 |
Even after your child's physician assures you that your baby is
normal, you may find that he or she looks a bit odd. Your baby does
not have the perfect body you have seen in baby books. Be patient.
Most newborns have some peculiar characteristics. Fortunately they
are temporary. Your baby will begin to look normal by 1 to 2 weeks
of age.
This discussion of these transient newborn characteristics is
arranged by parts of the body. A few minor congenital defects that
are harmless but permanent are also included. Call your physician
if you have questions about your baby's appearance that this list
does not address.
HEAD
- Molding
Molding refers to the long, narrow, cone-shaped head that
results from passage through a tight birth canal. This compression
of the head can temporarily hide the fontanel. The head returns to
a normal shape in a few days.
- Caput
This refers to swelling on top of the head or throughout the
scalp due to fluid squeezed into the scalp during the birth
process. Caput is present at birth and clears in a few days.
- Cephalohematoma
This is a collection of blood on the outer surface of the
skull. It is due to friction between the infant's skull and the
mother's pelvic bones during the birth process. The lump is usually
confined to one side of the head. It first appears on the second
day of life and may grow larger for up to 5 days. It doesn't
resolve completely until the baby is 2 or 3 months of age.
- Anterior fontanel
The "soft spot" is found in the top front part of the skull. It
is diamond-shaped and covered by a thick fibrous layer. Touching
this area is quite safe. The purpose of the soft spot is to allow
rapid growth of the brain. The spot will normally pulsate with each
beat of the heart. It normally closes with bone when the baby is
between 12 and 18 months of age.
EYES
- Swollen eyelids
The eyes may be puffy because of pressure on the face during
delivery. They may also be puffy and reddened if silver nitrate
eyedrops are used. This irritation should clear in 3 days.
- Subconjunctival hemorrhage
A flame-shaped hemorrhage on the white of the eye (sclera) is
not uncommon. It's harmless and due to birth trauma. The blood is
reabsorbed in 2 to 3 weeks.
- Iris color
The iris is usually blue, green, gray, or brown, or variations
of these colors. The permanent color of the iris is often uncertain
until your baby reaches 6 months of age. White babies are usually
born with blue-gray eyes. Black babies are usually born with
brown-gray eyes. Children who will have dark irises often change
eye color by 2 months of age; children who will have light-colored
irises usually change by 5 or 6 months of age.
- Tear duct, blocked
If your baby's eye is continuously watery, he or she may have a
blocked tear duct. This means that the channel that normally
carries tears from the eye to the nose is blocked. It is a common
condition, and more than 90% of blocked tear ducts open up by the
time the child is 12 months old.
EARS
- Folded over
The ears of newborns are commonly soft and floppy. Sometimes
one of the edges is folded over. The outer ear will assume normal
shape as the cartilage hardens over the first few weeks.
- Earpits
About 1% of normal children have a small pit or dimple in front
of the outer ear. This minor congenital defect is not important
unless it becomes infected.
NOSE, FLATTENED
The nose can become misshapen during the birth process. It may
be flattened or pushed to one side. It will look normal by 1 week
of age.
MOUTH
- Sucking callus (or blister)
A sucking callus occurs in the center of the upper lip from
constant friction at this point during bottle- or breast-feeding.
It will disappear when your child begins cup feedings. A sucking
callus on the thumb or wrist may also develop.
- Tongue-tie
The normal tongue in newborns has a short tight band that
connects it to the floor of the mouth. This band normally stretches
with time, movement, and growth. Babies with symptoms from
tongue-tie are rare.
- Epithelial pearls
Little cysts (containing clear fluid) or shallow white ulcers
can occur along the gumline or on the hard palate. These are a
result of blockage of normal mucous glands. They disappear after 1
to 2 months.
- Teeth
The presence of a tooth at birth is rare. Approximately 10% are
extra teeth without a root structure. The other 90% are prematurely
erupted normal teeth. The distinction can be made with an x-ray.
The extra teeth must be removed by a dentist. The normal teeth need
to be removed only if they become loose (with a danger of choking)
or if they cause sores on your baby's tongue.
BREAST ENGORGEMENT
Swollen breasts are present during the first week of life in
many female and male babies. They are caused by the passage of
female hormones across the mother's placenta. Breasts are generally
swollen for 2 to 4 weeks, but they may stay swollen longer in
breast-fed and female babies. One breast may lose its swelling
before the other one by a month or more. Never squeeze the breast
because this can cause infection. Be sure to call your physician if
a swollen breast develops any redness, streaking, or
tenderness.
GENITALS, GIRLS
- Swollen labia
The labia minora can be quite swollen in newborn girls because
of the passage of female hormones across the placenta. The swelling
will resolve in 2 to 4 weeks.
- Hymenal tags
The hymen can also be swollen due to maternal estrogen and have
smooth 1/2-inch projections of pink tissue. These normal tags occur
in 10% of newborn girls and slowly shrink over 2 to 4 weeks.
- Vaginal discharge
As the maternal hormones decline in the baby's blood, a clear
or white discharge can flow from the vagina during the latter part
of the first week of life. Occasionally the discharge will become
pink or blood-tinged (false menstruation). This normal discharge
should not last more than 2 to 3 days.
GENITALS, BOYS
- Hydrocele
The newborn scrotum can be filled with clear fluid. The fluid
is squeezed into the scrotum during the birth process. This
painless collection of clear fluid is called a "hydrocele." It is
common in newborn males. A hydrocele may take 6 to 12 months to
clear completely. It is harmless but can be rechecked during
regular visits. If the swelling frequently changes size, a hernia
may also be present and you should call your physician during
office hours for an appointment.
- Undescended testicle
The testicle is not in the scrotum in about 4% of full-term
newborn boys. Many of these testicles gradually descend into the
normal position during the following months. In 1-year-old boys
only 0.7% of all testicles are undescended; these need to be
brought down surgically.
- Tight foreskin
Most uncircumcised infant boys have a tight foreskin that
doesn't allow you to see the head of the penis. This is normal and
the foreskin should not be retracted.
- Erections
Erections occur commonly in a newborn boy, as they do at all
ages. They are usually triggered by a full bladder. Erections
demonstrate that the nerves to the penis are normal.
BONES AND JOINTS
- Tight hips
Your child's physician will test how far your child's legs can
be spread apart to be certain the hips are not too tight. Upper
legs bent outward until they are horizontal is called "90 degrees
of spread." (Less than 50% of normal newborn hips permit this much
spreading.) As long as the upper legs can be bent outward to 60
degrees and are the same on each side, they are fine. The most
common cause of a tight hip is a dislocation.
- Tibial torsion
The lower legs (tibia) normally curve in because of the
cross-legged posture your baby was confined to while in the womb.
If you stand your baby up, you will also notice that the legs are
bowed. Both of these curves are normal and will straighten out
after your child has been walking for 6 to 12 months.
- Feet turned up, in, or out
Feet may be turned in any direction inside the cramped quarters
of the womb. As long as your child's feet are flexible and can be
easily moved to a normal position, they are normal. The direction
of the feet will become more normal between 6 and 12 months of
age.
- Long second toe
The second toe is longer than the great toe as a result of
heredity in some ethnic groups that originated along the
Mediterranean, especially Egyptians.
- "Ingrown" toenails
Many newborns have soft nails that easily bend and curve.
However, they are not truly ingrown because they don't curve into
the flesh.
HAIR
- Scalp hair
Most hair at birth is dark. This hair is temporary and begins
to shed by 1 month of age. Some babies lose it gradually while the
permanent hair is coming in; others lose it rapidly and temporarily
become bald. The permanent hair will appear by 6 months. It may be
an entirely different color from the newborn hair.
- Body hair (lanugo)
Lanugo is the fine downy hair that is sometimes present on the
back and shoulders. It is more common in premature infants. It is
rubbed off with normal friction by 2 to 4 weeks of age.
|