Scenario:
The baby is sleeping. It’s her first day at home! Suresh and Seema keep looking at her. No, they are not looking at her very fondly. They are just nervously examining her from every possible angle.
They both don’t want to admit that to each other. But many things about their newborn baby are looking…hmm…quite different!
Her head looks odd-shaped. Her feet look curved. There are some rashes and spots on her skin. Her breathing keeps changing its rhythm.
What is all this? Is everything normal?
Discussion:
In nature, there is rarely a sharp demarcation between the normal and the abnormal. In its countless variations, rules don’t apply and norms are useless.
This is true even in the case of a newborn human baby – especially the way it looks!
Looks can kill! Looks are deceptive!
Combine these oft-repeated statements with human mind’s natural curiosity and anxiety and you won’t take long to understand why some ‘abnormal’ findings in a newborn cause undue worry in the parental minds.
But let me assure you that in most cases these so-called ‘abnormal’ things are perfectly natural and normal.
So let’s take a head to toe look at the new baby and see where we can usually see some unusual findings.
- Head:
Newborn baby’s head shape may look odd and swollen if there is Molding – a temporary displacement of soft skull bones; Caput – a back of the head circular swelling with mild bruising or Cephalhematoma – a localized collection of blood on one of the skull bones.
These conditions happen due to increased pressures and minor injuries sustained during the baby’s delivery process. They are temporary and settle by themselves within next few days or weeks.
The two soft skull-spots (Fontanelles) – one in the front and one in the back- are normal. Posterior fontanelle (the small spot at the back) closes within first few months and Anterior fontanelle (the larger diamond-shaped spot in the front) fills up by 1 – 2 years.
- Face:
- Because of the delivery-related pressures, sometimes the new baby’s face may look puffy and misshapen. It will ‘normalize’ after few days.
- Nose-block and noisy breathing are common in early days.
- The newborn baby is hypersensitive to light and keeps her eyes tightly shut most of the times.
- There may be a bloody spot (Subconjuctival hemorrhage) in the white of one or both eyes. It is caused by minor injury during birth and it subsides within next few weeks.
- Till six months, baby’s eyes can look crossed as they haven’t yet learned to focus properly.
- Baby’s outer ears may show skin-tags or pits.
- Abdomen:
- The umbilical cord is cut and clamped with a plastic clip at birth. Over the next 7-0 days, it shrivels, darkens and finally falls off.
- A balloon-like boggy belly-button swelling of an umbilical hernia often causes parental anxiety. It gurgles on touching and it increases in size on crying. Hence many a time, it is attributed wrongly as a cause of abdominal pain.
Many parents keep it under tight wraps after putting a coin over it but actually no treatment is necessary in most cases. Usually it corrects itself in a year.
- Skin:
Skin of the newborn baby often gets under the parental skin with its confusing array of ‘birth-marks’ or temporary rashes.
- ‘Mongolian spots’ – the slate-grey or bluish spots on the buttocks and back (occasionally elsewhere) are caused by the deposition of normal body pigment under the skin. They are harmless and disappear by the age of 7 years at the latest.
- ‘Strawberry hemangioma’ is a small, ripe strawberry-like soft swelling that is sometimes present on the face or on other body parts. ‘Stork bites’ or ‘Port wine stains’ are reddish stains mainly seen on the neck, forehead and eye-lids. All these conditions are caused by the excessive proliferation of the skin blood vessels and are mostly harmless. In most cases, they disappear with time alone and rarely require treatment.
- ‘Erythema toxicum’ is a transient harmless rash on the chest, which consists of small whitish spots on a red base. It needs no treatment.
- ‘Miliaria’ is ‘sweat-rash, which appears as multiple, tiny, colorless blisters or as a reddish rash on the face and neck. It only needs the baby to be shifted in cool surroundings and loose clothes.
- ‘Milia’- pinhead like multiple, tiny, whitish swellings on the nose/ cheek and ‘Epstein’s pearls’– tiny pearl-like white spots on roof of mouth are harmless; need no treatment and are just caused by the proliferation of some glands.
- Because of immature heat regulation and blood circulation, many times, baby’s hands and feet become blue on exposure to cold (Acrocyanosis).
In some other cold-exposed babies we see a bluish blotched marble- skin (Cutis marmoratus). Both conditions revert back to normal on providing warmth.
- Various other body systems:
- The female hormonal surge in the early days of life leads to vaginal discharge or even vaginal bleeding in the female babies. These are transient and without any significance. Similar hormonal changes can lead to genital and breast enlargement and even lactation – in both, female as well as male babies.
Overzealous ‘massage – ladies’ often try to ‘milk’ these ‘baby breasts’. Invariably such a thing results into an infection and abscess of the breast. Please don’t do such a thing, in fact don’t do anything!
- The babies yawn. They sneeze. They cough. They get startled. They stretch themselves. These are all perfectly normal things for them.
- Periodic breathing is a pattern of breathing where the baby breaths very rapidly for a few seconds, then pauses and then resumes normal rhythmic breathing. Again it is just a normal variation.
- Skin tags, ear tags, extra digits for hand or foot, mild curving of the foot (Talipes)- these are physical anomalies which are easily correctable and without much clinical importance.
Final word of advice
So my dear fellow parents, it is unnecessary to look suspiciously at each and every part of the baby looking for a sign of abnormality when there is none!
When you look at your new bundle of joy, don’t think of the abnormal before the normal. It just doesn’t make any sense. Whenever you are in doubt, just consult your doctor. Most of the times, you would find that you were just making a mountain out of a mole-hill!
