Newborn Appearance

Parents often dream of what their new baby may look like. They think about a pink, round, chubby-cheeked and gurgling wonder. It may be surprising for many parents to see their newborn the first time—wet and red, with a long head, and screaming—nothing at all like they had imagined.

Newborns have many variations in normal appearance, from color to the shape of the head. Some of these differences are just temporary, part of the physical adjustments a baby goes through. Others, such as birthmarks, may be permanent. Understanding the normal appearance of newborns can help you know that your baby is healthy. Some of the normal variations in newborns include:

Variation

Details

Color

A baby’s skin coloring can vary greatly, depending on the baby’s age, race or ethnic group, temperature, and whether or not the baby is crying.

When a baby is first born, the skin is a dark red to purple color. As the baby starts to breathe air, the color changes to red. This redness normally starts to fade in the first day. A baby’s hands and feet may stay bluish in color for several days. This is a normal response to a baby’s underdeveloped blood circulation. But blue coloring of other parts of the body isn’t normal.

Some newborns develop a yellow coloring of the skin and whites of the eyes called jaundice. This may be a normal response as the body gets rid of older red blood cells. But it may mean there’s a problem, especially if it gets worse.

Molding

Molding is the irregular shape of a baby’s head from the birth process. Normal shape often returns by the end of the first week.

Vernix

This is a white, greasy, cheese-like substance on the skin of many babies at birth. It protects the baby’s skin during pregnancy.

Lanugo

This is soft, downy hair on a baby’s body, especially on the shoulders, back, forehead, and cheeks. It’s more noticeable in premature babies. It will slowly disappear.

Milia

Milia are tiny, white bumps on a newborn’s nose, cheeks, chin, and forehead. Milia form from oil glands and disappear on their own. When these occur in a baby’s mouth and gums, they are called Epstein pearls.

Stork bites or salmon patches

These are small pink or red patches often found on a baby’s eyelids, between the eyes, upper lip, and back of the neck. The name comes from the marks on the back of the neck where, as the myth goes, a stork may have picked up the baby. They’re caused by a concentration of immature blood vessels and may be the most visible when the baby is crying. Most of these fade and go away completely by age 18 months.

Congenital dermal melanocytosis

Congenital dermal melanocytosis (formerly called Mongolian spots) are blue or purple-colored splotches on the baby’s lower back and buttocks. Over 80% of African-American, Asian, and Indian babies have these marks, but they occur in dark-skinned babies of all races. The spots are caused by a concentration of pigmented cells. They often disappear in the first 4 years of life.

Erythema toxicum

This is a red rash on newborns. It’s often described as flea bites. The rash is common on the chest and back, but may be found all over. About 50% of all babies develop this condition in the first few days of life. It’s less common in premature babies. The cause is unknown but it’s not dangerous. This rash doesn’t need any treatment and goes away by itself in a few days.

Acne neonatorum (baby acne)

About 1 in 5 newborns develop acne in the first month. It often appears on the cheeks and forehead. They often go away in a few months. Gently wash the areas with mild soap.

Strawberry hemangioma

This is a bright or dark red, raised or swollen, bumpy area that looks like a strawberry. Hemangiomas are formed by a concentration of tiny, immature blood vessels. Most of these occur on the head. They may not appear at birth, but often develop in the first 2 months. Strawberry hemangiomas are more common in premature babies and in girls. These birthmarks often grow in size for several months, and then slowly fade. Nearly all strawberry hemangiomas go away completely by age 9.

Port wine stain

This is a flat, pink, red, or purple-colored birthmark. They are caused by a concentration of tiny enlarged (dilated) blood vessels called capillaries. They often occur on the head or neck. They may be small, or they may cover large areas of the body. They don’t disappear over time. Port wine stains on the face may be linked to more serious problems.

Newborn breast swelling

Breast enlargement may occur in newborn boys and girls around the third day of life. In the first week, a milky substance, sometimes called witch’s milk, may leak from the nipples. This is related to the mother’s hormones and goes away in a few days or weeks.

Swollen genitals/discharge

Premature baby girls may have a very prominent clitoris and inner labia. Full-term girls have larger outer labia. Girls may have a small amount of whitish discharge or blood-tinged mucus from the vagina in the first few weeks. This is a normal occurrence related to the mother’s hormones.

Premature boys may have a smooth, flat scrotum with undescended testicles. Boys born later in pregnancy have ridges in the scrotum with descended testicles.