Common Concerns in the Early Weeks -Part Four

So much happens so fast as your baby adjusts to life outside the womb and you adjust to life with this little person. Knowing what to expect and understanding why babies do what they do will help you ease more comfortably into parenting.

New Born Skin Marks And Rashes

Run your handover your baby's kin. So soft, so smooth, but not perfect. You feel dry patches, flaky areas, areas that are rough and winkled, and some areas where the skin doesn't seem to fit, such as around the chin, neck, wrist, and heels. But don't worry, your baby will grow into it. Let's run you hands and eyes, head to toe, over the variety of skin changes in most newborns.

Normal Baby Marks

When you look at your baby's skin, it doesn't look perfect either. There are spots and specks, blotches and bruises, streaks and stains -- a cost of many hues that your newborn wears. But newborn skin has a remarkable quality -- the ability to change -- sometimes before your eyes.

Stork bites.
Most newborns have areas where lots of blood vessels bunch up and show through their thin skin. These smooth reddish-pink marks are most prominent on the eyelids, the nape of the neck, and in the middle of the forehead. They are not, in correct skin talk, rashes. These are called nevi or, in parent terms, birthmarks. Grandmothers dubbed them stork bites. But the mythical stork did not bite your baby. These skin curiosities stem from bunches of overgrown blood vessels showing through the newborn's thin skin As the excess blood vessels shrink and your baby's skin thickens, they nearly always disappear or fade by the first birthday. Some nevi, especially on the nape of the neck, persist but are obscured by hair. Sometimes these distinguishing marks fade but reappear when baby strains or cries, prompting parents to exclaim, "His forehead lights are on."

Strawberries.
While stork bites appear at birth and fade with time, other birthmarks appear a week or two later and grow with time. Most begin as a raised red circle and gradually enlarge to coin size during the first year. Between one and three years they begin to shrivel up. You will know when the growth has reached its peak when you see the center turn gray.

Called strawberry bemangiomas -- they look and feel like a strawberry -- these birthmarks come from blood vessels that went astray and kept growing. Most babies have at least one. And, like a bunch of strawberries, they come in various sizes and shapes, ranging from freckle size to as large as a golf ball.

While cosmetically unattractive, most of these strawberry hemangiomas are best left alone to self-destruct. Sometimes they are a nuisance by location. Such a growth on the eyelid, for example, may interfere with lid opening and strain baby's developing vision. Others reside in areas such as the arms and legs where they bleed when struck. Rarely do they persist as a cosmetic nuisance. In these situations, disfiguring or annoying hemangiomas can be shrunk and removed by injections and laser treatment.

Moles.
Called pigmented nevi, these brown-to-black moles range from freckle size to large, hairy patches. The moles usually remain the same, so they appear relatively smaller as your baby grows. They are benign and need neither worry nor treatment. When you start using sunscreen, be sure to cover the moles with it. Very large pigmented hairy nevi should be removed because of their potential for becoming malignant.

Mongolian spots.
Never a year goes by that pediatricians don't get an embarrassing call from someone accusing a parent of child abuse because of black-and-blue marks on baby's bottom. These bruise like spots, common in African American, Latino, Asian, Indian, and Native American babies, are prominent on the lower back and buttocks and sometimes also on the shoulders and legs These "spank" marks fade in time, but most never completely disappear.

Cafe-au-laity spots.
These are flat, brown birthmarks, resembling tiny puddles of coffee and cream. Most remain the same size, becoming relatively smaller as baby grows.

Baby's First Spots

Milia.
In the early weeks you may see and feel tiny whiteheads sprinkled over your baby's face, especially the nose. Caused by secretions plugging the skin pores, these Milia are normal and disappear with a few months without treatment.

Toxic erythema.
Don't be frightened by its alarming name. The dot like spots appear as yellowish-white pimples surrounded with a red blotchy ring. They look like bites. These normal spots appear during the first week most commonly on your baby's abdomen, and disappear without treatment by two weeks.

Prickly heat.
A reddish pimply rash, prickly heat appears on excessively moist areas of the skin, such as between the neck folds, behind the ears, in the groins, or in areas where clothing fits tightly. Run your fingers gently over the rash, and you will know why parents call this rash prickly. It has a coarse, sandpaper like feel. I suspect prickly heat can bother a baby. To take the heat and the prickles out of the rash, dress you baby in light-weight, loose-fitting cotton clothing and gently wash the skin with plain cool water or a solution of baking soda (one teaspoon to a cup of water). Remember to dab, wash, and blot dry; do not scrub and rub sensitive newborn skin.

Newborn acne.
Around the third or fourth week be prepared for the picture-perfect baby face to show its first complexion problem.

In a situation similar to the hormonal stages of puberty, the increased hormones at birth may cause the overproduction of a waxy, oily substance called sebum in the oil glands of the skin, most noticeably in the face and scalp. Plugging of these glands leads to inflammation and the formation of pimples. Parents call it baby acne. The medical term is Seborrheic dermatitis.

Like teenage acne, the red, pimply, oily rash covers much of baby's face, and the previously soft, smooth cheeks feel sandpaper rough. Hold the camera; this first puberty is short-lived (in fact, veteran baby-face watchers plan first photos or christenings before or after the acne period). Newborn acne usually peaks around the third week and clears within a month or six weeks,

Newborn acne bothers parents more than baby. Cut baby's fingernails short to prevent scratching. Gentle washing with water and a mild soap will remove the excess and sometimes irritating oil. If the acne pimples get infected (red area around the pimples or honey like oozing), your doctor may prescribe an antibacterial cream. Most newborn acne disappears completely without any special care of the skin.

If the condition appears early (that is, in the second week) and/or worsens quickly, spreading past the face into the hair and down onto the neck and even the shoulders, you may be observing one of the first signs of allergy to a nutrient in baby's formula or in your breast milk. The acne will most likely retreat dramatically when cow's milk products are eliminated from a breastfeeding mother's diet.

Cradle cap.
In another form of Seborrheic dermatitis, you will notice and fee a crusty, oily, plaque like rash on baby's scalp, especially over the soft spot. In a mild case of cradle cap the flaky, dry skin on the scalp resembles dandruff. This seldom needs any more treatment than gentle washing and increased humidity. Wash the scalp with a milk shampoo no more often than once a week. Too-vigorous and too-frequent hair washing will only dry out the scalp and make the cradle cap worse.

Here's how to treat a more severe case of cradle cap:

* Massage cold-pressed vegetable oil into the crusty areas to soften them. Give the oil fifteen minutes or so to soak in.
* Using a very soft toothbrush, gently remove the scales.
* Wash off the excess oil with a mild baby shampoo.

If the cradle cap is persistent, severe, and itchy, try an over-the-counter (OTC) mild tar shampoo twice a week until it clears up. (See "Rx for Healthy Baby Skin," further on in this article.)

You may also notice a crusty, oil rash behind your baby's ears and in the skin folds of the neck. This Seborrheic dermatitis is usually cleared with gentle washing with warm water, but sometimes hydrocortisone cream may help. Skin enjoys humidity. This is why most rashes worsen during the winter months, when central heating dries the air. A vaporizer or humidifier in your baby's sleeping room will moisturize dry skin..

Healing Cracked Skin

Many newborns, especially if post-mature, have dry flaky skin, most noticeably on the hands and feet. Baby's natural skin oils suffice; no lotion is necessary, if cracks develop in the creases around the wrists and ankles, apply a moisturizing cream such as Soothe and Heal with Lansinoh or an infant massage oil, such as coconut, almost, safflower, apricot or avocado oil.

There will be more articles on infants, breast or bottle feeding and other related topics to follow. So please keep an eye out for more of my articles.