Top 10 Things that are Normal in Newborns

Happy BabyBabies are cute; there’s no denying it.  But our mental picture of what a baby “should” look like comes from glossy magazine photos of babies between six and nine months old.  When your baby is born, he or she will look very different.  Your newborn will also act different than older, more settled babies.  Some of these natural adjustments to living outside the womb can concern parents.  The following list provides a head-to-toe guide to what’s normal for your newborn baby.

1.  For starters, your baby, especially is she is your first born, may have a cone-shaped head after traveling through the birth canal.  The bones of the skull are designed to ride over each other during labor; afterwards, the head gradually rounds down again.  Labor can also cause swelling and bruising on the scalp, which resolve in the first weeks after birth.

2.  It’s okay if your baby’s eyes cross.  Over time, your newborn will develop the fine-tuning he needs to move his eyes together and focus on things.  But make no mistake: your baby sees quite well immediately after birth and focuses best on objects that are nine to fifteen inches from his face.  Sometimes a blood vessel in the whites of the eyes breaks from all the pushing during labor, and you may notice a patch of red.  These subconjunctival hemorrhages are common and resolve completely.

Many babies have eyes that water or accumulate mucus.  Rarely, this can be a sign of a serious infection such as chlamydia or gonorrhea.  The most common cause of gooey eyes, however, is the small diameter of the tubes at the inside corner of the eyes that drain the tears.  These tear ducts grow as your baby grows, and by the first birthday this problem will take care of itself.

3.  Newborn noses are sneezy and stuffy by design.  Sneezing is a reflex that clears the nose; it’s not a sign of a cold.  Your baby’s tiny nostrils are easily blocked by mucous, and it will take a few months before he learns how to breathe out of his mouth when his nose is clogged.  Until then, clean his nose before he nurses or tries to sleep with the bulb syringe from the hospital and salt water drops.

4.  Hiccuping, like sneezing, is a reflex.  Your baby may have hiccuped quite a lot before she was even born.  Hiccuping spells diminish over time, and it’s often helpful to let the baby nurse when hiccups strike.

5.  When your baby yawns or cries, you may notice small, white nodules on his gums or the roof of his mouth.  These harmless collections of keratin are called Epstein’s pearls, and they will wear away.  Your baby can also have sucking blisters on his lips.  These can dry and peel and dry and peel again.

6.  Most babies have dry patches of skin that peel shortly after birth.  Peeling is the result of spending nine months in water, and no cream or lotion will speed up the process.  Newborns also have a common rash with an uncommon name: erythema toxicum neonatorum.  The rash looks like tiny bug bites, and it comes and goes for a few days before fading.  By the time the bug bite rash fades, you will start to see baby acne.  These little bumps on the face, chest, and back are caused by the pregnancy hormones.  Clean your baby’s face with warm water, and by the time the acne fades, she will have enough head control for her first formal photograph.

7.  The umbilical cord can take a week or two to fall off.  Clean around it with alcohol on a cotton swab, making sure to get at the gooey parts at the base.  Cleaning the cord more than four times a day can slow healing.

8.  Whether your baby breast feeds or formula feeds, you can expect up to three months of tummy troubles with gas and straining.  You wouldn’t expect your newborn to pick up a pencil and write his name any more than you should expect his digestion to progress flawlessly.  Breast-feeding mothers should modify their diets according to the pediatrician’s recommendations.  If mothers avoided all the foods that supposedly make babies “fussy,” there would be nothing left to eat!  Likewise, consult your pediatrician before changing formulas.

Once feeding is established, a healthy baby can have a bowel movement anywhere from twelve times a day to once a week.  As long as your baby’s stool is not hard, little balls, he’s not constipated.

9.  In the first days, you may notice a brick red tinge to your baby’s urine.  Newborn urine is concentrated, and urate crystals cause the red color.  Little girls can also have a milky vaginal discharge or some vaginal bleeding–like a mini-period–caused by the hormones of pregnancy.

10.  Baby legs are not straight because they’ve been curled up tight in the uterus.  As your baby stands and jumps on his legs, he will strengthen muscles and straighten bones.  Special shoes, bars, and casts are rarely needed.

There are many more things that are normal in the newborn period–too many for most lists and books.  Your pediatrician doesn’t expect you to learn everything about pediatrics in a few weeks, so call if you have any questions about your new baby.

Find us at http://www.cvpediatrics.com

About Lisa M. Asta, MD

Lisa M. Asta, M.D. is board-certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics, for which she is also a Media Representative (she has been interviewed for “Kids Health” on Health Radio, and quoted in Parenting Magazine, USA Today, and the New York Times, among other publications). She is a Clinical Professor of Pediatrics at the University of California at San Francisco and past pediatric chair at John Muir Medical Center in Walnut Creek. She graduated from Temple University School of Medicine and the Johns Hopkins University. Dr. Asta is also a writer whose fiction has appeared in Inkwell, Philadelphia Stories, Schuylkill, and Zeniada. Her essays have appeared in the Journal of the American Medical Association, Hippocrates, the San Jose Mercury News, and The New Physician Magazine. She is an occasional contributor to KQED public radio’s Perspectives series, and has written articles for Bay Area Parent, Valley Parent, Parents’ Press, and Parents Express, as well as online at WebMD.com, Rx.com, and MyLifePath.com. She wrote a chapter in The Field Guide to the Normal Newborn, ed. Gary Emmet, M.D. BabyCenter.com currently has two how-to videos for parents in production which feature Dr. Asta. For more on Dr. Asta’s writing, visit www.LMAsta.com
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