Freshly-birthed newborns are covered in goop and other fun stuff, their skin may look blotchy and rashy, and their hands and fingers might even be blue. Some parents are understandably frightened by how their newborns look, but most of the newborn features you may notice—even the icky or unsettling ones—are totally normal. It can be helpful to know what to expect so that you are not alarmed by what your baby looks like at birth. Let’s take a look at some perfectly normal features when it comes to a newborn’s appearance.
Umbilical Cord
The umbilical cord, which connected your baby to your placenta during pregnancy, can have a pretty unsightly appearance, says Molly O’Shea, MD, a pediatrician at Birmingham Pediatrics Wellness Center. “The umbilical cord looks like a semi-clear jelly and feels like it too,” Dr. O’Shea says. “It’s sort of gross.” Mitchell S. Kramer, MD, chairman of the department of obstetrics and gynecology at Huntington Hospital, says that the umbilical cord, more specifically looks whitish with a blue tint, and has a rubbery feel to it. “It can be as long as 2 feet or more, or as short as 10 inches,” he notes. “The umbilical cord stump usually will have a cord clamp on it and as it dries, it darkens and shrinks,” Dr. Kramer describes. The nursery staff at the hospital as well as your pediatrician will discuss how to care for the cord stump, he says. These days, the advice is to usually leave the cord stump alone. It’s important that it stays dry until it naturally falls off, according to the American Academy of Pediatrics (AAP). So that means no immersive baths, though sponge baths are fine. You can fold your baby’s diaper down so it doesn’t make contact with the stump. There is no need to clean it with alcohol either.
Vernix
Vernix is a creamy, waxy white substance that covers a baby’s body at birth. Parents may be taken aback by just how much vernix is on their baby and may be in a rush to have it removed. But vernix is actually good for your baby, says Alexandra James, MD, a pediatrician at the University of Missouri Health Care. Vernix protects your baby’s skin and has some germ-fighting capabilities as well, says Dr. James. Vernix acts as a natural moisturizer for baby skin, and also has antibacterial qualities. This is why the AAP advises leaving it on your baby’s skin for a while and not bathing your baby immediately after birth. Dr. James agrees. “Newborns typically get a bath in their first 48 hours of life, so this white substance may stay on for a while, and that’s a good thing,” she says.
Birthmarks
Birthmarks are common for newborns—many will be born with one kind of birthmark or another. “Most birthmarks are nothing of concern,” Dr. Kramer says. However, any birthmark your baby has should be checked out by your pediatrician. If a birthmark is unusually large or dark, a specialist may need to examine your baby, Dr. Kramer advises. Let’s take a look at the different kinds of birthmarks newborns could have, and what to know about them.
Stork Bites and Angel Kisses
Sometimes called salmon patches, stork bites and angel kisses are tiny red marks that are found on a baby’s face, eyelids, upper lips, and the backs of their necks. They occur as a result of stretched blood vessels and usually fade in a year or two.
Port-Wine Stains
Port-wine stains are purplish, reddish marks that usually appear on the face and neck. They are vascular birthmarks and are permanent. You can speak to a pediatric dermatologist about how to treat these birthmarks, if desired.
Congenital Nevi
Congenital nevi are brown pigmented moles that are present at birth. They tend to get darker as your child gets older. Most are small, but some are large and cover large parts of a child’s body. If your child has a large nevus, you should visit a pediatric dermatologist. Some will need to be removed down the road.
Hemangiomas
Often referred to as “strawberry birthmarks,” hemangioma birthmarks may be light at birth and then become a deeper red and slightly raised. Hemangiomas usually fade on their own within the first six years of a child’s life.
Cafe-Au-Lait Spots
Cafe-au-lait spots are light brown and flat and resemble the color of coffee with added milk. A child may have several of these spots, and more may appear in time. If a child has a large number of spots or if the spots are large, you should visit your healthcare provider to rule out a condition called neurofibromatosis.
Dermal Melanocytosis
Formerly called Mongolian spots, dermal melanocytosis are flat, blue or gray spots that can be very large at times, and are often found on the buttocks or back. They are most common in people of African, Asian, and Native American descent. They are not harmful and usually fade in a few years.
Lanugo
After birth, your baby may be covered in a fine hair called lanugo. Some babies can be quite hairy, but it’s nothing to be alarmed about, says Jee Shim, MD, OB/GYN at Long Island Jewish Forest Hills Hospital and a clinical assistant professor at Zucker School of Medicine at Hofstra/Northwell. “Lanugo is very fine, soft hair that you may see on your baby’s face, back, neck and arms and legs,” Dr. Shim explains. “Some parents may notice it and become concerned that their baby will grow up to be ‘very hairy’ but it will resolve in a couple of weeks as well.” Some of the lanugo is shed before a baby is born, which is why premature babies may have more lanugo than full-term babies. Either way, the hair will be gone within a few days or weeks.
Misshapen Heads
All babies are different, but some—especially babies born vaginally—will have misshapen heads at birth. Thankfully, this should resolve in due time, says Dr. Shim. “Parents may notice, especially after a vaginal birth, ‘cone head’ or ‘cone-shaped head,’ which may happen when babies have to make their way through the vaginal canal, but this will resolve and return to its round shape in a couple of days,” Dr. Shim explains.
Caput and Cephalohematoma
You may also notice some lumps on your baby’s head. These are usually nothing to be concerned about and resolve on their own. Pressure from birth may cause swelling and lumps on your baby’s scalp called caput. “Caput is swelling of the baby’s scalp—edema, usually from pushing during the last stage of labor,” Dr. Kramer explains. “These changes resolve usually within 24 hours or less.” “Blood collects due to the pressure as the baby’s head is pushed through a tiny space,” says Dr. O’Shea. “The blood will be slowly absorbed by the body over a couple of weeks.” The only thing you need to watch for is jaundice, as cephalohematomas can increase that risk, Dr. O’Shea notes. Your pediatrician will be looking for signs of jaundice during routine check-ups, but be sure to speak to your healthcare provider if your baby is looking more yellow than usual, is lethargic, or is having trouble feeding.
Blue Hands and Feet
It’s our instinct to worry if we see someone’s hands and feet turn blue. But infants are often born with blue hands and feet, and it’s usually not something to be concerned about. Blue hands and feet in newborns is called acrocyanosis, and it’s a normal occurrence right after birth and for your baby’s first few hours of life. Your baby may also get cold and get blue hands and feet when they take a bath. “It is normal for babies to have blue hands and feet throughout the first few weeks of life,” says Dr. James. “Parents should check around the mouth and in the center of the body, like the chest. If these areas are pink, it is OK.”
Looking “Floppy” and Fragile
Besides blue hands and feet, your baby may generally look a little floppy and fragile at the time of birth, and this is normal, too, says Dr. O’Shea. Still, it can be scary for parents to witness. “Right after birth, some babies are quite floppy and exhausted from the process of birth and as they are whisked to the warmer for assessment, some parents think their baby isn’t alive,” she describes. “The blood and goop from birth all over the baby add to the feeling of worry.” But this is typically all very temporary, Dr. O’Shea says, and your baby should perk up very soon. “After getting wiped off and warmed up, you’ll often hear your baby’s cry and breathe a sigh of relief,” she says.
Rashes, Milia, and Acne
Seeing a newborn with a rash or little bumps on their skin can be very worrisome! The truth is that baby skin is sensitive and is prone to certain rashes and skin conditions. For example, your baby may have something called milia on their face, which are tiny white bumps. They also may have erythema toxicum, which causes red pustules to appear on legs, arms, face, and trunk a few days after birth. Your baby may even get a case of acne a few weeks after they are born. All of this is common, Dr. O’Shea assures. “Red pustules and rashes are common in the early days of life,” she says. “A good rule of thumb is if your baby is acting fine, eating well and the only way you knew the rash was there was that you undressed your baby, the rash is not likely to be a problem.”
Flaky Skin
Your baby will generally have very sensitive skin, and you shouldn’t be surprised if some of it starts to flake off, says Dr. O’Shea. This may happen on the second or third day after birth. Again, this is a completely normal and common occurrence. “Some babies’ skin will completely shed, almost like a snake,” Dr. O’Shea notes. “No moisturizing needed, the skin underneath is fine!”
Vaginal Discharge and Bleeding
If you have a baby girl, you may notice that she has a little white vaginal discharge or even a little vaginal bleeding. This is due to the influence of the birthing parent’s hormones. “It is normal for a newborn girl to have white vaginal discharge,” says Dr. James. “At 2 weeks of age, infant girls can even have a small amount of vaginal bleeding as mom’s hormones go away.”
A Word from Verywell
It’s OK to feel disappointed or taken aback by your newborn’s appearance. In due time, your baby will look like a more traditional “cute baby,” but how they look now has its own delicate sweetness. They will never again be this little and brand new, so try to soak it all up while it lasts. While things like rashes, bumps, birthmarks, and blue hands and feet are usually normal, you should not hesitate to reach out to your baby’s pediatrician if you have concerns about any of these things. They are there to answer your questions and to make sure your baby is healthy.
