Newborn Body: Common Concerns and What's Normal

Why Is My Newborn's Head Shaped Oddly?

An oddly shaped head after birth is completely normal and called "molding." During vaginal delivery, the overlapping skull bones allow the baby's head to fit through the birth canal. The head typically rounds out within a few days to weeks after birth, though some asymmetry may persist for several months.

When you first see your newborn, you might be surprised by the shape of their head. Instead of the perfectly round head you might expect, many babies are born with heads that appear elongated, cone-shaped, or even lopsided. This is one of the most common concerns new parents have, yet it's almost always completely normal and temporary.

The process of head molding occurs during vaginal delivery when the baby moves through the birth canal. The bones of a newborn's skull are not fused together like an adult's skull. Instead, they are connected by flexible fibrous tissue called sutures, which allows the bones to overlap and compress during birth. This remarkable adaptation protects the baby's brain during delivery while allowing passage through a narrow space.

The fontanelles, or soft spots, play a crucial role in this process. These gaps between the skull bones provide additional flexibility. The anterior fontanelle at the top-front of the head is diamond-shaped and the most noticeable, while the smaller posterior fontanelle is triangular and located at the back of the head.

When Does the Head Shape Normalize?

In most cases, the head begins to round out within the first few days after birth as the skull bones gradually shift back into their natural positions. By the time your baby is a few weeks old, the head shape is usually much more symmetrical. However, some degree of asymmetry is common throughout infancy and is rarely a cause for concern.

Babies who are delivered via cesarean section often have rounder heads at birth because they didn't experience the compression of the birth canal. However, these babies may develop flat spots (positional plagiocephaly) later if they consistently lie in one position.

When to Be Concerned About Head Shape

While head molding is normal, some conditions require medical attention. Consult your healthcare provider if you notice that the head shape doesn't improve after several weeks, there's persistent bulging or depression over the fontanelle, the sutures (lines between skull bones) appear fused or prematurely closed, or there's significant asymmetry that worsens over time.

Craniosynostosis, a condition where one or more sutures close prematurely, affects about 1 in 2,500 births and may require treatment. Early detection leads to better outcomes, so regular well-baby checkups are important.

What Are the Soft Spots on My Baby's Head?

The soft spots, called fontanelles, are gaps between the bones of your baby's skull. The anterior (front) fontanelle is diamond-shaped and closes between 12-18 months, while the smaller posterior (back) fontanelle closes by 2-3 months. These gaps allow for rapid brain growth during the first year of life.

Fontanelles often cause anxiety for new parents who worry about accidentally hurting their baby's brain. Understanding what these soft spots are and how they function can help ease these concerns. The fontanelles are covered by a tough, fibrous membrane that protects the brain, so normal handling, bathing, and even gentle brushing of your baby's hair are completely safe.

The human brain grows rapidly during infancy, more than doubling in size during the first year of life. The fontanelles provide the necessary space for this growth by allowing the skull to expand. If the skull bones were fused at birth, the brain wouldn't have room to grow properly.

Anterior Fontanelle (Front Soft Spot)

The anterior fontanelle is located on the top of the head, slightly toward the front, where four skull bones meet. It's diamond-shaped and typically measures about 2-3 centimeters across at birth, though this varies considerably between babies. You may notice this fontanelle pulsating gently in rhythm with your baby's heartbeat, which is completely normal and occurs because blood vessels pass beneath it.

This larger fontanelle gradually closes as the skull bones grow together, typically between 12-18 months of age, though some babies close earlier or later. As long as your baby is developing normally and there are no other concerning signs, variation in closure timing is usually not a problem.

Posterior Fontanelle (Back Soft Spot)

The posterior fontanelle is much smaller than the anterior one, roughly the size of a fingertip. It's located at the back of the head where three skull bones meet. Because of its small size, it may be difficult to feel, especially after the first few weeks of life. This fontanelle typically closes by 2-3 months of age.

How to Assess the Fontanelle

During routine care, you can check your baby's fontanelle to get a sense of hydration status and overall health. The fontanelle should be assessed when your baby is calm and upright or at a 45-degree angle. A normal fontanelle feels soft and flat, though it may pulsate gently.

A sunken fontanelle may indicate dehydration and can occur when a baby isn't getting enough fluids, has vomiting or diarrhea, or is otherwise ill. If you notice a sunken fontanelle along with fewer wet diapers, dry mouth, or lethargy, contact your healthcare provider promptly.

A bulging fontanelle (appearing raised or tense, especially when the baby is upright and calm) can indicate increased pressure inside the skull. This may be a sign of infection like meningitis or other conditions that require immediate medical attention. A fontanelle that bulges only during crying or straining is normal, but persistent bulging is concerning.

Why Does My Newborn Have Spots, Rashes, or Marks?

Most skin marks on newborns are harmless and temporary. Common ones include milia (tiny white spots), erythema toxicum (red blotchy rash), stork bites (pink patches), and Mongolian spots (blue-gray patches on lower back). Most resolve on their own within weeks to months without treatment.

Newborn skin often surprises parents with its variety of spots, rashes, and marks. The good news is that the vast majority of these skin findings are completely benign and will fade or disappear entirely as your baby grows. Understanding the most common types can help you feel more confident about your baby's skin appearance.

Newborn skin is still adapting to life outside the womb. In utero, the baby was surrounded by amniotic fluid and protected by vernix caseosa, a white, waxy coating. After birth, the skin must adjust to air exposure, temperature changes, and new environmental stimuli. This adaptation process can cause various temporary skin changes.

Milia (Milk Spots)

Milia appear as tiny white or yellowish bumps, usually on the nose, cheeks, and chin. These pinhead-sized spots are caused by blocked sebaceous glands and are present in up to 40% of newborns. Milia require no treatment and typically disappear within the first 1-3 months of life. They are not caused by anything the parent did or didn't do, and they are not contagious.

Erythema Toxicum (Newborn Rash)

Despite its alarming name, erythema toxicum is a common and harmless rash that affects about half of all full-term newborns. It typically appears 2-3 days after birth as blotchy red patches with small white or yellow bumps in the center. The rash can appear anywhere on the body except the palms and soles and may come and go for several days. It requires no treatment and usually resolves within 1-2 weeks.

Stork Bites and Salmon Patches

These pink or red patches, medically known as nevus simplex, are caused by dilated blood vessels near the skin's surface. They commonly appear on the eyelids, between the eyes, on the forehead, or at the back of the neck (where they're called "stork bites" because of the folklore that storks carry babies by the neck). Facial patches typically fade by 1-2 years of age, while patches on the neck may persist but are usually covered by hair.

Mongolian Spots

Mongolian spots are flat, blue-gray patches that look somewhat like bruises. They most commonly appear on the lower back and buttocks but can occur anywhere on the body. These spots are more common in babies with darker skin tones, including Asian, African, Hispanic, and Native American backgrounds, affecting up to 90% of these populations. Mongolian spots are completely harmless and gradually fade, usually by age 4, though some may persist into adulthood.

Birthmarks That Need Monitoring

While most skin marks are benign, some birthmarks should be monitored by a healthcare provider. Port-wine stains are flat, pink to dark red marks caused by malformed blood vessels. Unlike stork bites, they don't fade and may darken over time. Port-wine stains on the face, especially around the eye, should be evaluated by a specialist.

Hemangiomas (strawberry marks) are raised, bright red marks that may not be visible at birth but develop during the first few weeks. They typically grow during the first year before gradually shrinking. Most hemangiomas resolve by age 5-10, but those near the eyes, nose, or mouth may need treatment to prevent complications.

Why Are My Newborn's Genitals Swollen?

Swollen genitals in newborns are completely normal and caused by maternal hormones that crossed the placenta before birth. Both boys and girls may have swollen genitals, and girls may have vaginal discharge or minor bleeding. These changes typically resolve within 1-2 weeks without treatment.

Many new parents are surprised or even alarmed when they notice their newborn's genitals appear swollen or enlarged. This is one of the most common concerns raised during newborn checkups, yet it's almost always a normal, temporary effect of pregnancy hormones.

During pregnancy, the mother's hormones, particularly estrogen, cross the placenta and enter the baby's bloodstream. These hormones can cause tissue swelling in various parts of the baby's body, with the genitals being particularly sensitive to these effects. Once the baby is born and no longer receiving maternal hormones, the swelling gradually resolves.

Genital Changes in Female Newborns

Baby girls may have noticeably swollen labia (the outer folds of the vulva) at birth. This swelling typically resolves within the first two weeks. Additionally, many female newborns have a whitish vaginal discharge, which is normal and caused by the influence of maternal hormones on the baby's cervix and uterine lining.

Some baby girls may even experience a small amount of vaginal bleeding, sometimes called a "mini-period" or "pseudo-menstruation." This occurs because the withdrawal of maternal hormones after birth causes the uterine lining to shed, similar to what happens during menstruation. This is completely normal and typically occurs between day 3 and day 10 of life, lasting only a day or two. It requires no treatment and causes no harm.

Genital Changes in Male Newborns

Baby boys may have a swollen scrotum at birth, which is caused by maternal hormones and sometimes also by a small amount of fluid around the testicles (hydrocele). A hydrocele is a collection of fluid in the sac around the testicle and is quite common in newborns. It typically resolves on its own during the first year of life as the connection between the abdomen and scrotum closes.

The penis in a newborn boy may also look small relative to the scrotum due to the scrotal swelling. This is normal, and the proportions will look more typical as the swelling resolves. If your son has been circumcised, there may be some additional swelling in the healing area, which should improve within the first week or two.

Breast Buds in Newborns

Both male and female newborns can develop small breast buds, firm nodules under the nipples that may cause the chest to appear slightly swollen. This is caused by maternal hormones and is sometimes called neonatal mastitis or, historically, "witch's milk" because some babies actually produce a small amount of milk-like discharge. This is entirely normal and requires no treatment. The breast buds typically resolve within the first few weeks to months. Do not squeeze or massage the breast buds, as this can cause irritation or infection.

How Do I Care for My Baby's Umbilical Cord Stump?

The umbilical cord stump should be kept clean and dry. Modern guidelines recommend "dry care" - no alcohol or antiseptics are needed. The stump typically falls off within 7-21 days (average 10-14 days). Signs of infection include redness spreading beyond the base, pus, foul smell, or fever.

The umbilical cord connected your baby to the placenta during pregnancy, providing oxygen and nutrients. After birth, the cord is clamped and cut, leaving a small stump attached to your baby's navel. This stump gradually dries out, shrivels, and falls off naturally, leaving behind your baby's belly button.

Modern recommendations for umbilical cord care have simplified significantly over the years. The current evidence-based approach is "dry cord care," which means keeping the stump clean and allowing it to dry naturally without applying any substances. This approach has been shown to be as effective as antiseptic treatment and may even speed up cord separation.

Practical Cord Care Steps

Keep the cord stump exposed to air as much as possible. Fold the top of your baby's diaper down below the stump to prevent irritation and keep urine away from the healing area. If the stump gets wet during bathing, pat it dry gently with a clean cloth. Sponge baths are generally recommended until the cord falls off, though brief tub baths with careful drying afterward are also acceptable.

Avoid covering the stump with bandages or tight clothing. Let it fall off naturally - do not pull or twist the stump, even if it appears to be barely attached. After the stump falls off, there may be a small amount of blood or discharge for a few days, which is normal. Continue to keep the area clean and dry until it's fully healed.

Normal Cord Changes

As the umbilical cord stump heals, you'll notice several normal changes. Initially, the stump is yellowish-green and soft. Over the first few days, it becomes darker, drier, and harder, eventually turning brown or black. It may develop a slight odor as it dries, which is normal as long as there's no redness or pus. The stump may also appear to get smaller as it shrivels.

Signs of Umbilical Cord Infection

While umbilical cord infections (omphalitis) are uncommon, they can be serious and require prompt medical attention. Contact your healthcare provider if you notice redness spreading from the base of the stump onto the surrounding skin, pus or cloudy discharge with a foul smell, swelling around the umbilical area, bleeding that doesn't stop with gentle pressure, or fever or signs of illness in your baby.

An umbilical granuloma is a small, moist, pinkish-red tissue that may remain after the cord falls off. While not an infection, it may require treatment from your healthcare provider if it doesn't resolve on its own.

What Are Those Strange Movements My Newborn Makes?

Newborn reflexes are automatic, involuntary movements that indicate healthy neurological development. Key reflexes include the Moro (startle) reflex, rooting reflex, sucking reflex, grasp reflex, and stepping reflex. These primitive reflexes gradually disappear during the first months of life as voluntary motor control develops.

New parents often notice their babies making sudden, jerky movements or strange gestures that may seem alarming at first. These are typically primitive reflexes, also called newborn reflexes, which are automatic responses that develop in utero and are present from birth. These reflexes serve important survival functions and are assessed during routine newborn examinations to check neurological health.

Primitive reflexes are controlled by the brainstem and spinal cord rather than the higher brain centers. As your baby's brain develops and the cortex (the thinking part of the brain) matures, voluntary movements gradually replace these automatic responses. The presence of appropriate reflexes at birth and their gradual disappearance over the first months is a sign of healthy neurological development.

Moro Reflex (Startle Reflex)

The Moro reflex is one of the most noticeable newborn reflexes. When a baby is startled by a sudden noise, movement, or feeling of falling, they will throw their arms and legs outward, spread their fingers, arch their back, and then bring their arms back together in a hugging motion, often followed by crying. This reflex is thought to be an evolutionary adaptation to help babies cling to their mothers. The Moro reflex is strongest during the first month and typically disappears by 3-4 months of age.

Rooting Reflex

The rooting reflex helps babies find the breast or bottle for feeding. When you stroke or touch the corner of your baby's mouth, they will turn their head toward the touch and open their mouth, "rooting" for the nipple. This reflex is present from birth and is strongest during the first 3-4 weeks, after which it becomes more of a voluntary response. By about 4 months, babies no longer need the rooting reflex because they can visually locate and turn toward the breast or bottle.

Sucking Reflex

When something touches the roof of a baby's mouth, they begin to suck. This reflex is essential for feeding and is fully developed in full-term babies. Premature babies may have a weaker sucking reflex, which can affect their ability to breastfeed or bottle-feed initially. The sucking reflex coordinates with the rooting reflex to help babies find and latch onto the nipple and then feed effectively.

Palmar Grasp Reflex

If you place your finger in your newborn's palm, they will automatically grasp it tightly. This grasp can be surprisingly strong and was likely an evolutionary adaptation for clinging to the mother's body. The palmar grasp reflex is present from birth and gradually weakens around 3-4 months as babies develop voluntary grasping abilities.

Stepping Reflex

When held upright with feet touching a flat surface, newborns will lift one foot and then the other in a stepping motion, as if trying to walk. This fascinating reflex disappears around 2 months of age and shouldn't be confused with actual walking readiness. Your baby will develop the ability to walk through a completely separate developmental process many months later.

Why Is My Newborn's Skin Turning Yellow?

Mild jaundice (yellowing of skin and eyes) affects about 60% of full-term newborns and 80% of premature babies. It's usually caused by normal breakdown of red blood cells and an immature liver. Physiological jaundice peaks at 3-5 days and resolves within 2 weeks. Jaundice appearing within 24 hours of birth or persisting beyond 2 weeks needs medical evaluation.

Jaundice, the yellowing of the skin and whites of the eyes, is one of the most common conditions in newborns. While the yellow tint can be alarming for new parents, most cases of newborn jaundice are harmless and resolve on their own. However, it's important to understand when jaundice requires medical attention.

Newborn jaundice occurs because of elevated levels of bilirubin in the blood. Bilirubin is a yellow pigment produced when red blood cells break down. Newborns have a higher rate of red blood cell breakdown than older children and adults because their red blood cells have a shorter lifespan. Additionally, the newborn liver is still immature and may not process bilirubin efficiently. This combination leads to a temporary buildup of bilirubin, causing the characteristic yellow color.

Types of Newborn Jaundice

Physiological jaundice is the most common type and is considered a normal part of newborn adaptation. It typically appears on day 2 or 3 of life, peaks around day 3-5, and resolves within 1-2 weeks. This type of jaundice rarely causes problems and often requires no treatment beyond adequate feeding.

Breastfeeding jaundice occurs in the first week of life when breastfeeding is not yet well established, and the baby isn't getting enough milk. This can lead to dehydration and decreased stooling, which slows bilirubin elimination. The solution is to ensure adequate feeding, often with more frequent nursing sessions and, if necessary, lactation support.

Breast milk jaundice is different from breastfeeding jaundice and is caused by substances in breast milk that increase bilirubin reabsorption in the intestines. It appears later (after the first week) and may persist for several weeks to months but is generally harmless. Breastfeeding can and should continue in most cases.

When to Seek Medical Attention

While most jaundice is benign, certain situations require prompt medical evaluation. Contact your healthcare provider if jaundice appears within the first 24 hours of life (this is never normal and may indicate a blood type incompatibility or other problem), the yellow color extends to the arms and legs or appears very intense, your baby seems overly sleepy and is difficult to wake for feeding, your baby isn't feeding well or isn't producing enough wet and dirty diapers, or jaundice persists beyond 2-3 weeks.

Severe untreated jaundice can rarely lead to kernicterus, a form of brain damage. This is why healthcare providers monitor bilirubin levels in newborns and recommend treatment (phototherapy or "bili lights") when levels are too high. With proper monitoring and treatment, serious complications are extremely rare.

When Should I Be Worried About My Newborn's Body?

Seek immediate medical attention for: difficulty breathing or blue coloring, fever above 38°C (100.4°F) or below 36°C (96.8°F), refusal to feed for 6+ hours, persistent vomiting, no wet diapers for 6+ hours, bulging or sunken fontanelle, extreme lethargy or inconsolable crying, rapidly spreading jaundice, or signs of umbilical cord infection.

While most physical findings in newborns are normal variations, new parents need to know the warning signs that require prompt medical attention. Newborns can deteriorate quickly when ill, so it's always better to seek help early if you're concerned. Trust your instincts as a parent - if something seems wrong, contact your healthcare provider.

Breathing Problems

Normal newborn breathing can be irregular, with occasional pauses of up to 10 seconds. However, you should seek immediate medical care if your baby has persistent rapid breathing (more than 60 breaths per minute), visible difficulty breathing with nostril flaring, retractions (skin pulling in between ribs or below the ribcage), grunting with each breath, or blue coloring around the lips, tongue, or face (central cyanosis). Note that slightly blue hands and feet (peripheral cyanosis) is normal in the first day or two.

Temperature Abnormalities

Fever in a newborn under 3 months is always a medical emergency because young babies can develop serious infections quickly. Take your baby's temperature rectally for the most accurate reading. Seek immediate care for rectal temperature of 38°C (100.4°F) or higher, rectal temperature below 36°C (96.8°F) despite warming attempts, or if your baby feels very hot or very cold and is acting ill.

Feeding Problems

Newborns typically feed every 2-3 hours, or 8-12 times in 24 hours. While some variation is normal, concerning feeding patterns include refusing to feed or showing no interest in feeding for more than 6-8 hours, weak sucking or falling asleep immediately after starting to feed, persistent vomiting (not just spit-up) after every feed, and signs of dehydration such as fewer than 6 wet diapers in 24 hours, sunken fontanelle, dry mouth, or no tears when crying.

Changes in Behavior

Newborns sleep a lot, typically 16-17 hours per day, but they should wake for feedings and be alert for some periods. Seek medical attention if your baby is unusually difficult to wake, even for feeding, has a weak or high-pitched cry, is excessively irritable and cannot be consoled, or seems "floppy" or has poor muscle tone.