NEWBORN RASHES AND BIRTHMARKS
discusses the most common questions asked by parents about normal skin rashes
and normal birthmarks. If your newborn is healthy, go directly to the
number of the topic that relates to your child for care advice.
small red bumps on the face.
Erythema Toxicum - red blotches with small white lump in the
Forceps or Birth Canal Injury.
Milia - tiny white bumps on the nose and cheeks.
Mongolian Spots - bluish-green birthmark, usually on buttock.
Stork Bites (Pink Birthmarks) - on back of neck or bridge of
Strawberry Hemangiomas - raised red birthmarks.
See More Appropriate
Topic (instead of this one) If
WHEN TO CALL YOUR DOCTOR FOR NEWBORN
RASHES AND BIRTHMARKS
Call 911 Now (your child may need an ambulance)
or too weak to stand
Call Your Doctor Now (night or day) If
than 1 month old and looks or acts sick in any way
Age less than 12 weeks old with fever above 100.4°F rectally.
True blisters (little bumps containing clear fluid).
True pimples (little bumps containing pus).
Skin looks infected.
Rash is painful to the touch.
Call Your Doctor Within 24 Hours (between 9am and 4pm)
your child needs to be seen.
Call Your Doctor During Weekday Office Hours If
other questions or concerns.
Parent Care at Home If
newborn rashes or birthmarks and you don't think your child needs to be seen.
Home Care Advice
Go directly to the topic that pertains to your baby.
RASHES ADVICE (TOPICS 1-8)
More than 30 percent of newborns develop baby acne of
the face -- mainly small red bumps. This baby acne begins at 3 to 5 weeks of
age and lasts until 4 to 6 months of age. The cause appears to be the
transfer of maternal hormones just prior to birth. Since it is temporary,
no treatment is necessary. Baby oil or ointments make it worse.
Many babies have a rash on the chin or cheeks that comes and goes. This
is often due to contact with food and acid that has been spit up from the stomach
(especially prolonged contact during sleep). Other temporary rashes on the face
are heat rashes in areas held against the mother's skin during nursing (especially
in the summertime.)
Advice: Rinse the face with water after all feedings or spitting up. During
hot weather, change the baby's position more frequently and put a cool washcloth
on the area.
More than 50 percent of babies get a rash called erythema toxicum on the second
or third day of life. The rash is composed of ½ inch to 1 inch
red blotches with a small white or yellow lump in the center. They look
like insect bites, but are not. They can be numerous, keep occurring,
be present anywhere on the body surface (except the palms and soles), and look
terrible. Their cause is unknown, they are harmless, and they resolve
by 2 weeks of age. No treatment is necessary; ointments or baby oil make
- Forceps or Birth Canal Injury:
The pressure of a forceps on the skin can leave bruises, scrapes, or damaged
fat tissue anywhere on the head or face. Skin overlying bony prominences
(such as the sides of the skull bone) can become damaged even without a forceps
delivery by pressure from the birth canal. Fetal monitors can also cause
scrapes and scabs on the scalp. The bruises and scrapes will be noted
on day 1 or day 2 and disappear by 1 to 2 weeks. The fat tissue injury
won't be apparent until day 5 to day 10. A firm coin-shaped lump, under
the skin and sometimes with an overlying scab, is the usual finding. This
lump may take 3 or 4 weeks to resolve. For any breaks in the skin, apply
an antibiotic ointment 4 times per day until healed. Call back if it becomes
tender to the touch, soft in the center, or looks infected.
Milia are tiny white bumps that occur on the faces of 40 percent of newborn
babies. The nose and cheeks are most often involved, but milia are also
seen on the forehead and chin. Milia are many in number and occur equally on
both sides of the face. Although they look like pimples, they are much
smaller (pinhead size) and not infected. They are blocked-off skin pores and
will open up and disappear by 1 to 2 months of age. They do not look like
water blisters. No ointments or creams should be applied to them.
- Mongolian Spots:
A Mongolian spot is a normal bluish-green or bluish-gray flat birthmark that
is found in over 90 percent of Native American, Asian, Hispanic, and African
American babies. They are also seen in 10 percent of Caucasians, especially
those of Mediterranean descent. They occur most commonly over the back
and buttocks, although they can be present on any part of the body. They
vary greatly in size and shape. They have no relationship to any disease.
Most fade away by 2 or 3 years of age, although a trace may persist into
Stork Bites (Pink Birthmarks):
Flat pink birthmarks occur over the bridge of the nose, the eyelids, or
the back of the neck ("stork bites") in more than 50 percent of
newborns. The ones in front are often referred to as "an angel's kiss".
All the birthmarks on the bridge of the nose and eyelids clear
completely. Those on the eyelids clear by 1 year of age; those on the
bridge of the nose may persist for a few additional years. Those on the
forehead that run from the bridge of the nose up to the hairline usually
persist into adult life. Laser treatment during infancy should be
considered. Most birthmarks on the nape of the neck also clear, but 25
percent can persist into adult life.
- Strawberry Hemangiomas:
Red birthmarks that are raised or increasing in size (strawberry hemangiomas).
These usually start after 3 weeks of age. They become larger for
1 year, then fade away over 6 to 8 years without any treatment. They run
a small risk of bleeding with trauma. Any bleeding should stop with 10
minutes of direct pressure. Discuss with your child's doctor on next regular
visit (sooner if concerned).
information is not intended be a substitute for professional medical
advice. It is provided for educational purposes only. You assume full
responsibility for how you choose to use this information.
Pediatric HouseCalls Online. Copyright © 2000-2004
Barton Schmitt, M.D. FAAP
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