now for the “private” parts …

Perhaps most alarming of all is having to wonder whether your baby’s genitalia are normal.  The strange appearance can raise questions that you’d rather not have to ask, but that you need to know the answer to. 
 

If your baby is a boy, you may notice a bulging or swelling in his testicles.  This may be a hydrocele.  It is common in newborn males, and is the result of extra fluid trapped in the scrotum.  It’s harmless, and can take anywhere from six months to a year to completely go away.  Have it checked by your baby’s pediatrician at every appointment, though; if the size of the swelling changes frequently, it could signal a hernia.

 

Your baby boy also may have an undescended testicle.  Before a boy is born, his testicles are located way back inside his belly.  At about the 29th week of gestation, they slowly descend into the scrotum.  In about four percent of baby boys, one testicle will be undescended – meaning it didn’t “drop” like the other one and is still in the pelvic cavity.  The vast majority of undescended testicles will gradually drop into the normal position by the time the baby is a year old (in one-year-old boys, only 0.7% of testicles are undescended).  If the testicle doesn’t assume the normal position by age one, it can be brought down surgically.

 

If you chose not to have your baby circumcised, his foreskin will be tight, meaning that you cannot retract it to see the head of the penis.  This is normal.  The foreskin shouldn’t be forcibly retracted or you could cause injury to the baby.  Most baby boys’ foreskins will be retractable by age one, and the rest by about age three.

 

Baby girls can also have genital “issues” at birth; the most common is swelling.  The labia, or vaginal lips, may be very swollen at birth and from two to four weeks afterward.  Your baby girl may also have a projection of pink tissue from her vagina, called a hymenal tag.  All swelling is the result of Mom’s hormones still circulating in the baby’s system.

 

Mom’s hormones are also to blame for an occurrence that sends many parents of newborn girls into freak-out mode: vaginal bleeding.  No one is quite prepared for the shock of seeing blood at a routine diaper change.  Thanks to declining maternal hormone levels, baby girls can actually have a pseudo-period, resulting in bloody discharge that lasts for a few days.  Fortunately, it’s nothing to worry about.

 

Worth mentioning here – although it has nothing to do with genitalia – is swelling of the breasts.  Babies, both girls and boys, can have swollen breasts appearing at birth or a few weeks afterward.  This is also caused by those lovely maternal hormones.  The breasts may become hard, with lumps that you can actually move around with your fingers (although you shouldn’t squeeze the lumps, because this could lead to an infection).  The swelling can last for two to four weeks, and even longer in breastfed babies.  One breast may lose its swelling up to a month before the other.  It isn’t a cause for concern unless the swollen breast becomes red, tender, or gets streaks.  

 

Parts of your baby may appear strange for a while, and sometimes it seems that his various issues will never go away.  But keep in mind that it’s only an adjustment period, much like that awkward gangly stage known as puberty.  Baby’s body is simply reacting to an environment that’s vastly different than what he’s been accustomed to for the past nine months.  He may not look like the angelic picture you see in books, but he’ll straighten out soon enough – and besides, until then, you’ll be too in love with the rest of him to worry about a few bumps or blotches.


Quickly your sweet baby will be


"The most beautiful/handsome
girl/boy baby in the
WHOLE WORLD!"



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