Newborn appearance

Does my newborn baby look normal?

Mothers may see things that make them wonder if their baby is normal, such as enlarged breasts, strange vaginal discharges, blisters, rashes, and scratches. Often, there is no need for worry. Many babies, both boys and girls, are born with enlarged breasts. The swelling is usually gone by two weeks, but if one breast suddenly seems larger and redder than the other and the baby seems unhappy, see a health-care provider. Newborn girls may have a swollen vulva or a white discharge from the vagina. Again, this usually goes away after a few weeks. A baby may have a small blister on the upper lip, or rashes, such as milia and baby acne. These disappear within a few months. They are normal and are not caused by breastfeeding.

A) Breast tissue

Normal breast enlargement in a newborn baby girl.

Many babies, both boys and girls, are born with enlarged breast tissue. It does not require treatment. These breasts can make milk and may even leak milk. It is best to leave them alone. The swelling should be gone by two weeks of age.

If one breast suddenly seems larger and redder than the other and the baby seems unhappy or has a fever, see your health-care providers as soon as possible. Newborns can develop breast infections that can even go on to have pus in the center (abscess). Abscesses can affect later breast development in women.

B) Newborn girls

A baby girl reacts to her mother’s hormones, so the baby’s vulva, the external sex organs, may swell and a white discharge may come from the vagina. This lasts for the first weeks after delivery. Baby girls may also have a small, bloody secretion from the vagina on the third day.

C) Upper lip sucking callus

A two-week-old baby with a peeling sucking callous. The mother was pain-free and the baby was growing well.

A sucking callus or sucking pad is a small blister on the upper lip of a newborn. It will peel a few times and then disappear. They develop around the 25th week of pregnancy and are normal in many babies (Hendrik 2013). There is no need to worry about them.  

Lips that are white and swollen may happen when breastfeeding is going well. Occasionally, this can be a sign that the baby needs high levels of vacuum to stay latched, as with firmness of the nipple root, or is breastfeeding excessively (Thariat 2011).  

D) Newborn rashes and skin changes

This baby has cradle cap on the scalp and a stork bite on the forehead. Photo by Marcin Jozwiak on Unsplash

Newborn babies get various rashes and skin changes that will clear without treatment. These include:

  • Milia: These are small white dots on the nose and cheeks. They disappear in a few weeks or months after birth.
  • Baby acne: This is acne on the face. It starts a few weeks after birth and clears by three months of age.
  • Cradle cap: Cradle cap is caused by crusty or oily scaly patches on the baby's scalp. It does not bother the baby, and usually clears up on its own in weeks or a few months.
  • Stork bites: These are small pink or red patches often found on a baby's eyelids, between the eyes, upper lip, and back of the neck. They are caused by a concentration of blood vessels and may be most visible when the baby is warm or crying. Most of these fade and disappear completely.

These skin changes are all normal and are not caused by breastfeeding or the mother’s diet

E) Peeling or flaking skin

Normal flaking skin on a two-week-old baby's tummy.

After birth, the baby’s skin is no longer protected by a thick greasy coating (vernix) and amniotic fluid. As it adapts to being in a harsher, dry environment, it will shed the outer layer between one and three weeks of age. It does not need to be treated with lotions or creams.

F) Face scratching

All younger babies scratch their faces with their nails. Scratches nearly always heal without scarring.

In some cultures, parents try to prevent scratching by putting mittens on their babies. Touch is a highly developed sense in babies and their hands are a key tool in exploring their environment, feeling the mother’s body, and calming themselves. Mittens limit this ability.

Mittens are a nuisance to keep on and often get lost. Mittens with a long, attached string can be a choking hazard.

The alternative is simply to keep the baby’s nails on the shorter side.

References

Hendrik HD. Sucking-pads and primitive sucking reflex. J Neonatal Perinatal Med. 2013 Jan 1;6(4):281-3

Thariat J, Roth V, Marcy PY. Sucking pads in a full-term newborn. J Pediatr. 2011 Jan;158(1):166