By Sarina Gomez
Most newborns look puffy, red or purplish, a little squashed and coated in a white, waxy film when they’re born. Their head may be stretched into a cone, their eyelids swollen, and their hands and feet bluish. Almost all of it is normal, and most of it fades within days to a few weeks.
Here’s what you’re likely to see, head to toe, with how long each thing usually lasts, so the first look at your baby is a happy one rather than a worried one.
Skin at birth: red, waxy and sometimes fuzzy
A healthy newborn’s skin is often deep red or purple at birth, with bluish hands and feet. MedlinePlus lists three things you’ll likely notice in the first hours:
- Color. The skin darkens before the first big cry, then lightens somewhat over the second and third days. It may get dry and flaky.
- Vernix. A thick, waxy, white coating that protected the skin from the amniotic fluid. It washes off in the first bath.
- Lanugo. Fine, soft hair on the shoulders, back, forehead or cheeks. It’s more common in babies born early and disappears in the first few weeks.
Peeling skin is normal too, whether your baby was born early, late or on time, according to the American Academy of Pediatrics. All babies, including those with dark-skinned heritage, start out with lighter-appearing skin that gradually darkens. Our post on what skin color your baby will be explains why.
The head: cone shapes, swelling and soft spots
A newborn’s head often looks long or pointed after a vaginal birth, and it rounds out on its own. The skull bones are soft and separated by gaps, so pressure in the birth canal can mold the head into an oblong shape, as MedlinePlus explains. Babies born by C-section or bottom-first usually have rounder heads.
Two kinds of swelling are common:
- Caput. Soft swelling of the scalp where the head pressed first during birth. The AAP says it should disappear in a few days.
- Cephalohematoma. A firmer swelling on one or both sides from bleeding along the outside of the skull bones, not inside the brain. It usually takes six to ten weeks to go away.
Every baby also has two soft spots, or fontanelles, where the skull bones are still growing together. A tough membrane protects the brain underneath, and you can touch them gently.
Face and eyes: puffy now, clearer in a week or two
Puffy faces and eyelids come from the pressure of labor and settle quickly. Some babies also have a blood-red spot in the white of one or both eyes. The AAP says birth-related swelling and bruising are usually gone by the end of the first week or two, and red spots in the eyes in about three weeks. Babies born by C-section often skip the puffiness.
Eye color at birth isn’t final. Many white newborns are born with blue eyes that may change over the first year, while babies with dark-skinned heritage are usually born with brown eyes and keep them. If you want the month-by-month version, read when babies’ eyes change color.
Spots, rashes and marks that are usually harmless
Newborn skin often breaks out in the first weeks, and most of it clears without treatment. The common ones, from the AAP and MedlinePlus:
| What you see | What it is | How long it usually lasts |
|---|---|---|
| Tiny white bumps on the nose, cheeks and chin | Milia | Gone on their own in 2–3 weeks |
| Red blotches with yellow-white centers | Erythema toxicum | Comes and goes, gone in about a week |
| Pink patches on the eyelids, forehead or neck | Salmon patches (“stork bites”) | Fade over months to years |
| Blue-gray flat patches on the back or bottom | Slate gray macules, common in dark-skinned babies | Usually gone before school age |
| Pimples on the face | Baby acne from maternal hormones | Often appears in weeks 3–5, clears in a few weeks |
| Blotchy pink-to-blue skin | Cool air on the skin | Fades when the baby is covered |
One exception to “wait and see”: the AAP says any blister-like rash should be checked by your baby’s doctor to rule out infection.
Hair and body: what changes in the first weeks
Newborn hair is often temporary. The AAP says most or all “baby hair” falls out in the first six months and is replaced by mature hair, which can be a different color and texture.
The rest of the body changes fast too. According to the AAP’s first-month guide:
- Weight. All newborns lose weight in the first week. Most are back to birth weight by about 2 weeks, and almost all by 3 weeks.
- Posture. The tightly curled position from the womb gradually straightens out.
- Umbilical cord. The stump dries and falls off between 1 and 3 weeks after birth.
Babies of both sexes can also have slightly swollen breasts for a short time from their mother’s hormones, usually for less than a week.
Why your newborn won’t look like the scan, or a portrait
Your baby on day one will look different from any picture you’ve seen during pregnancy. A 3D ultrasound is a shaded image built from echoes, and a newborn’s face is puffy from birth, so the two rarely match closely. Our guide to 3D ultrasound vs the real baby explains exactly why.
The same goes for imagined portraits. SeeMyBaby can turn one photo of each parent or an ultrasound photo into an imagined newborn portrait for fun, but no portrait can show how your baby will look in the first hours, swollen eyelids and all. It’s a playful guess, not a preview. Your real baby’s features keep changing for years, as our timeline of how babies’ features change to age 4 shows.
When a newborn’s appearance needs a doctor’s look
Most newborn quirks are harmless, but a few are worth a call. Yellowing of the skin and eyes is the big one. MedlinePlus says most newborns have some jaundice, usually noticeable at 2 to 4 days old and gone within 2 weeks. It advises contacting your baby’s provider if:
- the skin is bright yellow;
- the yellowing keeps increasing after the newborn visit or lasts longer than 2 weeks;
- the feet, especially the soles, look yellow.
Jaundice with a fever, listlessness or poor feeding is an emergency. And, as above, have any blister-like rash checked.
Sources
- MedlinePlus Medical Encyclopedia. Skin findings in newborns, Newborn head molding and Newborn jaundice.
- American Academy of Pediatrics, HealthyChildren.org. How Your Newborn Looks and Your Baby’s First Month: Growth and Physical Appearance.
This guide is general information, not medical advice. More on your baby’s looks is on the SeeMyBaby blog.
Questions parents ask
Why do newborns look so swollen?
Pressure during labor makes the face and eyelids puffy. The AAP says this swelling usually fades by the end of the first week or two.
How long does a cone-shaped head last after birth?
Molding from a vaginal birth rounds out on its own soon after birth. Scalp swelling called caput also clears in a few days, while a cephalohematoma can take six to ten weeks.
What is the white stuff on a newborn?
That’s vernix, a waxy coating that protected your baby’s skin from the amniotic fluid. It washes off in the first bath.
When do newborns start to look like themselves?
The swelling, color changes and head shape settle over the first one to three weeks. Features like eye color and hair keep changing through the first year and beyond.
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