Your Newborn

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Your Newborn
Each newborn is an individual. Your baby probably looks different from what you expected. At birth, its skin is covered with a thick, white, greasy substance called vernix which, when removed, leaves a reddened, puffy, curled-up being—your new baby.
Your baby’s body may be covered with fine, downy hair (lanugo). The amount, color, and areas covered vary. The lanugo is shed naturally during the first weeks. The hands and feet may be bluish and cold because of immature circulation.
The skin may become dry and wrinkled because of the change from the moist womb environment to room air. It is not necessary to rub the skin and scalp with oil. During the first few weeks, approximately 40% of all babies may have a rash consisting of small, raised, white spots on the face (milia). This is the normal beginning of the function of oil and sweat glands. No treatment is needed as these spots disappear on their own (and should not be squeezed).
Fifty percent of all babies have a rash consisting of red, raised patches, and sometimes tiny white pus bumps (erythema toxicum). This rash begins during the first days of life and usually disappears within a week. The rash frequently occurs on the chest, abdomen, back, or bottom. No treatment is needed.
Babies are born with different amounts of hair. Some babies are even bald. The scalp hair may be rubbed away, in patches, as your baby shifts its head about. The hair color at birth is often different from that in childhood. Newborn fingernails are thin and may be long from growth in the womb.
The head appears large in relation to your baby’s body. Because of the head’s weight, it needs support when the baby is handled. The head may be misshapen because passage through the birth canal has molded the soft bones. This is normal and the skull will round out during the next year. The brain has not been damaged. If your baby favors lying in a particular position, that side of the skull may appear flat. This, too, returns to normal as the bones mature. There are two soft spots (fontanelles) in the head where the brain is covered by a tough membrane until bone grows over them during the next year. The size of the soft spot is different for each child. There is no danger in washing the skin or combing the hair in these areas.
The color of the eyes at birth may be different from that as an adult. Most newborns have eyes that are gray-blue or, if they are darker complected, brown in color. Occasionally,

there will be a red blood spot (hemorrhage) in the white portion of the eye. This is due to the breaking of a tiny blood vessel during the birth process. Though the spot looks bad, it will eventually disappear without treatment. Passage through the birth canal often causes considerable swelling of the eyelids which will take several days to resolve. Occasionally, mattering or tearing from both eyes occurs. Coordination of your baby’s eye movements develops gradually over the next year.

The newborn’s face is usually rounded with the cheeks being pudgy. In the first few days, the lips will begin to form sucking callouses which look like tiny blisters. Occasionally, a baby’s tongue is short but will lengthen with age. Contrary to popular misconception this rarely causes speech difficulties. Most babies’ teeth will not break through the gums for months.
During the ensuing days, some babies’ breasts become enlarged and may secrete a milky substance. This is due to the transmission of the mother’s hormones prior to delivery. As their influence wears off, the baby’s breast size will return to normal and milk flow will stop on its own during the next few weeks. Do not massage or squeeze the breasts.
The umbilical cord was the connection from the baby to the placenta inside the uterus. Though glistening white at birth, it turns brown during the first few days as it dries. If kept dry, it will fall off during the first few weeks. Some people dab it with alcohol, using a cotton ball or swab, several times daily to aid this drying process. When the cord falls off, it is normal to see some droplets of blood on the raw naval, clothing, or diaper. Continue to keep the raw area dry and clean until it heals. If the area develops a bad odor, redness, or pus, contact your physician. Do not tub bathe your infant until the raw area has healed. Many babies, particularly black infants, have an out-pouching of the belly button area (umbilical hernia). This hernia is due to a gap in the muscles of the abdominal wall around the naval. Most of these hernias disappear on their own during the first few years.
Often the genitals will seem large in comparison to the rest of the body. Females may have a discharge from the vagina varying from white to red or brown in color. This is also due to the influence of the mother’s hormones and usually starts and stops in the first few weeks.
In a male infant whose penis has been circumcised, the edge will take a number of days to heal. Care should be taken to prevent irritation of the wound. Wash and dry this area gently. A dab of Vaseline on the wound will prevent it from sticking to the diaper. If not circumcised the foreskin adheres to the head of the penis. It can loosen anytime in the next several years. Then begin trying to retract your child’s foreskin once daily during his bath, wash the head of the penis and replace the foreskin in its usual position. It is normal, and of no significance, for erections to occur.
The arms and legs will often temporarily stay in a position simailr to that in the womb. The legs may be bowed for the same reason. The feet, too, may be at an odd angle. As your child matures, particularly after walking has begun, the feet and legs take on more ormal positions.
Though your infant looks helpless and is dependent on you for most of his needs, there are a number of things babies can do. They can communicate with you by crying various ways. Each cry is different in characteristic. There is one for attention, feeding, diapering, or for just being uncomfortable. Babies may normally have fussy periods during each day when they cry for variable amounts of time without apparent reason. Most commonly, this occurs in the late afternoon or early evening when the household is least relaxed.
Your baby can perform the basic life functions of breathing, sucking, swallowing, keeping warm, and expelling waste. These functions are performed with a pattern of regularity unique to your child. Your infant’s normal breathing pattern will vary, just like yours. Your child has the ability to see, hear, taste, smell, and feel. Newborns are quite capable of movements. A number of these are involuntary reflexes; rooting (turning the hear toward that cheek which is touched as a prelude to feeding), sucking, startling to sudden contact or noise (known as the Moro Reflex), withdrawing the limbs (a means of protection), grasping, blinking, yawning, gagging, coughing, and sneezing. The degree of active movement varies with each individual. Frequent hiccups are another common occurrence. The frequency declines as the baby matures.
With all this activity, as well as considerable growth, it is no surprise that the average newborn sleeps 12 to 18 hours a day.
The frequency and intensity of these life functions and of various behaviors is different because each newborn is an individual.

From Anticipatory Guidance Sheets for Parents by Cohen, Hansen, and Skilling copyright 1994... May be reproduced for patient use carrying this notice by permission Sunbelt Medical Publishers, P.O. Box 13512, Tallahassee, FL, 32317-3512.

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