You and Your New Baby. Anna McGrail
Birth marks (if it’s going to be a mark that’s permanent, someone should come to talk to you about it)
Heads that are moulded (from labour) so that they look squashed; the bones will return to normal within days
Spots (usually entirely harmless, however disappointing)
Hair (either too much or too little, depending on what the parents had thought the baby would have, but any amount is normal)
The sex organs – those on some little boys can appear out of proportion (he will grow into them), those on some little girls may be red and swollen as a reaction to the hormones in her mother’s body. Swollen breasts and even occasionally small amounts of milk are caused by the mothers’ hormones. Breast size will reduce and milk disappear over the first few days
A squint (which often disappears as the baby learns to focus her eyes).
HOW MANY of us new parents were prepared for the black umbilical stump? For the blotchy skin which newborns are prone to? For the way our newborn’s hands and feet can turn blue after a long nap, a sign that the circulation is not yet efficient or mature? In fact, in many respects the picturebook baby you were expecting may bear no resemblance to the child you’ve actually got, as Lynn discovered: ‘It was only when I changed Adam’s nappy for the first time that I got a good look at the umbilical cord … which was definitely something I hadn’t been prepared for. There was this black thing, with a clip on it. What was I supposed to do? The nurse had said “Oh, sprinkle on some of this powder when you clean him”, so I stood there with this talcum powder tin trying to guess if I should move the stump to one side, or lift it up, or just sprinkle all around it. I hadn’t a clue. I was petrified of hurting him. I was convinced that whatever I did, it would be wrong: the clamp would come off, it would bleed, I’d knock it off and do him dreadful damage. Then Adam did a wee all over me and I stopped worrying about the cord and started worrying about that instead.’
THERE ARE MANY kinds of marks on your baby’s body that may worry you, although most need no worrying about whatsoever. There are two kinds of birthmarks: vascular, which are to do with the blood vessels, and pigmented, which are to do with skin colouration. Philippa’s daughter, Sophie, was born with a birthmark: ‘Sophie was born with a red mark on her forehead and at first we never gave it a second thought. The midwives said it was probably a pressure mark from the birth and we were quite happy with that explanation – and relieved. At the six- week check, the doctor was more specific: “It’s a strawberry birthmark – my daughter had one. Don’t worry – it’ll go away on its own. “We were due to go back when Sophie was six months old, but we went back long before then as the mark began to get darker and to swell and we were worried it was some sort of tumour. We saw a skin specialist in London when she was three months old. She started on steroids and almost immediately the mark stopped growing. We were lucky, they think there won’t be a permanent mark, but those first months of her life were dreadful. There was all that uncertainty, all that fear for the future, and all that guilt. Even though this wasn’t a life-threatening condition, and it didn’t mean she had any permanent disability, that mark takes away the enjoyment and all the joy of her arrival even now. I look back at photographs of her when she was newly born and I think: “I should be thinking what a beautiful baby she was”, but I’m not. I’m thinking: “Look at that red mark. Little did we know.”’
BIRTHMARKS
A brown mark – these are present in about ten per cent of babies: sometimes dark brown, sometimes a pale, milky coffee colour. Harmless. May not fade but no treatment necessary.
Mole – a very few babies are born with a mole; raised, flat, dark or light, of any shape. They are only a cause for concern if they suddenly get larger, itch or bleed. If this happens, see your GP.
Mongolian blue spot – a large, blue-grey or brown mark which occurs reasonably frequently in dark-skinned babies, usually on their back or bottom. Harmless. Soon fades.
Port wine stain – a flat, purple-red birthmark caused by blood vessels under the skin; usually harmless but can be distressing for parents, and permanent without treatment. Nowadays, laser treatment can remove these birthmarks safely and effectively in four or five treatments, which can usually be started almost immediately.
Stork bites – small pink blotches, usually near the eyelid. Harmless. Will fade. No treatment required.
Strawberry birthmarks – raised, red marks. Usually occur on the face or neck. They eventually stop growing – although they may initially get larger before they shrink again – and usually fade completely during childhood. May need treatment if it is near your baby’s eyes, or in an awkward place where it could cause her discomfort. In these cases, the mark can be removed with laser therapy.
Tiny brown marks – usually round… stop panicking – it’s a freckle.
DURING THE first 24 hours after the birth, a paediatrician will visit you to check over your baby. The paediatrician will check things like:
Your baby’s hips – to make sure they are fitting nicely in their socket and have not been slightly dislocated by the birth
The fontanelles: your baby will have two main fontanelles – soft spots on her head where the skull bones haven’t yet grown over and fused together.
IT’S NORMAL for the fontanelles to appear slightly indented, and you may notice a pulse beating through the skin. You may worry that they are very fragile, but they are covered by toughened membranes. If they do become very sunken or raised, this is a useful warning sign that your baby is unwell, possibly dehydrated and needs medical attention.
All babies, while in the womb, are covered with a fine fuzz of hair called lanugo. Sometimes there will still be a little of this lanugo left when the baby is born – but it will soon rub off.
Some babies may be born with coarse hair, often across the shoulder blades or down the spine, which can alarm parents. Most of this will fall out – it just rubs off.
In fact, the hair your baby is born with on his head may well not last – if you look at new babies a couple of weeks old, you will notice that they have a little bald patch on the back of their heads where the hair has been rubbed away by the mattress. All the hair is gradually replaced, and the colour it will finally be cannot be judged from the colour he started out with – many babies change from fair to dark, and some vice-versa.
A blister on the baby’s upper lip concerns some parents, but it is only a ‘sucking blister’, an indication of your baby’s enthusiasm for feeding. The blister may disappear between feeds, it may not. Babies seem entirely oblivious to the blisters and they soon fade as feeding frequency decreases.
If there’s anything that worries you, ask your midwife or health visitor. They will be visiting you regularly to check things like this. If your baby has a condition which needs further treatment, you will be given further information and often the names and contact numbers of support groups. If in doubt, ask.
VITAMIN K has been much in the news the last few years as health authorities and trusts have been rethinking their policies on this issue.
A few years ago, almost every newborn baby in this country was automatically given an injection of vitamin K just after birth with the aim of preventing haemorrhagic disease – a rare but dangerous condition in which the baby’s blood fails to clot in the event of any bleeding. Vitamin K prevents this disease developing and thus the injection programme gained widespread acceptance. No one knows why babies are born with low levels of vitamin