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When 'Abnormal' is normal in your newborn baby....
July 6, 2012 by Dr. Mandar V. Bichu
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When 'Abnormal' is normal in your newborn baby....

(Article reviewed and updated by Dr. Mandar V. Bichu on June 10, 2013).

In nature there is seldom a sharp demarcation between the normal and the abnormal. In its countless variations, the rules don’t apply and routine norms are useless. It is true even in case of a newborn human baby – especially the way it looks!

Looks can kill! Looks are deceptive! Combine these oft-repeated statements with the natural curiosity and anxiety in the Homo sapiens and you won’t take long to understand why some ‘abnormal’ looking things in a newborn (with perfectly ‘normal’ outcome) cause undue worry in the parental minds!

Skin of the newborn baby is often the first one to get under the parental skin with its confusing array of ‘normal’ abnormalities.

(Check the photo-gallery.)

‘Lanugo’ is a type of fine, immature hair, which is seen on many newborns’ bodies. It is more common in prematurely born babies. There is no treatment needed for lanugo and it usually disappears in few weeks.

 ‘Mongolian spots’ - the slate-grey or bluish spots on the buttocks and back (occasionally elsewhere) are caused by the deposition of normal body pigment under the skin. They are harmless and disappear by the age of 7 years at the latest.

‘Erythema toxicum’– another benign condition requiring no treatment presents itself by a rash on the trunk. The rash consists of whitish small papules or pustules on a red base. This rash is transient and self-limited.

‘Miliaria’ is nothing but a common ‘sweat-rash. Either as multiple, tiny, colorless vesicles or as a reddish rash it appears mainly on the face and neck. The only measures which are required are to keep the baby in open clothes and in cool surroundings.

‘Strawberry haemangioma’ is a soft swelling on the face or the trunk with a small strawberry-like appearance. The so-called ‘Stork bites’ or ‘Port wine stains’ are reddish stains mainly seen on the neck, forehead and eye-lids. In the present ‘skin deep’ age all these can be pretty disconcerting for the parents. These are caused by the excessive proliferation of the skin blood vessels and are mostly harmless. Most of the times they disappear with time alone and rarely require treatment.

Pinhead like multiple, tiny, whitish swellings on the nose and cheek are called ‘Milia’. Tiny pearl like lesions – ‘Epstein’s pearls’- are seen sometimes on palate and gums. Both these conditions are without any clinical significance and are just caused by the proliferation of the epithelial glands. They warrant no treatment.

The immature temperature and blood-flow control mechanisms in the newborn baby can cause some confusion in the ‘mature’ minds. Many a time, with exposure to cold the colour of the baby’s extremities becomes blue. This ‘Acrocyanosis’ immediately responds to warmth. The same ‘immature’ mechanism is at work when some babies get a bluish blotched up skin like marble (‘Cutis marmoratus’) on exposure to cold which reverts back to normal on providing warmth.

The female hormonal surge in the early days of life is responsible in the female babies for vaginal discharge or even vaginal bleeding. These are transient and without any significance. The same hormonal changes can lead to breast enlargement and even lactation – sometimes even in the male babies. Here the only danger is from overzealous parents , relatives or ‘massage – ladies’ who try to ‘milk’ these ‘baby breasts’. Invariably such a thing results into an infection and abscess of the breast. Please don’t do such a thing, in fact don’t do a thing!

The babies yawn. They sneeze. They cough. They get startled. They stretch themselves. These are all perfectly normal things for them. Periodic breathing is a pattern of breathing where the baby breaths very rapidly for a few seconds, then pauses and then resumes normal rhythmic breathing. Again it is just a normal variation. It is unnecessary to look suspiciously at each and every activity of the baby looking for a sign of abnormality when there is none!

Skin tags, ear tags, extra digits for hand or foot , minimal curving of the foot (Talipes)-  these are physical anomalies which are easily correctable and without much clinical importance.

A balloon-like boggy umbilical swelling of an umbilical hernia is often a cause of parental anxiety. It gurgles on touching and it increases in size on crying. Hence many a time, it is attributed wrongly as a cause of abdominal pain. Keeping it tightly under wraps after putting a coin over it is a popular method of ‘treatment’. But actually it is most of the times a self-limited condition which corrects itself in a year. The only treatment recommended by the revered textbooks is ‘masterly inactivity’!

So my dear fellow parents, when you look at your new bundle of joy, don’t think of the abnormal before the normal. It just doesn’t make any sense! If you are in doubt, just consult your doctor. Most of the times, you would find that you were making a mountain out of a mole-hill!

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