Newborn Physical Features: What's Normal in Your Baby's Appearance

Why Does My Newborn's Head Look Cone-Shaped?

A cone-shaped or elongated head in newborns is called molding and is completely normal after vaginal delivery. The soft skull bones overlap during birth to allow the baby to pass through the birth canal. The head typically returns to a normal rounded shape within a few days to two weeks.

One of the most common concerns for new parents is the unusual shape of their newborn's head. Many babies are born with heads that appear elongated, pointed, or asymmetrical. This is particularly noticeable after a long labor or when delivery required forceps or vacuum assistance. Understanding why this happens can help reassure worried parents that their baby is developing normally.

During vaginal delivery, the baby's head must pass through the narrow birth canal. To make this possible, the skull bones of a newborn are not fused together like adult skull bones. Instead, they are connected by flexible membranes called sutures. These sutures allow the skull plates to overlap and compress, reducing the diameter of the head so it can fit through the pelvis. This process is called molding.

The degree of molding depends on several factors, including the length of labor, the position of the baby during delivery, and whether any instruments were used to assist with birth. Babies who are born quickly may have less molding, while those who experience prolonged labor often have more pronounced changes in head shape. First-time mothers typically have longer labors, which can result in more significant molding.

Parents should know that molding is temporary. Within the first few days after birth, the skull bones begin to shift back into their normal positions. By one to two weeks of age, most babies' heads have assumed a more rounded appearance. In some cases, minor asymmetry may persist for a few months but usually corrects itself as the baby grows and spends time in different positions.

Caput Succedaneum and Cephalohematoma

In addition to molding, some newborns develop swelling on the head related to the birth process. Caput succedaneum is a soft, puffy swelling of the scalp that crosses over the skull suture lines. It occurs when pressure during delivery causes fluid to accumulate under the scalp skin. This swelling is harmless and typically resolves within a few days without treatment.

Cephalohematoma is a different type of swelling that occurs when blood collects between the skull bone and its covering membrane. Unlike caput succedaneum, a cephalohematoma does not cross suture lines and feels firmer to the touch. It may take several weeks to months to resolve and occasionally can cause mild jaundice as the body reabsorbs the blood. While cephalohematomas look concerning, they rarely cause any problems and heal on their own.

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

Soft spots, called fontanelles, are gaps between the skull bones that allow the baby's brain to grow rapidly in the first years of life. The anterior fontanelle on top of the head closes between 12-18 months, while the smaller posterior fontanelle at the back closes by 2-3 months.

The soft spots on a newborn's head often make parents nervous, but they are actually essential for normal brain development. These soft spots, known as fontanelles, are areas where the skull bones have not yet joined together. Rather than being gaps in protection, they are covered by a tough, fibrous membrane that provides adequate coverage for the brain underneath.

There are two main fontanelles that parents can typically feel. The anterior fontanelle is the larger one, located toward the front of the head on top. It is diamond-shaped and measures approximately 1-3 centimeters across at birth. This fontanelle remains open the longest because the brain grows most rapidly during the first year of life and needs room to expand. The anterior fontanelle typically closes between 12 and 18 months of age, though there is considerable normal variation.

The posterior fontanelle is much smaller and located at the back of the head. It is triangular in shape and may already be nearly closed at birth in some babies. This fontanelle usually closes completely by 2 to 3 months of age. Some babies also have additional small fontanelles on the sides of the head, which close even earlier.

Parents often wonder what the fontanelles should look and feel like. Under normal conditions, the anterior fontanelle should feel slightly soft and may curve gently inward. It is normal to see or feel the fontanelle pulse slightly with the baby's heartbeat. When the baby cries or strains, the fontanelle may bulge temporarily, which is also normal.

When to Be Concerned About Fontanelles

While most fontanelle variations are normal, certain findings warrant medical attention. A sunken fontanelle that appears significantly depressed below the level of the surrounding skull bones may indicate dehydration. This is particularly concerning if the baby has been vomiting, having diarrhea, or not feeding well.

A bulging fontanelle that remains raised even when the baby is calm and upright could indicate increased pressure inside the skull. This requires prompt medical evaluation, especially if accompanied by fever, irritability, lethargy, or vomiting.

Why Is My Newborn's Skin Peeling or Discolored?

Newborn skin changes including peeling, milia (tiny white bumps), erythema toxicum (red blotches), and varying color are completely normal. In the womb, babies are protected by vernix caseosa, and after birth, the skin must adapt to the air environment. Most skin changes resolve within 2-4 weeks.

Newborn skin undergoes remarkable changes in the first weeks of life, and many of these changes can worry new parents. Understanding that most skin variations are temporary and harmless can provide significant reassurance. The skin of a newborn is adjusting from the warm, wet environment of the womb to the cooler, drier air outside.

During pregnancy, the baby is protected by a white, waxy substance called vernix caseosa. This natural coating protects the delicate skin from the amniotic fluid and provides lubrication during delivery. Babies born at term may have very little vernix visible, while premature babies often have more. After birth, as the vernix wears off and the skin adjusts to air, peeling commonly occurs, especially on the hands, feet, and ankles. This is completely normal and requires no treatment, though gentle moisturizing with fragrance-free products can help if the skin appears very dry.

Another common finding is milia, which are tiny white or yellowish bumps that appear on the face, particularly on the nose and cheeks. These occur when dead skin cells become trapped in small pockets on the skin surface. Milia are harmless and disappear on their own within a few weeks. Parents should resist the temptation to squeeze or pick at them, as this can cause infection or scarring.

Erythema Toxicum Neonatorum

Many newborns develop a rash called erythema toxicum neonatorum, despite its alarming name. This rash consists of red blotches with small white or yellow bumps in the center. It can appear anywhere on the body except the palms and soles. The rash typically appears between the first and third day of life and may come and go for several weeks.

Erythema toxicum is completely benign and requires no treatment. It affects up to 50% of term newborns and is more common in babies born vaginally. The exact cause is unknown, but it may be related to the baby's immune system responding to the new environment.

Normal Skin Color Variations

Newborn skin color can vary significantly and change over the first few days. Many babies are born with a bluish tint to their hands and feet, called acrocyanosis. This is normal and occurs because the baby's circulatory system is still adjusting to life outside the womb. The blue color should improve as the baby warms up and circulation matures.

Some babies develop a temporary yellowish color to their skin and the whites of their eyes, known as jaundice. Mild jaundice is very common, affecting about 60% of term newborns and 80% of premature babies. It usually appears on the second or third day of life and resolves within 1-2 weeks. Jaundice occurs because the newborn's liver is not yet efficient at processing bilirubin, a yellow pigment produced when red blood cells break down.

Are Birthmarks Normal in Newborns?

Yes, birthmarks are extremely common and typically harmless. Up to 80% of newborns have some form of birthmark. Common types include salmon patches (stork bites), Mongolian spots, strawberry hemangiomas, and port wine stains. Most birthmarks fade over time, though some are permanent.

Birthmarks are colored marks on or under the skin that are present at birth or develop shortly after. They occur when blood vessels, pigment cells, or other skin structures develop abnormally. While birthmarks can sometimes look concerning to parents, the vast majority are completely harmless and many fade or disappear entirely as the child grows.

Salmon patches, also known as stork bites, angel kisses, or nevus simplex, are the most common type of birthmark. These are flat, pink or red patches caused by collections of small blood vessels. They commonly appear on the back of the neck (stork bite), on the eyelids, or between the eyebrows (angel kiss). Salmon patches on the face typically fade completely by age 1-2 years, while those on the neck may persist into adulthood but are usually covered by hair.

Mongolian spots are flat, blue-gray patches that resemble bruises. They are most common in babies with darker skin pigmentation and typically appear on the lower back and buttocks. Despite their sometimes alarming appearance, Mongolian spots are completely harmless and fade significantly by age 4-5 years, with most disappearing entirely by adolescence.

Hemangiomas

Infantile hemangiomas, sometimes called strawberry birthmarks, are raised, red marks that appear when blood vessels grow abnormally. They are not always present at birth but typically appear within the first few weeks of life. Hemangiomas go through a growth phase for the first 6-12 months and then gradually shrink, with most resolving completely by age 5-10 years.

While most hemangiomas require no treatment, some need medical attention based on their location or size. Hemangiomas near the eyes, nose, mouth, or in the diaper area may require treatment to prevent complications. Large hemangiomas or multiple hemangiomas may also warrant evaluation by a specialist.

Port Wine Stains

Port wine stains are flat, pink to dark red birthmarks caused by expanded blood vessels in the skin. Unlike salmon patches, port wine stains are permanent and may darken and thicken over time. They can occur anywhere on the body but are most common on the face and neck.

Port wine stains on certain areas of the face may be associated with an underlying condition called Sturge-Weber syndrome, which affects the brain and eyes. For this reason, babies with port wine stains involving the forehead or upper eyelid should be evaluated by a healthcare provider.

When Will My Baby's Eye Color Be Final?

Most babies' eye color is not permanent at birth. Eye color typically stabilizes between 6-12 months of age, though subtle changes can continue until age 3. Babies with darker skin often have darker eyes at birth, while Caucasian babies are frequently born with blue or gray eyes that may change to brown, green, or hazel.

Many parents eagerly wonder what color eyes their baby will have. Eye color is determined by the amount and distribution of melanin, a pigment, in the iris. At birth, melanin production is not complete, which is why eye color often changes over the first year of life.

Caucasian babies are typically born with blue, gray, or slate-colored eyes. This is because their irises have not yet produced significant amounts of melanin. As melanin production increases over the following months, the eyes may gradually darken to green, hazel, or brown. By 6 months of age, parents usually have a good indication of what the final eye color will be, though subtle changes can continue until age 3.

Babies with African, Asian, or Hispanic heritage often have brown or dark gray eyes at birth. These eyes may become slightly darker or develop additional depth of color over time, but dramatic color changes are less common in babies who start with dark eyes.

The genetics of eye color are complex and involve multiple genes. While brown eyes are dominant, having two blue-eyed parents does not guarantee a blue-eyed baby, and two brown-eyed parents can occasionally have a child with blue or green eyes depending on the genetic variations they carry.

Newborn Vision and Eye Appearance

In addition to eye color, parents often notice other aspects of their newborn's eyes. It is normal for newborns to have puffy eyelids for the first few days, especially after delivery. This swelling typically resolves quickly.

Crossed eyes or eyes that wander are common in newborns because the muscles that control eye movement are still developing. Occasional crossing is normal until about 3-4 months of age. However, if one eye is constantly turned in or out, or if crossing persists beyond 4 months, the baby should be evaluated by a healthcare provider or eye specialist.

Many newborns develop sticky eye discharge in the first weeks of life. This is often caused by blocked tear ducts, which are very common and usually resolve on their own by age 12 months. Gentle cleaning with a warm, damp cloth and tear duct massage can help. However, if the discharge becomes yellow or green, or if the eye becomes red and swollen, medical evaluation is needed to rule out infection.

How Should the Umbilical Cord Stump Look?

The umbilical cord stump should dry out and turn black over 1-3 weeks before falling off naturally. Keep the area clean and dry, allowing air circulation. Signs of infection include redness spreading around the base, foul odor, pus, or fever. Never pull off the cord stump, even if it appears loose.

After birth, the umbilical cord is clamped and cut, leaving a stump attached to the baby's belly button. This stump undergoes a natural drying and separation process over the first few weeks of life. Understanding what to expect can help parents care for the cord properly and recognize any problems.

Immediately after birth, the cord stump appears yellowish-green and moist. Over the following days, it begins to dry out and shrinks in size. The color changes from yellow-green to brown and eventually black as the tissue desiccates. This process typically takes 1 to 3 weeks, with most cord stumps falling off between days 7 and 21.

Current guidelines recommend dry cord care, which means keeping the cord stump clean and dry without applying any antiseptics, alcohol, or other substances unless directed by a healthcare provider. Fold the diaper below the cord stump to allow air circulation and prevent urine from keeping the area moist. Dress the baby in loose-fitting clothing that does not press on the cord.

It is normal to see a small amount of dried blood or slight oozing when the cord stump separates. The area may also have a mild odor as it dries. After the cord falls off, a small raw area may remain that heals within a few days.

Signs of Umbilical Cord Infection

Omphalitis, or infection of the umbilical stump, is rare but serious. Signs that require immediate medical attention include:

• Redness that spreads beyond the base of the cord stump onto the surrounding skin
• Foul-smelling discharge or pus
• The baby seems unwell, has fever, or is feeding poorly
• Bleeding that does not stop with gentle pressure
• The cord stump remains attached beyond 4 weeks

What Are Normal Newborn Reflexes?

Newborn reflexes are automatic movements that indicate a healthy nervous system. Important reflexes include the rooting reflex (turning toward touch on the cheek), sucking reflex, grasping reflex, Moro (startle) reflex, and stepping reflex. These primitive reflexes gradually disappear within the first 3-6 months as the baby develops voluntary control.

Newborn babies are born with a set of primitive reflexes that are essential for survival and indicate that the nervous system is developing normally. These reflexes are automatic, involuntary responses to specific stimuli. Healthcare providers check these reflexes during newborn examinations to assess neurological function.

The rooting reflex helps babies find food. When you stroke a baby's cheek near the mouth, they will turn their head toward the touch and open their mouth. This reflex helps babies locate the breast or bottle for feeding. The rooting reflex typically fades by 3-4 months as the baby develops voluntary control over feeding.

The sucking reflex is triggered when something touches the roof of the baby's mouth. This essential reflex allows newborns to feed effectively from birth. Premature babies may have a weaker sucking reflex that develops as they mature.

The grasping reflex occurs when you place your finger in the baby's palm. The baby will automatically close their fingers around your finger with surprising strength. This reflex fades by about 5-6 months as the baby develops intentional grasping abilities.

Moro Reflex and Startle Response

The Moro reflex, also called the startle reflex, is one of the most noticeable newborn reflexes. When a baby feels a sudden movement or loud noise, they throw their arms out wide, extend their fingers, and then bring their arms back in toward the body, often crying. This reflex is strongest in the first month and typically disappears by 3-4 months.

Many parents find the Moro reflex disturbing because it can wake a sleeping baby. Swaddling can help minimize this reflex and improve sleep. If the Moro reflex is absent on one side, it may indicate an injury to that arm during delivery and should be evaluated.

Stepping and Placing Reflexes

When you hold a newborn upright with their feet touching a flat surface, they will make stepping movements as if trying to walk. This reflex disappears around 2 months of age and does not predict when the baby will actually learn to walk.

The placing reflex causes the baby to lift their foot when the top of the foot touches the edge of a surface, as if stepping up onto it. This reflex is present at birth and fades over the first few months.

When Should I Worry About My Newborn's Appearance?

Most newborn physical variations are normal and temporary. Seek medical attention for persistent blue color (beyond hands and feet), difficulty breathing, high-pitched or weak cry, poor feeding, fever, excessive sleepiness, seizures, or rapidly spreading rash with fever. When in doubt, always consult your healthcare provider.

While this article has focused on the many normal variations in newborn appearance, it is equally important for parents to know when something requires medical attention. Understanding the difference between normal and concerning findings helps parents feel confident in their caregiving while ensuring that problems are addressed promptly.

Newborn breathing patterns can seem irregular and concerning to new parents. It is normal for newborns to breathe rapidly (30-60 breaths per minute), pause briefly between breaths, and make occasional grunting or snoring sounds. However, certain breathing patterns require immediate attention.

Trust Your Instincts

Parents often worry that they are overreacting when they have concerns about their newborn. However, parental instinct is valuable, and healthcare providers would rather evaluate a healthy baby than miss a problem. If something seems wrong with your baby, even if you cannot pinpoint exactly what it is, seeking medical advice is always appropriate.

Building a relationship with your baby's healthcare provider during the first weeks of life helps you feel more comfortable asking questions. Well-baby visits in the first weeks are an excellent opportunity to discuss any concerns about your baby's appearance or development.