Brand new babies can arrive with some very strange and bizarre looks indeed, which are usually all within the realms of ‘normal’. Then, within the first weeks of life babies can also develop some very curious and peculiar skin things that too are still within the realms of ‘normal’. Without doubt, understanding what is ‘normal’ can potentially alleviate a lot of unnecessary worrying! Let’s go over the basics:
Vernix Caseosa – Creamy, white, greasy, waxy paste which protected the baby’s skin while in the watery environment of the uterus (womb). A newborn covered in a lot of vernix can be said to be ‘early’. Massaging the vernix into their skin and leaving it in the creases as a moisture barrier can be a great idea.
Peeling Skin – A baby born with little vernix and ‘overcooked’ peeling skin (commonly on their hands, feet or tummy) can be said to be ‘late’ of ‘overdue’.
Lanugo – Some newborns can have quite a bit of dark body hair commonly across the shoulders, forehead and temples – which can be a bit freaky – but it usually falls out or rubs off in the first few weeks.
Strange-shaped Skulls – Newborns heads are designed to ‘mould’ (skull plate bones slipping under or over each other) as it descends through the birth canal – which can sometimes produce a ‘cone-head’ look visible for 2-48 hours. ◊ Often at birth there is a soft fluid-filled swelling on Bub’s head called a Caput Succedaneum, causing by the head pushing on the dilating ring of the cervix. This is not serious, and disappears within 24-48 hours. ◊ Sometimes within 12-72 hours after birth a blood-filled swelling appears called a Cephalhaematoma caused by fetal skull pressure against the mother’s pelvis during birth. These generally take around six weeks, or a bit longer, to slowly subside.
Thin Skin – Newborn skin can be so thin that blood vessels can often be easily seen through it – but as they grow the skin will fatten up and be less see-through.
Milk Spots – Yellowish-white pimple spots or pustules called Milia are common over a baby’s nose or cheeks. These are accumulations inside immature, enlarged, blocked sweat glands, and usually disappear within the first month.
Skin Colours – Dusky-blue purpled legs, feet, hands or mottled skin is common. Some newborns can be ‘two-tone’ (nicknamed a Harlequin Baby) because the circulation is not yet sending blood evenly around the body, so one whole side can be a different hue. Or, a baby may have red and white blotches, or alternating patches of pink and white skin, or mottling that occurs during crying. Eventually their circulation sorts itself out.
Birthmarks – It’s not uncommon for newborns to have a bit of bruising on their face, or have puffy-looking swollen eyes and eyelids. ◊ Little pinky-reddish-purply flat patches of skin, called Salmon Patches are common, which are blood capillaries under the skin surface. They are usually seen at the nape of the neck (nicknamed Stork-Bite Marks) or butterfly-shaped marks above the bridge of the nose between the eyebrows (nicknamed Angel’s Kiss), and/or on the eyelids. They’ve usually disappeared by the first birthday. ◊ Dark, slate-blue pigmented birthmarks commonly at the base of the spine around the tailbone or on the tummy or legs of dark-skinned babies, are called Mongolian Blue Spots. These are harmless, are not bruises, and usually fade in the first year. ◊ Brown or black moles, called Melanocytic Naevi become proportionally smaller over time – and are sometimes removed in childhood for cosmetic purposes. ◊ Large, flat, dark-red or purple, permanent birthmarks called Port Wine Stains are usually seen on the face or neck. These can be a significant cosmetic (self-esteem) problem, and so some parents opt for laser therapy before the child starts school. ◊ Within the first few days or weeks after birth, some babies can develop a tiny red dot that gradually increases in size over the first 6-12 months to perhaps a 2½cm bright-red or purplish bumpy-lump. This is a Haemangionmas, nicknamed a Strawberry Birthmark. These can be upsetting for parents as they can attract hurtful comments from ignorant people. The great majority spontaneously disappear by a child’s 5th-10th birthday.
Hormone Pimples – Technically called Erythema Toxicum, these tiny, red, pinhead, flat, clusters of pimples are very common, and usually arrive at around 2-4 weeks of age, predominantly on the face. Most are gone by around eight weeks – and for many babies (mine included) you can cancel the entry into the baby photo competition during that phase!
Cradle Cap – Also known as Scurfy Scalp, this starts as pink, raised patches of skin on the scalp that become a yellow-brown crust resembling a dry, scaly eczema, and is caused by overactive oil glands – not pretty at all! You can massage the scalp with a vegetable oil, or baby moisturizer, leaving it for a few hours until shampooing out at bath time and then gently rubbing it with a soft baby hairbrush. Or an old-fashioned remedy is a paste of 2tsp baking soda and 1tsp water rubbed on, left for five minutes and washed off with baby shampoo.
Dry Cheeks – Rough chapped cheeks are quite common in babies, and a little glycerine-sorbolene cream or cold-pressed vegetable oil can help – but definitely avoid normal soap.
Dermatitis – This can commonly occur in the creases under the neck or top of the legs or under the arms, or as a red rash on the face. It usually starts to improve at a month old and is typically gone by a year old, although a classical homeopath will probably be able to eradicate it sooner.
Nappy Rash – Shiny, red and flat nappy-rash is probably Ammonia Dermatitis – which can commonly be fixed with a bit of baby talc, dust of cornflour, zinc oxide, castor oil or barrier cream. Red bumpy pimples (perhaps even with water blister pustules) is probably the fungal infection Candida Albicans (Thrush). Calendula, hypercal, aloe vera or antifungal agents can be effective on this angry nappy rash.
Oral Thrush – Some babies can contract oral thrush (Candida Albicans) that looks like white patches of milk curd on their tongue or on the inside of their cheeks, which cannot be wiped away or rubbed off. This requires a modern antifungal medicine, or there is the old-fashioned treatment of painting baby’s mouth with well-diluted fungicide Gentian Violet. [At the same time a breastfeeding mother will also need to treat her nipples for Thrush the same way.]
The Golden Rule with infant ‘skin things’ is remembering that what can seem startling or disconcerting, can often be of no real concern at all. But never hesitate to check with your LMC or GP – it’s their job to answer your questions and put your mind at ease.