The majority of babies will display some yellowness (or jaundice) in the first few days of life (especially breastfed babies). This is because the baby’s liver is not yet fully mature and cannot process a normal human waste product called bilirubin. Most infants’ jaundice will improve without any intervention. However, some children will require a little help from their parents. At home, we recommend placing your baby in indirect sunlight with just a diaper on. You can do this in the home next to a window, even on a cloudy day. Hold them in the light for ten to fifteen minutes at a time, three to four times a day. The sunlight helps to break down the bilirubin.
If your baby’s jaundice is severe (in other words, your child looks very yellow or the whites of the eyes have turned yellow), you should come to our office as soon as possible. We will need to check your baby’s bilirubin level and may need to place your child in the hospital for phototherapy (placing them under a blue ultraviolet light) or arrange for home phototherapy. Most babies will not require this.
You may have heard that stopping breastfeeding will help jaundice. While it is true that breastfed babies are more likely to display jaundice, studies clearly show there is little benefit to stopping breastfeeding. In other words, keep breastfeeding your child even if they have jaundice. It is still the best source of nutrition and food!
Some babies have white dots on their noses. This condition is called sebaceous gland hyperplasia and it will go away without treatment. It’s helpful to wash the area with a mild soap once daily.
Some babies have similar white dots on their nose, face and other parts of their body, however unlike sebaceous gland hyperplasia they are raised and not clustered. These dots are called milia and are small cysts filled with keratinaceous debris. They also will eventually resolve without treatment.
Most babies will have a rash that usually starts on the cheeks and can include the scalp, face, neck, upper back, upper torso, and ears in the first few months of life. Like cradle cap, it is thought to be an immunological response to the presence of beneficial skin yeast. The condition is often called “neonatal acne,” but has recently been renamed “neonatal cephalic pustulosis.” It generally peaks at about one month of age and can last several months. The rash does not require treatment, but 1% hydrocortisone cream (sold over-the-counter) to the non-facial areas two times per day for about one week will reduce the amount of inflammation especially behind the ears and around the neck.
Some newborns may have red splotches on their eyelids, nasal bridge or forehead. A similar spot may also be found on the back of the neck. These are termed nevus simplex, a type of capillary malformation. On the face they are also known as “angel’s kisses.” On the back of the neck they are called “stork bites.” They typically will fade during the first few years of life. No treatment is necessary.
Some newborns have dark blue-black spots on the back and buttocks called “Mongolian spots.” They look very much like a bruise, but are in fact a type of birthmark. They typically will fade over the first few years of life. No treatment is necessary.
Skin care of the newborn consists of moisturizers as needed. Use only “hypoallergenic” moisturizers such as Aveeno, Cetaphil, Eucerin, Cerave, or Lubriderm and try to avoid moisturizers with fragrances or other added chemicals.
It’s normal for newborn babies to have white or yellow dandruff-like flakes on their scalps. This skin change is called “cradle cap” or seborrheic dermatitis. If the flakes become thick and scale-like you can put baby oil on them over night and then use a baby brush to remove them once they have softened in the morning. Selsun Blue, Head and Shoulders Intensive Treatment, or T-Gel shampoo used daily or every other day will help keep this condition at bay. Do not get these shampoos in your baby’s eyes and be sure to rinse all of the shampoo off of your baby’s skin, including the folds. After several days of use, try to use the shampoo less and less, only for maintenance purposes. You also have the option not to treat at all as cradle cap is only a cosmetic issue and will resolve on its own with time.