It is normal, and very common, for infants to have a bluish skin color when they're first born. This is due to a decreased oxygen supply in the moments right before delivery. It usually goes away quickly once your baby starts crying. On occasion, the staff may need to give baby a little extra oxygen to help them "pink up" and start breathing on their own.
Your baby's skull bones are not fused together at birth. This is to make sure there's room for your baby's brain to grow, and also to allow the shape of your baby's head to change during birth. Your baby's head will become molded into an egg or cone-like shape to better travel through the birth canal. The bones in your baby's head can sometimes overlap. Molding is more prominent in first time babies, but it is temporary. Your baby's head will return to a more rounded shape during the first few days after birth.
You may notice that your baby has two soft spots on his head. These are called fontanels, which are spaces between the bone plates that will eventually fuse together. The anterior, or front, fontanel is shaped like a diamond and is located towards the front of his skull above his forehead. This fontanel will normally close by the time your baby is 18 to 24 months old. The posterior, or back, fontanel is a much smaller, triangular shaped space toward the back of your baby's head. This fontanel will close after about 6 months.
At birth your baby may be covered with a thick, white, cream cheese like substance called vernix. This is a protective coating made by your baby's skin. At birth your baby may have a lot of vernix or hardly any at all.
Sometimes babies, particularly if they move through mom's pelvis rapidly, can become bruised during delivery. This will often give their face a purplish appearance. As long as the rest of your baby is pink, don't be concerned. The bruising will fade with time.
Sometimes pressure during birth can cause a swollen bump on your baby's head. This bump is made of extra fluid in the tissue of the scalp, and will usually be reabsorbed within the first week of your baby's life. Occasionally a baby can develop something called a cephalohematoma. This is caused by a collection of blood between baby's skull and skin. A cephalohematoma can appear immediately, or several days after your baby is born. Don't worry. The bleeding doesn't involve the brain, and there's no treatment required. It will normally go away within several weeks after birth.
Sometimes a baby is born with a bluish tint to her hands and feet, although her body is nice and pink. This bluish tint is called "acrocyanosis" and it happens because your baby is reacting to leaving your warm body, and entering the cooler air. This can also show up later, if your baby gets cold. It should disappear once your baby warms up.
Caucasian babies are usually born with dark, slate blue or gray eyes, while dark skinned babies are born with dark brown eyes. Your baby's eye color may change up until he's about 6 months old. It's normal for your baby's eyes to be swollen when he's first born, but this will go away within a few days. You'll see jerky, uncoordinated eye movement because the muscles in a new baby's eyes are not yet mature. Your baby may even look cross-eyed. This is temporary and will improve as your baby's eye movements become more coordinated.
Babies don't have perfect vision when they're first born. They're able to focus only about 8 to 12 inches away from their own face for short periods of time. Fortunately, this puts your face into viewing range while you're holding your baby in your arms for feeding. Faces and items with high contrast attract a baby's attention most. By the time your baby is 4 to 6 months old, he'll be seeing as well as you do!
Your baby's ears may appear flat or misshapen when she's first born. It's easy for ears to get a little bent or flattened when your baby's in your uterus or birth canal. This is usually temporary. It's also not unusual for premature babies to have slightly flattened ears.
A new baby's nose is generally somewhat flat and wide. It may even seem bent to one side, because of pressure in your uterus or birth canal. Infants breathe almost exclusively through their nostrils. When your baby sneezes, it helps to clear his airway and doesn't necessarily mean that he has a cold. Babies have a great sense of smell. Within the first days of life, your baby will be able to recognize you simply by your scent.
You may notice small whitish spots along your baby's gums or on the roof of her mouth. These are called Epstein's Pearls. They are normal and usually disappear within a month after birth. Babies are born with a well-developed sense of taste. They actually have more taste buds than adults, and they can tell the difference between sweet, sour, salty, and bitter.
About 50% of babies will have a condition called newborn jaundice, which is the yellowing of your baby's skin. Jaundice is a symptom of a condition called hyperbilirubinemia.
Newborns are born with higher amounts of red blood cells than children or adults have. When your baby is inside your uterus, he depends on your placenta to give him the oxygen he needs. Because he does not breathe inside your uterus, your baby makes more and larger red blood cells to help carry more oxygen to his muscles and tissues. Once your baby is born, he no longer needs these extra red blood cells, so his liver destroys them. One of the waste products from the breakdown of red blood cells is something called bilirubin. Bilirubin is removed from your baby's blood by his liver and then removed from his body in his urine and stool. Because your baby's liver is immature at birth, it may become overworked, and so the extra bilirubin can make his skin and eyes look yellow. Newborn jaundice usually appears on the second or third day of a baby's life. In most cases, a baby's body will remove the bilirubin itself, but if your baby's skin gets more yellow after you go home, please be sure to let your pediatrician or family doctor know.
If your baby's bilirubin level becomes too high, your provider may recommend phototherapy treatment. When your baby's skin is exposed to these special lights, the bilirubin breaks down and your baby's body can get rid of it through his urine and stool. When a baby is having phototherapy it's especially important to feed him every 2 to 3 hours so that he stays well hydrated. During phototherapy, your baby’s eyes will be covered to protect them from the bright lights.
Breast milk jaundice is another variation of jaundice and is thought to happen because a mother's breast milk may interfere with an enzyme in the liver that helps to break down bilirubin. This jaundice usually appears on day four or five when a mother's milk comes in. If your baby's bilirubin level doesn't rise too high then nothing will be done and your baby will clear the bilirubin on his own. If the bilirubin levels rise too high, your provider may temporarily interrupt your breast feeding for 24 to 48 hours to consider a trial of phototherapy. While your baby is not nursing during this time, you'll need to pump your breast milk to maintain an adequate milk supply for your baby.
ABO incompatibility jaundice is a unique form of jaundice. This condition can show up if a mother has type O blood and her baby has A, B, or AB type blood. During pregnancy a mother may produce antibodies against the baby's blood type. These antibodies can pass through the placenta to the baby and cause the baby to start to break down extra red blood cells even before he's born. The result may be a quick onset of jaundice in the newborn. If the levels of bilirubin rise too quickly in the first 24 hours after birth, the pediatrician will place the newborn under phototherapy. In extreme situations when the baby gets a very high bilirubin level, the baby may require a blood transfusion. This will not affect breast-feeding.
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