Your newborn baby’s skin

Newborn babies have fragile delicate skin which is vulnerable to trauma from friction and pressure. Babies also have plenty of skin creases on the palms of their hands and soles of their feet. If your baby was born post mature (ie were over due), you may also notice that the skin of their hands and feet is quite dry and is peeling. This is because your baby was exposed to amniotic fluid (also called ‘liquor’ and the ‘waters’) without being protected by vernix caseosa (see below).

The colour of your baby’s skin will depend on their ethnic origin. Babies with darker skin tones have deeper pigmentation of their nipples and genitalia (nappy area); particularly, the scrotum in male infants. Another feature of a baby’s ethnic origin is the Mongolian blue spot. This is a bluish mottled area of skin, which can look rather like a bruise, but unlike a bruise does not fade. Mongolian blue spots are found in babies with dark skin tones but can also appear in babies with paler skins. They tend to present over the sacral area of your baby’s back (ie lower back) or their buttocks (bottom). There have however, also been cases where Mongolian blue spots have presented on babies legs, ankles and feet.

Congestion of the face (also called traumatic cyanosis)

This refers to the bluish tinge of the skin on your baby’s face and head; it is caused by small pin-head bruises in the skin (called petechiae). Petechiae are the result of the nature of your baby’s birth; particularly where you have had a rapid labour and birth. They are also commonly seen where the baby is born with the umbilical cord wrapped tightly around its neck. Babies who are born with congested faces are more likely to develop facial jaundice as the petechiae fade.

Vernix caseosa

When you look at your newborn baby you may notice that the surface of their skin is covered in a white, creamy substance called ‘vernix caseosa’. This creamy substance works rather like a long-distance swimmer covering their body with goose fat. Vernix helps to protect your baby’s skin so that they aren’t born ‘wrinkly’ from spending nine months in the amniotic fluid. If your baby was born around their due date or was post mature, most of this vernix will have been absorbed into the skin and only remnants will be noticeable in their skin folds. These include the folds of your baby’s neck, armpits and groins (nappy area). However, where your baby is born prematurely, they are likely to be covered in large amounts of vernix. NB. Because vernix is a thick grease-like substance you will find it doesn’t wash off easily, but will be absorbed within a few hours following your baby’s birth.

Lanugo

This is the very fine downy hair that tends to cover the skin of your baby’s shoulders, upper arms and thighs. Some babies have more hair than others and lanugo tends to be more noticeable if your baby is born prematurely (too early) or is dark-haired. Lanugo is gradually lost during the first month post birth.

Should you have any concerns about your baby; you should always seek advice from your midwife, health visitor or GP.

References and further reading

Johnston PGB (1998). The newborn child (8^th ed). Edinburgh: Churchill Livingstone. 246 pages.

Stokowski LA (2006). Neonatal skin: back to nature? Midwifery Today (78):34-35.

Trotter S (2010). Neonatal skincare. In: Lumsden H and Holmes D eds. Care of the newborn by ten teachers. London: Hodder Arnold. 78-88.

Trotter S (2013). Why no baby skincare product should be advertised or promoted as ‘suitable for newborn skin’. MIDIRS Midwifery Digest 23(2):217-221.

VisscherMO, Narendran V, Pickens WL et al (2005). Vernix caseosa in neonatal adaptation. Journal of Perinatology 25(7):440-446.

VisscherMO, Utturkar R, Pickens WL et al (2010). Neonatal skin maturation – vernix caseosa and free amino acids. Pediatric Dermatology 28(2):122-132.

Yoshio H, Lagercrantz H, Gudmundsson GH et al (2004). First line of defense in early human life. Seminars in Perinatology 28(4):304-311.