At 4 weeks old, Andrew Crawford’s face broke out in tiny red bumps. Worried that something was terribly wrong with her newborn, Andrew’s mother called his doctor. “That’s not something I had read or they had even mentioned in the hospital,” explains first-time mom Elizabeth Crawford of Cottage Grove, Minn. “They tell you not to bathe them too often, so you don’t, but you’re not sure why your baby is getting all these little red bumps.” Andrew’s doctor assured her that the unsightly condition, known as infant acne, is common and would most likely disappear on its own within a few weeks. Sure enough, Andrew’s face returned to its angelic state by the time he was 6 weeks old.
Perfectly normal changes in newborns, whether they are blemishes, a belly bulge, crossed eyes or a number of other occurrences, are scary for many new parents. Even when prepared for “anything,” a new parent’s heightened sense of protectiveness and anxiety can get the best of them when their newborn begins to look and act a bit like a Frankenstein creation. Strange rashes, crusty scales on the scalp, tarry bowel movements and a scabbed belly button – what parent wouldn’t be a bit nervous?
Tiny white, pearly bumps commonly found across the bridge of the nose, cheeks and chin are called milia.
“Parents are naturally going to tend to worry, but I would stress that they not be shy about bringing concerns up with their doctor,” says Dr. Eric Barth, a pediatrician at Allina Medical Clinic – Ramsey in Ramsey, Minn. He also recommends writing down your concerns so you don’t forget anything at your baby’s next checkup. “The vast majority of time we’re going to be able to assure you it’s normal.”
The following are some of the often frightening, yet common, things first-time parents may encounter in their newborn.
Many people are surprised to see blemishes on babies, perhaps because of the images of infants in magazines and on television showing flawless skin, Barth says. “What I try to stress to parents is that babies don’t have perfect skin. It’s an unrealistic expectation,” explains Barth. The red spots, which may pop up on the upper chest and back as well as the face, typically last for a few weeks – although they can persist for up to eight months. While unsightly, infant acne does resolve on its own without the need for treatment.
Tiny white, pearly bumps commonly found across the bridge of the nose, cheeks and chin are called milia. Although they resemble acne, this type of blemish is more like a tiny cyst. Like baby acne, no treatment is necessary. The bumps generally disappear around the second or third month of life.
Known to show up in the first several months after birth, cradle cap involves flaking of the scalp. Like infant acne, parents don’t need to treat cradle cap; the condition should go away on its own. “It’s more of a nuisance-type of problem,” Barth says. “If it’s really, really thick, it can be troubling for the parents.” While some parents use mineral oil or baby oil to remove the flakes, Barth suggests another method for severe cases: dandruff shampoo. Parents must keep in mind, however, that these shampoos aren’t tearless. If parents choose this route, Barth advises them to use the shampoo only two or three times a week. “And s with anything you put on the skin, watch for reactions,” Barth says.
Some babies have a soft bulge at their belly button consisting of fluid from the abdominal cavity or small loops of bowel. “It’s actually a small defect in the abdominal wall,” Barth says, adding that the majority of cases improve over time. “It really is extremely uncommon to cause any problems.” Parents worry that the bulge bothers their babies. “One question I get a lot from parents is, ‘Is it painful?’ The answer is no,” says Barth. The condition simply is more noticeable when the baby is upset. “When baby happens to be crying, it increases the pressure within the abdomen and you see it very prominently.”
Umbilical Cord Stump
First-time parent Trisha Ager wondered if she was doing something wrong when her son Jacob’s umbilical cord stump remained intact long after his birth. “At 3 weeks it still hadn’t fallen off,” Ager, of Traverse City, Mich., recalls. “Every time I put the alcohol on it, I thought it would fall off – but it didn’t.” A visit to the doctor calmed her fears. “He said every baby is different and don’t worry about it. He assured me it would fall off.” Pouring alcohol onto the stump, something her doctor suggested, helped. A couple of days later, as she played with Jacob on the couch, Ager noticed the stump had fallen off. Barth says he often notices babies with their cord stump intact at their 2 week checkup. “If it stays on for more than a month, that can be cause for concern,” he says.
Crossed Eyes and Quivering Chin
Newborns delight their parents by opening their eyes and gazing back at them. But when the baby’s eyes sudenly appear crossed, parents may wonder if something is amiss. Barth says crossed eyes are normal in newborns up to 2 months. “They are learning to focus their eyes, and training the muscles of their eyes to align properly,” explains Barth. Parents also may notice a slight twitch in their newborn’s chin – another instance where the baby is getting used to its body. “A little bit of quivering is quite normal,” Barth says. “It’s immaturity of the nervous system.”
Babies have two soft spots, or fontanels, on top of their heads: one in back and one in front. These spots, which should be handled carefully, are spaces between plates of bone. The soft spot in the back of the baby’s head will close quicker than the front one, which is evident until about 15 to 18 months of age. New parents often are concerned about the size of these spots. “There’s a wide variety of normal in terms of size,” Barth says. Another common question is whether a baby’s soft spot is sunken, which may signal dehydration. While this is important to watch for, Barth says some soft spots simply are more sunken in nature than others.
A newborn’s first bowel movement catches many parents off guard. The thick, blackish-green, tarry and extremely sticky stuff, called meconium, is generally expelled in a few bowel movements during the first 24 to 48 hours. Meconium coats the baby’s intestines during pregnancy and consists of amniotic fluid, lanugo (the soft, fine hair that covered the baby’s body before birth), mucus and bile. After the meconium passes, regular bowel movements begin.
After getting used to her son having seven bowel movements a day for the first month and a half, Ager was startled when he began having only a couple of dirty diapers a day. Ager, who is nursing, and her husband, Todd, decided to call their doctor. They discovered that breastfed babies’ stools usually taper off over time. Indeed, both bottle-fed and breastfed babies experience changes in this area, Barth says. “There’s a lot of variability in terms of the number of stools a baby has a day and it can change over time,” he explains. Whether a baby goes several times a day or only a few times a week, Barth says there’s nothing to worry about as long as the stool is soft and doesn’t appear to cause the baby discomfort.
It’s in the Eyes…
Eye color is determined by the amount of pigment – called melanin – in the iris of the eye. The more pigment, the darker the eye color. Contrary to popular belief, not all babies are born with blue eyes. Caucasian newborns generally have slate-blue eyes, but can be born with any shade of the other eye colors. African-American and Asian babies are generally born with gray-brown eyes.
As a newborn’s eye develops, the pigment increases. In babies who are born with dark colored eyes, permanent eye color may develop in the first few months of life. Babies with lighter eye color at birth may average about six months to develop their permanent eye color. However, as is true with most infant development stages, some babies take much longer to achieve their permanent eye color and may go through several intervals of change before reaching final development.