A Head-to-Toe Guide on Your Newborn\’s Physical Features

When you first lay eyes on your baby, chances are you'll think he's absolutely perfect, but you can't help noticing that his body has a few blemishes. So what's normal? Here, a head-to-toe guide to your newborn's birthday suit.

If you gave birth vaginally, your baby's head may be elongated or misshapen. “The odd shape of the head is the result of the baby passing through the birth canal,” explains Richard L. Saphir, M.D., clinical professor of pediatrics at Mt. Sinai School of Medicine in New York City. The two soft spots on your baby's head, called fontanels, aren't fused yet in order to make delivery easier.  The head should take on a more normal shape within two weeks.

Babies born by Cesarean section are more likely to enter the world with picture-perfect round heads, though not always: The tops of C-section babies’ skulls can appear flat, mimicking the shape of the womb. Flat-tops, which are more common in breech babies, change more gradually, Saphir says, sometimes taking a full year.

You also may notice your baby has a recessed chin; it’s just nature’s temporary way of making it easier for him to breastfeed.

Some babies are born bald; others arrive with a full head of hair. The texture and color may be equally surprising – fair-haired couple may leave the hospital with a raven-haired infant, while dark-haired parents are often surprised to bring home a blond. Babies who are born late may have especially large amounts of coarse hair.

Either way, don’t be alarmed. A newborn’s hair is a terrible predictor of what it will look like in a few months. “By four to six months, most newborn hair will be gone,” Saphir says. That’s because hormonal changes after birth cause a baby’s hair follicles to enter a period of rest, followed by regrowth. 

Some babies are born with a substantial coating of fine hair over most of their bodies. This soft, downy hair, called lanugo, covers all babies in the womb, but most of it usually sheds several weeks before birth. Although most babies are born with some lanugo, preterm babies are likely to have more of it at birth than full-term babies; within a few weeks the hair will naturally shed.

You’ll never forget the first time your eyes meet your newborn’s. Yet that tender moment can be quickly supplanted by alarm: Why is my baby cross-eyed? “Almost all newborn babies will have somewhat crossed eyes,” Saphir says. “Just as a newborn doesn’t have the muscle strength and coordination to crawl, newborns don’t have the eye-muscle strength and coordination to synchronize eye movements.”

Most Caucasian babies are born with blue eyes that may go through several color changes in the first few months. They usually darken to their final color between 6 and 12 months. Darker-skinned babies are usually born with brown eyes, which tend to stay brown or turn another dark color, such as a deep green.

Babies delivered vaginally also may have some blood spots in the whites of their eyes (from the pressure of being pushed through the birth canal). These will disappear within a few days.

Your baby’s skin will be a telltale sign of gestational age: Babies born early have thin, almost translucent skin and may still be covered in vernix – the white, greasy coating that protects the fetus’ skin from amniotic fluid. Babies who arrive past their due dates, on the other hand, may have almost no lanugo and a wrinkly appearance, as if they’ve been lolling in the bath a little too long.

Your newborn will be wrinkly because she's just spent nine months in fluid – and now she's exposed to dry air, plus she's a little dehydrated right after birth. Her circulatory system isn't quite up to speed yet, so when she sleeps, her hands and feet may look bluish. If you're worried, pick her up and watch her skin return to a normal color.

It’s common for babies to be born with some form of skin rash, and the most common in newborns is milia—flat, minuscule white dots that resemble pimples and often pop up on the face. These may look like acne, but are merely blocked sweat and oil glands. Milia disappears within two to three weeks, Saphir says. In the meantime, it’s fine to gently wash the area with mild soap and water. True “baby acne” can appear after the first month, but it’s harmless and disappears on its own.

Fair-skinned babies often have a hemangioma, a cluster of red blood vessels close to the surface of the skin that go by the name “stork bites” or “salmon patches.” They tend to disappear over several months; those that appear on the back of the neck are more likely to persist. “Strawberry hemangiomas” are more raised and last longer, but they, too, are most likely temporary: 30 percent disappear within three months; 60 percent within six months; and 90 percent within nine months.

Asian, African and other dark-skinned babies may be born with “Mongolian spots,” deeply pigmented birthmarks usually found on the lower back or buttocks. “Mongolian spots can persist, but they become less noticeable because they get lighter while the rest of the skin becomes darker,” Stratbucker says.

Something you never see on TV is the little plastic clamp that will be placed on your baby’s umbilical cord stump, which will shrivel and come off in an average of 10 days (though this can take up to three weeks). In the meantime, you don’t have to compulsively swab the stump with alcohol. “It’s an open wound and you want to keep it clean and dry,” says Bill Stratbucker, M.D., assistant professor of pediatrics at Rush University Medical Center in Chicago, adding that washing the stump with gentle soap and water is sufficient.

Some babies have a noticeably puffy appearance around the umbilical cord, where the abdominal muscles are still weak. These “umbilical hernias” usually resolve on their own in nine months to a year, says Stratbucker, as the surrounding muscles get stronger. (Steer clear of “belly bands” and old wives’ tales that advise taping a silver dollar to your baby’s belly—neither is necessary and can be potentially harmful.)

Don't worry if Baby’s feet look pigeon-toed. They've rotated inward because he was curled up snugly in the womb for nine months. After about 6 months, they'll relax into a straighter position. He may also appear to have flat feet, but his arch is there – it's just hidden by a pad of fat.

The key is to remember that no two babies are alike, which is, after all, what makes each infant so special. “A baby will come out looking different from her sibling or her neighbor in the nursery,” Saphir says. So relax, and savor your baby’s uniqueness.