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Last updateTue, 28 Oct 2014 9pm

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Newborn Appearance: Face

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When picturing your newborn, many parents imagine a perfect Gerber-looking baby and are very shocked by the normal facial and skin appearances of newborns. Here are just a few of the most common newborn facial appearances:

  • Milia, “whiteheads”, may appear on the nose, cheeks and forehead and are due to trapped skin flakes near the skin surface. These tend to disappear without additional treatment within the first month.
  • Newborn rash (erythema toxicum neonatorum) is the most common skin rash in newborns and is often seen on the 2nd or 3rd day of life. This rash appears suddenly and can be very concerning to parents. Newborn rash appears on the face, body and diaper area. The rash has raised white or yellow pustules which are surrounded by a red base. No special treatment is necessary and most of the rash will disappear within a week. 
  • Newborn acne (acne neonatorum) appears as red splotches and whiteheads on baby’s cheeks, forehead, nose and chin and is thought to be caused by maternal hormones. The mean age of onset is 3 weeks of age. Newborn acne can come and go until approximately 4 to 6 months of age.
  • Swollen eyes are common and are due to pressure on the eyes during delivery and from fluid shifts after delivery.
  • Most babies are born with blue-gray eyes. Eye color may be predicted by 3 months of age, but may change any time up to one year of life.
  • Subconjunctival hemorrhage, which is the breakage of small blood vessels in the eyes, is not uncommon following a difficult delivery. This should go away in a few weeks.
  • Since the muscles of the eyes are not well developed, you may notice your baby’s eyes cross occasionally.
  • Most newborn babies will not produce tears when crying until around the second month of life due to the immaturity of the tear duct system.
  • Blocked tear ducts, “nasolacrimal duct obstruction”, are common in the first weeks of life. The affected eye appears watery and may produce mucous which can dry and become crusty. Notify pediatrician for further instruction. Common treatment involves gently cleaning the affected eye with a clean, warm, moist cotton ball or washcloth. When cleaning the eye, clean from the inner aspect of the eye to the outer. Change the cotton ball or move the cotton ball around so that every time you swipe to clean the eye, you are using a clean area of the cotton ball. Some physicians may recommend massaging the duct 2-3 times per day. To provide lacrimal massage, gently stroke the area from the inside corner of eye pressing downward to the bridge of the nose using a clean finger. Repeat for about five to ten strokes several times a day. Did you Know?:  Breastmilk has antibacterial properties and is a great home remedy for cleaning crusty, watery eyes. Just add a drop or two of mother's milk in the inside corner of your baby's eye several times a day.

American Academy of Ophthalmology. Blocked Tear Duct Treatment 
Davidson, D., London, M., Ladewig, P. (2012). Olds' Maternal-Newborn Nursing & Women's Health Across the Lifespan (9th Edition). Boston: Pearson.
Gleason, C. & Devaskar, S. (2012). Avery's Diseases of the Newborn (9th Edition). Philadelphia: Elsevier Saunders.

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