Your newborn baby’s appearance at birth may surprise or even shock you. How newborns look in reality is not usually how we picture them beforehand. For infants, a misshapen head, peeling yellow-tinged skin, swollen eyes, and bright red birthmarks are common and are nothing to worry about.
All of these conditions will likely clear up in the first weeks of your baby’s life.[pq]A newborn looks very different from older babies and children—his head is relatively large, measuring one-fourth of its entire length, and his legs are only one-third of his length.[/pq]
In humans, brain development takes precedence over development of the rest of the body.
Besides being large, your newborn’s head may look misshapen and even a little bruised—this is due to the fact that the baby’s head was squeezed in the birth canal during delivery. The bones of the skull are separated rather than fused, as they are in adults. This separation allows the bones to slide over each other as the head passes through the narrow birth canal. This mobility in the baby’s cranial bones is essential to accommodating an infant’s rapid brain growth.
When you caress the top of your baby’s head, you can feel the soft spots—fontanelle—in the skull. Here, the bones are widely separated, but the brain is covered by a tough membrane and scalp. You won’t hurt your baby by gently touching these areas. The anterior fontanelle, located in the midline on top of the head, usually closes between nine and 18 months after birth.
Behind it is the smaller posterior fontanelle which closes within four months after birth.
The amount of hair on a baby’s head varies and any amount is normal. Most of this hair falls out and is replaced. The color and texture of the new hair may be quite different from that of the hair the baby was born with.
Inside the womb, the baby’s body was covered with fine, downy hair called lanugo. Unless your baby was premature, most of this body hair has disappeared, except for some fuzz on the back and the residual lanugo disappears in a few weeks.
Your baby’s eyelids may be red and swollen from pressure during the delivery. In most hospitals, antibiotic drops are applied to the newborn’s eyes, which may cause mild but temporary inflammation.
As your baby studies your face, you may notice one eye wonders or the two eyes don’t move together smoothly. Unless one eye seems to be almost fixed in a position (cross-eyed or wall-eyed), this wandering is normal and is corrected as the baby gains strength and coordination in the muscles that move the eyes.
The cartilage in the outer area is very flexible in the newborn. If an ear looks folded, don’t worry—it will most probably straighten out in time. If the problem continues, talk to your doctor.
At birth, the nose and mouth are often filled with mucus. After the delivery, your caregivers suction the baby’s airways with a rubber-syringe to clear them and help the baby breathe. His or her own sneezing helps clear the nasal passages and is not necessarily the sign of a cold.[pq]Occasionally, babies are born with one or more teeth, which usually fall out. Your doctor may want to extract these teeth so your baby doesn’t later choke on them.[/pq]
Most babies, however, are born without teeth.
If your baby did a lot of sucking in the womb, he or she may have blisters on the upper lip, as well as on the fingers, hands or forearm.
Your baby’s skin is very soft. It may not, however, appear as flawless as the complexion of an older infant. For the first few days, the hands and feet may appear to be tinged with blue. Soon, the baby’s circulation improves, and the skin color will become more uniform.
More than half of newborns have some degree of jaundice in the first week of life. In most cases, this condition is due to immaturity of the liver and is not a threat to the baby. The liver is the organ that helps to clear bilirubin, a waste product of broken-down red blood cells. Since the liver is not completely mature at birth, babies often are not able to excrete bilirubin as well as adults do. The deposits of bilirubin in the skin and the whites of the eyes give them a yellowish tinge.
Jaundice first appears on the face and spreads downward as the bilirubin level increases. Normal newborn, or physiologic, jaundice is usually first visible between the second and fifth days of life, peaks between the fifth and seventh days, and clears up within one to two weeks. In some breast-fed babies, jaundice may last a bit longer.
Unless your doctor determines that the baby’s bilirubin level is too high, you can probably manage your baby’s jaundice at home. The mainstay of home treatment is frequent breast feedings.
Bilirubin is eliminated in the urine and feces; the elimination can be accelerated by increasing fluid intake. Bilirubin is broken down in the skin and light stimulates the action. The wavelength of light that hastens bilirubin breakdown in the skin passes through glass and plastic. Because this is so, sometimes just placing the baby near a sunny window for short periods of time is good.
Your doctor may follow your baby’s progress by checking the bilirubin with a simple blood test. If the level rises excessively, the baby will require hospitalization for phototherapy treatment (exposure to light at a wavelength similar to that of ultraviolet light) and to determine whether the jaundice is due to something more serious than immature liver function.
In most babies, the jaundice resolves spontaneously. If your baby has jaundice, your doctor will tell you what to do to quickly get rid of it.