Your Baby’s Body
Your baby is born with a soft spot on the top of his head known as the fontanel. This is the area where all of the skull bones come together. The fontanel is ‘open’ to allow the bones to grow and make room as the brain grows. Sometimes, you can feel a second soft spot at the back of the head as well. Do not be afraid of the soft spots. It takes a lot of force to cause any damage to your baby.
When your baby is first born, during the first week of life there may be small white flakes in the scalp. This is old skin that the baby is shedding and is completely normal. It may also be accompanied by peeling of the skin on other areas of the body.
Thick, stuck on yellow plaques are known as “cradle cap.” These are basically the oils of your baby’s skin that collect and dry on the scalp. The best way to prevent this is to wash your baby’s scalp with a gentle shampoo several times a week and to be sure to massage the scalp with a soft-bristled baby brush when you wash. Should your baby develop the plaques anyway, you can often remove them by adding a small amount of baby oil to the scalp and brushing with the baby brush or gently scraping with your nail. The oil helps to dissolve the plaques.
The face is one of the more common areas for babies to develop rashes. This is mostly because your baby’s face comes into contact with your face, hands, and lips as well as those of your friends and family, and with formula or breastmilk when the baby is feeding. The best way to prevent rashes is to limit your touching or kissing the baby’s face. Instead, try to kiss their head. It also helps to clean the face after each feeding. If your baby should begin to develop a red, slightly raised rash, try applying a gentle, unscented lotion such as Eucerin or Aveeno after cleaning the face with water. Do this several times a day. If there is no improvement or the rash is getting worse, please contact your pediatrician.
Babies will also frequently have small pimples that come and go, known as baby acne. These are due to the presence of maternal hormones in the baby’s body. Typically, this will resolve after 2-3 months. If the bumps are getting worse, let your pediatrician know. Never try to pop these bumps as you can cause damage and introduce infection.
The neck and underarms are very common places for babies to develop a moist rash due to the skin being folded onto itself. Moisture becomes trapped and can irritate the skin. The best prevention is to keep these areas clean and dry. If you notice a rash appearing, try applying a small amount of medicated baby powder with your fingers, being careful not to make a ‘dust cloud’ that your baby could inhale. NEVER shake the powder directly from the bottle onto your baby. This is a sure way to cause your baby to inhale the powder and can be very dangerous.
Babies have very soft, sensitive skin and are, therefore, more susceptible to irritation and rashes. When using lotions or soaps on your baby, it is best to use the most gentle cleansers designed specifically for babies. Some babies may be more susceptible to irritation and may break out in a rash, even with these lotions. The other source of irritation that many parents do not think about comes from the chemicals in your baby’s clothes. You should always wash the baby’s clothes with gentle laundry detergent such as Dreft, and never use dryer sheets or fabric softener in the wash. These unnecessary chemicals will often cause pesky rashes for your baby.
Babies are often born with small white bumps on the nose and chin known as milia. These bumps are due to skin gland secretions and will disappear in the first 2-3 weeks of life. Again, never try to pop these bumps as you can cause damage and introduce infection. Any rash that develops in your baby that you are concerned about, please contact your pediatrician and discuss your concerns. We are always happy to take a look at any rash and to make sure that there is not a problem.
The first question many parents ask about the eyes is, “When will my baby have his permanent eye color?” Babies are all born with a blue-gray hue to the iris of the eye. Over the first year of life, a baby’s eye color can continue to change, therefore, we tell parents that you may not know for sure until one year of age.
When babies are born, the muscles of the eyes are still developing. For this reason, babies will sometimes appear to be crosseyed. As long as the eyes return to normal position, there is no cause for concern. This will usually resolve by 6 months of age.
Eye discharge is another frequent concern of parents. Sometimes babies are born with a condition known as lacrimal duct stenosis which causes one or both eyes to tear more than usual. The discharge will always be clear with this condition. The treatment is to massage the inner corner of the eye with a warm washcloth several times a day to help open the duct. Usually this will resolve by 6-12 months. If it is severe, or if it does not resolve on it’s own, an ENT physician may need to use a special probe to open the duct. Any discharge with color (white, yellow, green, etc.) should be seen by your pediatrician immediately as this may be a sign of infection. Also, any redness should be seen by your pediatrician.
Babies are born as obligate nose breathers. This means that they rely on their nose to breathe. For this reason, any time that a baby becomes congested, he will have difficulty breathing. Every parent should have a nasal aspirator bulb to use to clear the nose when it becomes congested. You can also place a few drops of saline into the nostrils to help loosen up the congestion prior to using the aspirator.
When babies finish feeding, they sometimes will not swallow all of the formula or breastmilk left in their mouth. When this sits in the mouth, it becomes a good medium in which yeast can begin to grow. This condition is known as thrush and appears as white spots usually on the inside of the cheeks and on the tongue. If you should notice white spots, please let your pediatrician know. Sometimes right after a feed, there will be formula on the tongue that can appear white. If you can wipe the white discoloration off with a soft cloth, it is not thrush. If your baby has a problem with thrush, you can wipe the inside of the cheeks after each feed to remove the extra formula.
Frequently parents ask us about cleaning their baby’s ears. The reality is that most babies do not need to have their ears cleaned unless there is excessive wax production. Always talk to your pediatrician before cleaning the ears. Any ear discharge or drainage should be seen by your pediatrician. Never push any object, including Q-tips, into the ears as you can damage the eardrum. If you can see visible wax on the rim of the ear canal, you can gently rub a Q-tip around the rim without placing the Q-tip into the ear. Now the makers of Q-tips have come out with a safety Q-tip for infants which has a large base with a very short tip that prevents the Q-tip from entering into the ear canal. This type is generally safe to use on your baby.
When giving your baby a bath, it is always a good idea to avoid getting excessive water in the ears. Moisture in the ear canals can lead to bacterial overgrowth and infection. It is not necessary to use any ear plugs, simply avoid pouring water directly over the ear. You can shield the ear with your hand when you rinse the scalp.
Babies have very soft fingernails, but they tend to grow fast. Most babies will scratch themselves on the face if their nails are not kept trimmed. Babies are not coordinated and reflexively grab at whatever comes into contact with their hands. When the hand touches the face, they will grab it and scratch themselves. The best way to trim the nails is to purchase a baby nail trimmer and to attempt to cut the nails when your baby is calm or asleep. Gently grasp the finger and pull back on the fingertip gently to expose the nail. Slide the trimmer around the nail and avoid cutting it too short as you may trim the skin on the finger as well. Inevitably, you will clip your baby’s skin at some point because the fingers are so small, and the nails can be hard to trim. Do not let this deter you from trying. It is best for your baby to keep the nails trimmed. The other trick you can do to prevent scratching is to put mittens or socks on the hands.