By now it is obvious to you that your baby's personal characteristics are unique to him or her. However, there are some general physical developments which most baby's share. We hope the following guidelines and descriptions of these physical changes and traits will be helpful to you as you watch your newborn develop in the next few weeks.

• Bowel Movements
• Breasts
• Breathing
• Cradle Cap
• Eyes
• Fingernails & Toenails
• Fontanels (soft spots)
• Genitalia (female)
• Genitalia (male)
• Head and Face
• Jaundice
• Lanugo
• Milia
• Navel & Umbilical Cord
• Rashes
• Reflexes
• Senses
• Skin

Bowel Movements

The baby's first bowel movements are comprised of a sticky, greenish-black material called meconium which was in the baby's intestines during pregnancy. If you are breastfeeding, the colostrum acts as a laxative and assists the baby with moving his bowels. Meconium stools are present for about two days following birth.

Later, it is normal for babies to have yellow, or slightly brown-yellow stools. The number of stools per day and their consistency varies from baby to baby, and with the method of feeding — bottle or breast. A breastfed baby will generally have loose, seedy stools and a bottle-fed baby will have stools which have a more pasty appearance. It may be normal for your newborn to have one to ten stools per day. Constipation is usually indicated by a hard, dry stool whereas diarrhea is usually mucousy, thin and watery, and may have a foul smell.
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Breasts

Your baby's breasts, whether boy or girl, may be temporarily swollen due to the mother's hormones which are passed to the baby while in the uterus. A very small amount of thin milk may be seen at the nipples. Do not squeeze the breasts to remove this milk; it will disappear once the hormones are no longer present.
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Breathing

Babies breathe solely through their nose for the first few months. It is normal for a newborn to have periods of irregular breathing. While your baby is sleeping he may snort or even pause in his breathing briefly. Your baby's breathing pattern will appear to be more regular in about a month or two.

It is common for some babies to sneeze frequently in order to clear moisture out of their nose, as nasal hair has not yet formed. This is considered normal and not a cause for concern.

If your baby has a lot of mucus, making it difficult for him to breathe, you can remove it with a bulb syringe. Follow these steps:
• Squeeze the air out of the bulb syringe
• Gently insert the tip into the baby's nostril
• Release the pressure and remove the mucus
• Remove the syringe and discard the mucus
• Repeat with the other nostril
• Clean the bulb syringe by flushing it with hot soapy water

In addition to using the bulb syringe, try these other tips:
• Raise the head of your baby's bed.
• Use a cool mist vaporizer in your baby's room.
• The use of saline drops in your baby's nose may help to soften mucus.
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Cradle Cap

Cradle cap is a common condition which appears as a yellowish, scaly, patchy area over part of the scalp, or sometimes behind the ears. Daily washing or brushing may help prevent cradle cap. Using a baby comb, a fingernail brush, or a soft toothbrush, gently scrub the affected area with mild soap and continue this procedure each day until the cradle cap is gone.
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Eyes

During the first few days of life your baby's eyes may appear puffy due to the birth process and the medication used in the infant's eyes to help prevent infection. It is common for a newborn's eyes to have poor control or appear cross-eyed. This should decrease as the eye muscles strengthen. Newborns' eyes usually look blue-gray or brown. In general, your baby's permanent eye color will be apparent within six to 12 months.
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Fingernails & Toenails

You may wish to trim your baby's nails to prevent accidental scratching. Several options include:
• Filing the nails with an emery board.
• Trimming the nails with round-edged, or stainless steel baby scissors or baby clippers (available at Newborn Connections). Cut straight across the nail, not in the corners.

Be careful when cutting your baby's nails. They are very soft and may be difficult to distinguish from the finger tip. Any of these methods may be easier to do when your baby is asleep or busy feeding.
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Fontanels (soft spots)

At birth, there are two soft spots, or fontanels, on the baby's head. The larger is diamond-shaped and toward the front on the top of the head; 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 six months, and the larger one usually closes by 18 months. The fontanels have a tough membranous covering, so the scalp can be gently brushed and shampooed without causing harm to your baby.
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Genitalia (female)

A white coating called vernix may be present between the labial folds of a female baby; this coating is normal and doesn't need to be washed off. A clear, mucus-like discharge, sometimes blood-streaked, may occur and is also a normal result of the mother's hormones. During bathing and diaper changes, gently clean the vaginal area by spreading the labia and wiping from front to back.

Both male and female newborns may have swollen genitals because the mother's hormones are passed to the baby prior to birth.
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Genitalia (male)

Most newborn boys' scrotums are swollen at birth, and will return to normal within about a week.

Care of the Penis
In general, whether cleaning the circumcised or uncircumcised penis, avoid the use of premoistened towelettes, alcohol, powders, and lotions, as these substances may cause or contribute to irritation.

Uncircumcised
The uncircumcised penis of a newborn requires no special care.
• Wash the penis with warm, soapy water just as you would any other part of his body.
• Do not retract the foreskin. As your baby gets older, you'll find that the foreskin will become easier to retract, although it may not retract completely for many years.

Circumcised
For a day or two following circumcision, your baby may be more irritable. No special cleaning procedure is required for the circumcised penis other than wiping around the penis with a clean, warm, wet cloth. It is normal for the first few diaper changes to show some spotting of blood and for a healing penis to have a whitish coating on the tip. As the penis heals, follow these simple steps to keep your baby comfortable:
• Cloth diapers may be recommended until the penis heals.
• If the diaper sticks to the penis, wet the diaper to loosen it. Spread a dab of Vaseline on the area of the diaper that has contact with the penis to help prevent further sticking.
• Keep the area clean and dry to promote healing.
• The best sleeping position for your baby is on his back.

Once the circumcised penis heals, normal washing is sufficient.

Discuss the pros and cons of circumcision with your health care provider prior to delivery. NOTE: Many insurance companies will not cover circumcision as it is considered elective surgery.

Read more about Deciding on Circumcision


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Head and Face

A newborn's head is large in proportion to the rest of his body. Initially, your baby's head may not be round because passage through the narrow birth canal requires the bones of the skull to squeeze together and elongate (mold) the head. The head returns to its normal shape, usually within a few weeks.
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Jaundice

A small amount of jaundice, or yellow color of the skin and eyes is common in many full-term babies and even more common in premature babies. If it occurs, it usually appears in the first three to five days of life and typically disappears by the end of two weeks without treatment. Notify your health care provider if you notice any yellow color to your baby's skin.

To check for jaundice:
1. Undress your baby and place him on a white sheet or blanket.
2. Gently press on his nose, then chest, then leg. Note if there is a yellow color to the skin when you release your finger.

Causes of jaundice:
• Most jaundice is caused by an excessive accumulation in the blood of bilirubin, a by-product of the breakdown of red blood cells.
• Newborns have proportionately more red blood cells than adults. Also, their livers are immature and less able to effectively break down the bilirubin.
• Certain conditions which increase the likelihood of jaundice include:
-not being fed often or long enough
-prematurity
-Rh negative mom with Rh positive baby
-blood type incompatibility
-bruising to the baby during birth

Bilirubin is measured by taking a small blood sample.
• If the bilirubin level is minimally elevated, treatment may include both:
-placing the baby by a sunny window
-frequent breast milk or formula feedings (not water) to help in the elimination of bilirubin.

•If the bilirubin level is of concern, treatment may include:
-phototherapy (exposing the baby's skin to a special light source) to help break down the bilirubin. This can be done in the hospital, but is often done in your home.
-frequent breast milk or formula feedings (not water) to help in the elimination of bilirubin.
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Lanugo

Lanugo is fine, downy hair which is most noticeable over a newborn's back, shoulders, forehead, ears, and face. It is more pronounced in premature babies and will disappear in the first few weeks.

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Milia

The pinhead-size white spots on your baby's nose, cheeks or chin are due to blocked sweat and oil glands. They will disappear without treatment in several weeks when the glands begin functioning. Wash your baby's face with water and a washcloth while they are present; do not try to remove them.
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Navel & Umbilical Cord

The stump of the umbilical cord, which remains temporarily attached to the navel, should be kept clean, dry, and free from diaper irritation. Report any bleeding, unusual discharge, redness, swelling, irritation or bad odor around the navel to your health care provider.

• Although cleaning with alcohol has been common practice, recent studies have shown there is no benefit with this method.
• Avoid bathing your baby in a tub until the umbilical cord has fallen off. Sponge baths are preferred until that time. See page 18.
• When diapering your baby, fold the front edge of the diaper below the healing navel, so it doesn't irritate this area or add moisture.
• Usually the stump will fall off between seven and 14 days after birth, but may stay attached up to a month.
• After the stump has fallen off, there is often a pinkish discharge from the navel. This is normal and doesn't need any treatment.
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Rashes

Baby 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 the baby. No treatment is usually necessary other than gentle washing with a mild soap and water. It is caused by the stimulation of the baby's oil glands due to the increased hormones passed from the mother to baby at birth.

Diaper Rash
Irritation to your baby's skin can be caused by urine, stool, some laundry products, excessive ammonia retained in the diaper from inadequate washing, chemicals used in some disposable diapers, or often unknown causes.

Heat Rash
This is common during warm weather and with babies who are kept overdressed or over wrapped. 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 apparently feels to the baby. The best treatment is to keep your baby cool and dry and dress the baby as you dress yourself.
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Reflexes

Most of your baby's behaviors in the early days and weeks are involuntary reflexes. Typical reflexes are yawning, quivering, coughing, sneezing, stretching, and hiccuping. These reactions help insure your baby's survival while others help relieve irritation.

Grasp Reflex
If you touch the palm of your baby's hand, he will grasp firmly. This reflex disappears soon after birth. The feet exhibit the same reaction as the hands, but in the feet the reflex continues for a longer period.

Hiccuping
Hiccuping is common in newborns and is not a cause for concern. Hiccups will stop on their own and do not require any special attention on the parent's part.

Moro or “Startle” Reflex
When a newborn is startled, he will initially stretch out all his limbs and straighten his body, then curl up. By the fourth month this response will be less noticeable. By the sixth month, usually, this reflex will have disappeared.

Rooting Reflex
Lightly stroking your baby's cheek or lower lip will cause your baby to turn his head in that direction and open his mouth. Stroking the lower lip will be helpful with latch on while breastfeeding. Avoid stroking your baby's cheek once he is latched on as it will confuse your baby.

Standing & Walking Reflex
If a newborn is supported upright on his feet, the baby will stand, carrying some of his body weight, and will imitate a walking motion. These reflexes usually disappear by the second month.

Sucking
Newborns have a strong sucking desire. Sucking is needed not only to ensure nourishment, but as a self-calming method (non-nutritive sucking). Sucking motions do not necessarily indicate hunger. Evaluate your baby's needs before feeding.
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Senses

All five senses are functioning at birth enabling newborns to respond to their environment in many ways.

Hearing
A baby's hearing is well developed even in the uterus and is evidenced by the startle or Moro reflex in response to loud noises (see above). Babies are able to recognize both of their parents' voices immediately after birth. However, babies are more attentive to high pitched voices, as they hear best in the higher ranges.

Sight
Your baby may be fascinated by dramatic contrasts such as black and white shapes, but will be most responsive to your face. A routine application of eye ointment is given after birth to prevent possible eye infections, which may blur his/her sight for a brief period of time.

Taste and Smell
There is evidence that a newborn has the ability to respond to sweet, salty, sour and bitter tastes as well as to a variety of smells. Newborn babies have been observed to distinguish their mothers' clothing from others solely by a sense of smell.

Touch
Touch is your baby's first sensation. Most of your early contacts will involve touch as you cuddle, rock and caress your new baby. Feeding, whether by breast or bottle, affords an ideal time for you to give your baby this essential close physical contact.
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Skin

Birthmarks
There are many types of birthmarks which may be found on various parts of your baby's body. If your baby has any unusual marks, discuss them with your health care provider before going home. Many birthmarks will fade over time.

Mongolian Spots
A greenish-blue pigmentation seen on the lower back area, primarily in dark skinned babies is called Mongolian spots. These spots are not painful or cause for concern and usually fade over time.

Mottled Skin/Blue Hands and Feet
Newborns' skin can remain slightly transparent for several weeks and have purplish blotches. This is particularly true of fair-skinned babies. Due to immature circulation, it is common for newborns to have blue hands and feet.

Peeling Skin
During the first few weeks, your baby may have peeling or cracking of the skin, particularly at the wrists and 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.

Stork Bites
Occasionally, blood vessels close to the skin are visible on the back of the baby's neck, eyelids, nose, or forehead. These will usually fade or disappear in several months.

Vernix
This is the white creamy substance which protected your baby's skin before birth. It can remain in the creases of the skin for several weeks, even after bathing. There is no need to remove it as it continues to provide protection for your baby's skin.
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