If this is your first baby, you may well have absolutely no idea about what he or she will be like when they’re born. A lot of new parents nowadays have had no contact at all with newborn babies before they have their own so they don’t know what to expect. This means that they also don’t know what’s normal in a newborn baby and what isn’t, and that can be very worrying. Even if this isn’t your first baby, you may find that there are things about him or her that you don’t have previous experience of, or have forgotten from last time, and you may worry whether these are normal or not.
Many newborns can look cross, grumpy, and a bit wrinkled. Newborns are also likely to have the following characteristics if the first days and weeks:
Head
It is a tight entry into the world for your baby and the skull bones are designed to slide over one another. This can lead to a slightly oval shaped or “cone-shaped” head when he or she arrives. This tends to right itself within a couple of days, although two areas at the front and back of the head remain soft – known as the fontanelles. They can seem very vulnerable but they are tougher than they seem. It is quite normal to be able to see his pulse beating under his scalp at these soft spots. Babies born by ventouse can have an exaggerated fontanelle and some can be bruised, which will disappear within the first weeks.
His nose may a bit squashed and his ears may be folded forwards. They will straighten out by themselves in a few days.
Eyes
Almost all babies have bluey-grey eyes at birth and it can take weeks or months for them to become what will be their lasting colour. Babies with dark skins may be born with brown eyes.
In the first day or two, your baby’s eyelids may be a bit puffy caused by bruising from the birth, but the swelling should lessen within a few days.
Some have small burst blood vessels in the whites of their eyes, which are caused by pressure on the blood vessels during birth. These can look very alarming, but they are nothing to worry about. They generally disappear in a couple of weeks.
A lot of newborn babies look a little cross-eyed or as if they have a squint. This is only temporary and usually goes away in the first month or two.
His eyes may also get sticky. If this happens, bathe them carefully using cooled boiled water and clean pieces of cotton wool for each eye to stop cross infection.
Hair
Your baby may have lots of hair on his head when he is born, or none at all. If he is born with hair, it will very probably all rub off in the first few weeks, and may grow back a completely different colour.
Some babies are born with fine, dark downy hair, called lanugo, and this may be across their shoulders, down their spine or on their forehead and the tops of their ears. If they are born early, this is more common and they may have this hair on other parts of their body too.
Mouth
Occasionally, a baby’s tongue may seem to be attached to the bottom of his mouth all along its length. This is called a tongue tie. It isn’t usually a problem but sometimes a tongue tie can cause problems with breastfeeding as the baby may find moving his tongue forward and backward under the breast to drain the milk from the breast difficult. If his tongue is very small and tied, then he may not be able to make the right movement. This can make breastfeeding painful for the mother.
Your midwife will be able to tell just by looking if the tongue is tied and if it’s causing problems with feeding, may recommend that it’s cut (which is a very quick and easy procedure). Often a baby’s tongue looks white rather than pink, simply because of the milk he is feeding on. If his tongue is pink with white patches, though, he may have thrush and you should see your doctor.
Some babies develop a blister on their upper lip from sucking. It doesn’t seem to bother them and isn’t any cause for concern.
Genitalia/breasts
Both boy and girl babies sometimes develop slightly swollen breasts in the first few days, which may even produce a few drops of milk. This is due to some of your hormones still being in the baby’s bloodstream. This is quite normal and there is no need to do anything about it.
A baby girl’s genitals may look red and swollen, and she may produce a slight discharge or a few drops of blood from her vagina. This is entirely normal and happens because she still has some of your hormones in her system. A baby boy may also have swollen genitals also caused by your hormones, and may be born with his penis and foreskin partly fused, so that the foreskin cannot be pulled back. This is quite normal; they will separate in time. There is no need to pull back the foreskin or clean under it.
Skin
In some cases your baby may be born covered in vernix, particularly in the creases, which is a creamy white substance that protects their skin from the amniotic fluid in the womb. This gets absorbed into the skin, there’s no need to wash it off. Some babies that are born later can sometimes have less vernix on them.
Your baby’s skin may look quite red at first, which is due to the high proportion of red blood cells that newborns are born with. His skin may well also be blotchy and slightly spotty. Black babies may look rather pale-skinned at first. It can take some months for their skin to take on its permanent colour.
He may develop tiny white spots (commonly called milk spots but actually caused by his sweat glands beginning to work) across the top of his nose or on other parts of his face. These spots are harmless and will disappear by themselves. Don’t be tempted to squeeze or pick any spots your baby has. If you’re worried about them, talk to your midwife or doctor.
Newborns often get heat rashes (tiny red spots) too, which disappear when the baby cools down.
If your baby was born late, his skin may be a bit wrinkled at first.
You may find that your baby’s skin is dry and peeling, especially on his hands and feet. This usually goes within the first week.
Circulation
You may notice in the first two or three days that your baby’s hands and feet look pale or bluish, and feel a bit cold, especially after a long sleep. This is because his circulation isn’t yet quite efficient enough to get blood to his extremities. It doesn’t necessarily mean that he’s cold (the best way of checking that he’s warm enough is to feel the back of his neck or his chest under his clothes).
You may also notice that his upper body looks pale while his lower body is pink, again often after he’s been asleep for a while. Picking him up and moving him can help get his circulation going.
His immature circulation may mean that he suddenly develops (especially if crying) an alarming-looking blotchy red rash on his face, neck or trunk, but this is likely to go away as quickly as it appeared.
Jaundice
Over half of all new babies go a slightly yellow colour after two or three days. This is due to a form of jaundice, which develops because the baby’s liver isn’t yet mature enough to process a particular chemical, called bilirubin, in the blood. It is so common that it is considered
to be quite normal. It goes away by itself, usually by the end of the first week, and doesn’t require any special treatment unless it becomes severe.
You may be advised to feed your baby frequently to help clear the jaundice, as the chemical in the blood binds with the fat in the milk and is cleared more quickly from the system if you feed frequently. But jaundice can make babies sleepy, so you may need to wake him for feeds.
If your baby has jaundice, your midwife may take a blood sample to check if it’s severe enough to need treatment. If the level of bilirubin in the blood is very high, then your baby may be treated with phototherapy, where the baby is put under a special bright light. Occasionally, jaundice may have a more serious cause, especially if it develops either straight after birth or during the baby’s second week, or if it doesn’t go away after about two weeks. See your doctor, who may refer you to a specialist.
Birth marks
There are several different kinds of marks that a baby can be born with (and most babies have at least one). Some of these fade over time while others are permanent unless they are treated. Although you might find it distressing if your baby has a birthmark, they are usually harmless and the more disfiguring kinds can generally be treated.
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Strawberry birthmark
This is a bright red, raised mark, usually on the face or the neck. It is often quite small at first, though it tends to grow in the first few months. It can be there at birth or appear in the first few days. These marks generally disappear by themselves during childhood, though they can be removed with laser treatment if necessary. Your doctor will advise you about this.
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Port wine stain
This is a flat, purplish mark which can occur anywhere on the body. It is permanent, though it can be removed with laser treatment, which your doctor can advise you about. Port wine stains that cover the eyelid need checking by an eye specialist since sometimes there can be a problem with the eyesight as well.
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Stork marks
These are pink, blotchy marks which occur between the baby’s eyes and/or on the nape of the neck (supposedly from where the baby was carried in the stork’s beak!). They are very common and fade in time, usually within the first year.
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Mongolian blue spots
These are blue marks, rather like small bruises, that are often found on the lower backs of dark-skinned babies. They fade quite quickly.
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Freckles, moles and brown patches
Some babies are born with freckles. A few are born with a mole, which is no cause for concern unless it gets bigger or starts to bleed or itch, in which case you should see your doctor (this is extremely rare). Some babies have dark or pale brown patches which can occur anywhere on their bodies. These don’t usually fade – they may even get darker in the sun – but they don’t need any treatment.
Umbilical cord
Your baby will have the remains of the umbilical cord, plus a little plastic peg for several days. The cord starts off a shiny silver white/blue, then turns greeny-yellow. Around the end of the first week (although it can be sooner, or later than this), the stump shrivels, turns black and falls off. It’s normal for the cord to smell and bleed slightly, but if it looks red and pussy, inform your midwife or health visitor.
Limbs
In the first few days after his birth, your baby will probably hold his arms and legs in the position they were in when he was curled up in your womb – his knees will be bent up towards his chest, and his elbows bent so that his hands are by his face. He will also probably hold his hands curled up in fists. Don’t try and straighten him out – he will begin to do this for himself in the next few weeks. His arms and legs may look quite thin, but this is normal and they will soon fill out.
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