Newborn Health Tips From Sutter Health

As you enjoy baby snuggles and gaze at your newborn in awe, you may notice some things you didn’t expect. Is that dandruff? Does my baby have acne? Why is she losing weight? The good news is: A lot of what you’re seeing is perfectly normal.

So, what newborn symptoms are normal, and when should you see a doctor about your new baby? Here are the answers to the most common questions we get from parents and some newborn health tips to help you get through these early weeks stress-free.

Is my baby’s weight loss normal?

Many babies lose approximately 7% to 10% of their birth weight during their first days of life. Babies are born with fat reserves and usually regain that weight by 2 weeks of age. Frequent around-the-clock feedings at least every two to three hours will help prevent a major drop in weight, says Catherine Pourdavoud, M.D., a pediatrician with Sutter.  

“Initially, both breastfed and bottle-fed babies need to be fed at least 8 to 12 times in a 24-hour period,” she says. “After the initial weight loss, the goal is for most babies to gain about 1 oz of weight a day.”

You don’t need to weigh your baby at home unless directed by your pediatrician. Your baby’s weight will be checked at their first newborn check up after you leave the hospital.  

If you’re worried about your baby’s weight, contact your pediatrician.

Does my baby have dandruff?

What you’re probably seeing is commonly called “cradle cap.” It’s a common condition that looks like a yellowish or whitish, scaly, patchy area over part of the baby’s scalp or sometimes behind the ears or on the eyebrows. It usually begins once babies are several weeks old and is not harmful.

Daily washing and/or brushing may help prevent cradle cap. If your baby has cradle cap, apply mineral oil or coconut oil, wait 15 to 20 minutes, and then use a baby comb, fingernail brush or soft toothbrush to gently scrub the affected area during bathtime. Be sure to wash all the oil off the scalp with shampoo or a mild soap after. Repeat during bathtime until the cradle cap is gone.

Should I worry if my baby’s eyes are puffy?

During the first few days of life, your baby’s eyes may look puffy from the birth process. This should go away on its own. Babies also commonly may have watery eyes or constant tearing out of one or both of their eyes due to a clogged tear duct.

“This usually resolves by the time a baby is 1 year old,” Pourdavoud says. “A specific gentle massage called the Crigler massage several times a day as tolerated can be helpful.”

It’s common for a newborn’s eyes to have poor control and appear cross-eyed. This should lessen as the eye muscles get stronger, around 4 months. Newborns’ eyes usually look blue-gray or brown but can change. In general, your baby’s permanent eye color will be visible within six to 12 months.

Call your baby’s healthcare provider if your baby has constant yellow or green drainage from one or both eyes, redness in the whites of their eyes, difficulty opening their eyes or matting of the eyelashes.

Is it normal for my baby to have breasts?

Whether your baby is a boy or a girl, their breasts may be temporarily swollen due to normal hormones passed to the baby while in the uterus. A very small amount of thin milk may be seen at the nipples. Don’t squeeze the breasts to remove this milk. It will disappear once the hormones leave your baby’s body and is not dangerous.  

“If you notice any increased swelling, redness, warmth or other concern in the breast area, it is important to see your pediatrican for an evaluation,” Pourdavoud says.  

How can I trim my baby’s nails safely?

To trim your baby’s fingernails or toenails to prevent accidental scratching, you can try:

• Filing the nails gently with an emery board (preferred)
• Gently trimming the nails with round-edged or stainless-steel baby scissors or baby clippers. Cut straight across the nail, not in the corners. Be very careful not to cut baby’s skin.  
• No matter which approach you take, it may be easier to do when your baby is sleeping or busy feeding.

Why does my baby’s head have soft spots?

At birth, there are two soft spots (called fontanels) on the top of the baby’s head. The larger spot is diamond shaped and toward the front. The smaller one is located at the back of the head. These soft spots are areas where the bones of the skull have not yet grown together. The smaller one closes within two to three months after birth. The larger one usually closes by nine to 18 months. The fontanels have a tough membranous covering, so the scalp can be gently brushed and shampooed without harming your baby.  

Will the shape of my baby’s head change?

A newborn’s head is large in comparison to the rest of their body. At first, your baby’s head may not be round because passage through the narrow birth canal causes the bones of the skull to squeeze together and mold the head.

Your baby’s head may be elongated or have a cone shape after birth. Their scalp can also have bruising or swelling from delivery. That’s normal and the head usually returns to a rounder shape in a few weeks.

Is it normal for my baby to have acne?

A red pimply rash known as “baby acne” may break out on your baby’s face during the third or fourth week of life. This rash seems to bother parents more than babies. No treatment is usually necessary other than gentle washing with a mild soap and water. It’s caused by the stimulation of the baby’s oil glands due to the increased hormones passed from the mother to baby at birth.

You might also see milia, which are pinhead-size white spots on your baby’s nose, cheeks or chin caused by blocked sweat and oil glands. They'll disappear without treatment in several weeks when the glands begin functioning. Wash your baby’s face with water and a washcloth while milia are present. Don’t try to remove or squeeze them.

And those fine hairs some babies are born with? That’s called lanugo. This fine, downy hair is most noticeable over a newborn’s back, shoulders, forehead, ears and face. It is more obvious in premature babies and will disappear during the first few weeks of life.

How should I care for my baby’s belly button?

The stump of the umbilical cord, which remains temporarily attached to the belly button, should be kept clean, dry and free from diaper irritation.

Follow cord care instructions given by your baby’s healthcare provider. But in general:

• If the cord becomes soiled, clean it thoroughly with a  wipe or a wet washcloth with soap and water, making sure not to submerge the belly button in water until the cord falls off completely. Dry thoroughly with a clean cloth.
• When diapering your baby, fold the front edge of the diaper below the healing navel, so it doesn't irritate the area or add moisture.
• The stump will usually fall off between one and three weeks after birth. There’s often a pinkish discharge after the stump falls off. This is normal and doesn’t need to be treated. The discharge will resolve after a couple days and the area should be dry.

If you see any excessive bleeding, unusual or prolonged discharge, redness, swelling, irritation or bad odor around the navel, or if the belly button still doesn’t look dry several days after the stump has fallen off, call your baby’s doctor.

What can I do about diaper rash?

Diaper rash consists of red patches with tiny pimple-like bumps that appear in areas covered by the diaper. It can be caused by urine, stool, some laundry products, too much ammonia in cloth diapers that aren’t washed well, chemicals used in some disposable diapers, or unknown causes. Exposing the skin to air improves healing. Protective barrier ointments are available in drug stores.

Once the rash is present, Dr. Pourdavoud recommends a zinc-oxide based diaper ointment to help it improve. Call your baby’s healthcare provider if a rash won’t go away.

What does heat rash look like?

This is common during warm weather and with babies who are overdressed or overwrapped. It appears most often in the shoulder and neck regions and looks like clusters of tiny pink blemishes. (When it begins to dry, it looks slightly tan.) The rash looks worse than it probably feels to the baby.  Dress your baby for the same temperature and comfort level as yourself — keep them cool and dry, and choose clothing similar to what you would wear in those conditions.

Why does my baby do that?

Most of your baby’s behaviors in the early days and weeks are involuntary  reflexes, such as yawning, quivering, coughing, sneezing, stretching and hiccupping. Some of these reactions help ensure your baby’s survival, while others help relieve irritation. For example:

• Grasp reflex: If you touch the palm of your baby’s hand, they’ll grasp your finger firmly. This reflex disappears soon after birth. The feet show the same reaction as the hands, but the reflex lasts longer in the feet.
• Hiccupping: Hiccupping is common in newborns and is not a cause for concern. Hiccups will stop on their own and don’t require any special attention on your part.
• Moro or startle reflex: When a newborn is startled, they will initially stretch out the arms and legs and straighten the body, then curl up. This response will be less noticeable by four months of age and usually disappears by the sixth month.  
• Rooting reflex: Lightly stroking your baby’s cheek or lower lip will cause your baby to turn their head in that direction and open their mouth. Stroking the lower lip can be helpful with latching while breastfeeding. To avoid confusing your baby, don’t stroke your baby’s cheek once they’re latched on.
• Standing and walking reflex: If a newborn is supported upright on their feet, the baby will stand and imitate a walking motion. These reflexes usually disappear by the second month.

Is this mark on my baby normal?

There’s a range of what’s normal in newborn skin. Here are a few common conditions that aren’t a cause for concern:

• Birthmarks: Many types of birthmarks can be found on various parts of your baby’s body. If your baby has any unusual marks, discuss them with your baby’s healthcare provider before going home. Many birthmarks will fade over time.
• Blue-slate spot or slate-gray nevi: These spots are greenish-blue pigmentation commonly seen on the lower back or buttocks area, primarily in dark-skinned babies. They aren't painful or cause for concern and usually fade over time.
• Mottled skin or blue hands and feet: A newborn’s skin can remain slightly see-through for several weeks and have purplish blotches, especially in fair-skinned babies. It’s also common for newborns to have bluish hands and feet (called acrocyanosis) since their circulatory system isn’t fully developed yet.
• Peeling skin: During the first few weeks, your baby may have peeling or cracking of the skin, especially on the wrists, hands, ankles and feet. Overdue babies seem to peel more than babies born closer to their due date. This is normal, and no treatment is necessary. If you would like to moisturize baby’s skin, look for an over-the-counter cream that’s gentle, dye-free and fragrance-free.
• Nevus simplex (“stork bites”): Occasionally, blood vessels close to the skin are visible on the back of the baby’s neck, eyelids, nose or forehead. These are often called “stork bites” or “angel kisses.” They usually fade or disappear over several months.
• Vernix: Vernix is the white creamy substance that protected your baby’s skin before birth. It can remain in the creases of the skin for several weeks, even after bathing. There's no need to remove it as it continues to provide protection for your baby’s skin until it’s completely absorbed.