Newborn or Alien?

Red marks, coneheads and crossed eyes are just some of the features infants may be born with. But don't worry; they aren'’t permanent.


For Kelly and Mike Copeland, learning the gender of their baby was a long-anticipated moment, one they had chosen to save for delivery day. When that moment finally came, the proud father announced, “It’s a boy!”

“No,” said the OB-GYN, smiling. “It’s a girl.” How could a perfectly normal baby girl be mistaken for a boy? When she emerged from the womb, the baby’s genital area was swollen, a completely normal occurrence that results from a surge in maternal hormones through the placenta immediately before birth. (For the same reason, male newborns have an enlarged scrotum and may appear to have breasts or nipple discharge.)

Newborns on network sitcoms may present with nice, round heads, creamy complexions and perfectly proportioned little bodies, but real-life babies usually arrive with a variety of appearance nuances that can be perplexing—or even startling—to first-time parents. The good news is in most cases, such quirks are entirely normal and, almost always, temporary. To be prepared for what your baby may look like, here are a few things you might expect to see.

Stork Bites & Strawberries 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.

Head shape» From pointy to perfect I thought I’d taken enough classes during my first pregnancy to ready myself for just about anything, yet nothing prepared me for the initial shock of seeing my newborn son’s cone-shaped head. When the nurse placed a knit cap on Declan before putting him in my arms, I wondered if the cover-up was for him or me.

Of course, Declan’s head took on a lovely, kissable, round shape in time, as do all babies’. “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. A newborn’s skull bones are not yet fused expressly to make delivery easier. The head takes 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.

Eyes» Crossing and color changes 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.”

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. Just as likely to change is the color of your newborn’s eyes: The permanent color of the iris, which at birth may appear blue-gray in lighter-skinned babies or brown-gray in darker-skinned babies, often is undetermined until your baby is 6 months old.

Hair» A little or a lot Your baby may be born completely bald or with a full mop of hair, and the texture and color may be equally surprising. A 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. Umbilical cord» Belly blues Another thing 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.)

Skin» Rashes and discoloration 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.

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.

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.

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.

Newborn Noises “Newborns are surprisingly noisy. They grunt, groan, snort, snore, gag and sputter,” says pediatrician Jennifer Shu, M.D., F.A.A.P., co-author of Heading Home With Your Newborn: From Birth to Reality (American Academy of Pediatrics, 2005). “Parents may expect their babies to be quiet except when they’re crying, but all these noises are very normal.” Here are some of the sounds you can expect:

Sneezing No, she probably doesn’t have her first cold. “Infants are born with so much fluid in their noses that in the first 24 hours they have to sneeze it all out, and the sneezing may continue for the first few weeks,” says assistant professor of pediatrics Bill Stratbucker, M.D.

Hiccups Newborns make lots of gassy sounds, especially hiccups, which can begin even in the womb. These are harmless to your baby, Shu says.

“Periodic” breathing Newborn babies have a “bizarre” breathing pattern, Stratbucker says. They may breathe very slowly, then gasp and breathe very fast. As long as there are no accompanying color changes in your baby’s skin, she’s breathing normally.