Newborn Characteristics and Care

Head

Molding of the head coming through the birth canal results in the "conehead" shape at birth. This returns to a normal shape after several days. The head may also appear asymmetrical for the same reason. The "soft spot" in reality has a tough fibrous covering. It normally closes between 9 and 18 months of age.

Eyes

The eyelids may be swollen at birth. This resolves in a few days. The eyes may also have a slight mucousy discharge at birth which is usually of no concern. A small, red flame-like hemorrhage may be present on the sclerae (white part) of the eye. This also is very common and will resolve in 2 to 3 weeks. The eye color is usually a slate blue at birth, and the permanent eye color appears usually by 5 to 6 months of age.

Mouth

The undersurface of the tongue may contain a short right band that connects the tongue to the floor of the mouth. This tongue tie is common, and rarely causes any problems. It usually stretches later in life. It only requires medical intervention if it is causing feeding problems early on or speech problems later.

Legs

Bowing of the legs is common in infants because of intrauterine positioning. If your baby pushes up while held in a standing position it will not cause the bowing to worsen.

Feet

The feet may also be turned inward. As long as the feet are flexible, they will straighten out as the child grows. The toenails of newborns are often very soft and may curl over the end of the toe, or may curve upward. The nails will become firm and straighten later in life.

Behaviors

Newborns have a variety of behaviors that frequently cause concern in new parents. A few of these include: hiccuping, sneezing, yawning and trembling of the chin or lower lip. Your baby may also stare or jerk suddenly in response to sounds or movement. All of these behaviors are usually normal and will decrease as the infant becomes older and his neurological system matures.

Bowel Movements

Many babies during the first few weeks will have bowel movements whenever they eat, and also one will be noticed upon their awakening. This may add up to quite a large number of bowel movements. These may be very explosive, loud, watery and mucousy. Breast-fed babies can have watery bowel movements with yellow curds in them, while the stools of formula fed babies tend to be more formed. Pure water and hard pebble-like bowel movements are abnormal. The number of stools can range from 10-12 per day to one every 4-5 days. Babies frequently strain to stool but are not constipated unless the stools are hard or firm.

Vomiting

A small amount of spitting up after eating is normal in infants. If this pattern becomes progressive with more frequent spitting up, larger amounts of spit up, or more forceful vomiting the infant should be seen for evaluation.

Umbilical Cord

Your newborn should not be immersed in water until the cord has fallen off and the navel healed. This should occur within a few weeks. Each time you change the baby's diaper use a cotton ball soaked with alcohol to clean the cord until it separates. Occasionally a small amount of blood will appear when the cord separates. This is not of any concern unless the bleeding is substantial or prolonged. Do not attempt to remove the cord yourself.

Skin

The skin is often dry and flaky and subject to many nonspecific rashes that come and go over the first few months of life. Erythema Toxicum is a common rash in the newborn period that appears as small yellow bumps surrounded by a red area about the size of a dime. The rash looks similar to an insect bit but is harmless and goes away by itself. Milia are small white bumps over the nose and may appear elsewhere on the face. They are unopened skin pores, and will resolve in 1 to 2 months. We do not usually recommend using a lot of creams or lotions on a newborn's skin. These agents usually cause more irritation to the sensitive skin of the newborn. No special treatment is necessary. "Stork bites" are flat pink birthmarks appearing on the forehead, upper lip, eyelids, and the back of the neck. The vast majority of these birthmarks disappear by themselves within two years. Mongolian spots occur on the lower back as a bluish-gray flat area varying greatly in size in infants with a darker complexion. Most fade away by 2 to 3 years of age.

Jaundice

Yellowing of the skin or the eyes is common and usually a harmless condition in newborn infants. Normal jaundice usually appears on the second or third day of life in healthy, full term infants. It can occur in both breast-fed and formula fed babies. A few babies require a blood test and/or examination by the doctor to determine the cause of jaundice. In most cases, jaundice can be treated at home. Please call during office hours if you think your baby has jaundice.

Colic

Colic is common during the first three months of the infants life. An Infant with colic frequently has unexplained periods of crying. Call our office for advice if your infant is having frequent crying episodes. The nurse may be able to offer phone advice, but if the problem continues call the office to schedule an appointment.