Your baby's skin
Your newborn baby may have some skin conditions that seem unusual to you. Most are fairly common and do not need to be treated.
- Baby acne is a red, pimply rash on the face. It usually starts when a baby is 2-3 weeks old and disappears within a few weeks.
- Cutis marmorata is a condition where the skin looks like pinkish-blue marble in cold temperatures. It’s not serious and will get better over time.
- Erythema toxicum is a common, splotchy red rash that can affect newborns. Some have firm yellow or white bumps surrounded by a flare of red skin. The rash can come and go on different parts of the body. It’s most common on the second or third day of life, but can appear at birth or within the first two weeks. The individual splotches can stay for a few hours, or for 8-10 days. There is no treatment – it will gradually disappear.
- Milia are tiny whiteheads on your baby’s face. They will disappear on their own.
- Dermal melanocytosis (mongolian spots) are flat birthmarks that can be deep brown, slate gray, or blue-black in colour. They sometimes look like bruises and are often found on the lower back and bottom. Mongolian spots are present at birth. Most fade (at least somewhat) by age 2 and usually completely by age 5. They are very common in babies of Aboriginal, African, Asian, Hispanic and bi-racial descent.
- Vernix is a greasy, white substance that covers and protects your baby’s skin in the uterus. Some babies are born with lots of vernix still on their skin. It’s harmless and can be washed or wiped off. Losing vernix may cause the skin to peel during the first week of life. This is normal and will go away on its own. Don’t use moisturizing cream on your baby during this time, or it will interfere with the natural peeling process.
Caring for the umbilical cord
By the time you are home from the hospital, your baby’s cord will have started to dry. It should fall off within 1 to 3 weeks. Until then, you should keep it clean and dry.
Water is all you need to clean it. Do not pull on the stump even when it starts to come off. It will fall off on its own. You can prevent your baby’s diaper from rubbing the area by folding it over.
Contact your doctor if your baby has a fever (temperature of 38.0° C or higher) or if the umbilical area:
- appears red and swollen,
- oozes yellow pus,
- produces a foul-smelling discharge, or
- bleeds (a small amount of bleeding is normal and you may find a few spots of blood on the undershirt or sleeper.
Bathing your baby
It is okay to give your baby a full bath once you bring her home, but you don’t need to bathe her every day. A wash with a warm cloth will help keep her clean between bathings.
Wash her face and hands often and thoroughly clean the genital area after each diaper change. You don’t need to use soap, but if you do, make sure it is mild and unscented. Rinse well to prevent skin irritation.
- Bathe your baby in a warm room. The water should feel comfortable to the touch.
- Make sure you have all of your supplies within reach so that you never leave your baby alone.
- Remove any jewelry that might scratch your baby.
- Hold your baby securely.
- Use clean water to wash her eyes, ears, mouth and face.
- Wipe a girl’s genitals from front to back. Gently wash the vaginal lips.
- Keep your baby boy’s penis clean by gently washing the area. Do not try to pull back the foreskin. Usually, it is not fully retractable until a boy is 3 to 5 years old, or even until after puberty. Never force it.
- Do not use cotton swabs to clean inside baby’s nose and ears. Mucus or earwax will work itself out in time. Use a clean wash cloth wrapped around your little finger to clean the outer areas.
- Pat your baby completely dry with a towel.
- Never leave your baby unattended while bathing her, even for a moment.
Diaper rash, also called diaper dermatitis, is caused by wet or soiled diapers. It happens when urine or stool in the diaper irritates baby’s skin, making it tender and red. Candida diaper rash usually shows up around the genitals and buttocks. It’s usually very red with small red spots close to the large patches. Candida is a type of yeast that causes an infection on the skin or mouth. When it’s in the mouth, it’s called thrush.
If you think your baby has a Candida infection, contact your doctor. Candida rashes need to be treated with an antifungal cream that a doctor can prescribe.
How can I prevent diaper rash?
The best way to prevent diaper rash is to change your baby’s diaper often, especially if your baby has diarrhea. If your child has diarrhea, you can also help to prevent diaper rash with an unscented barrier cream, such as petroleum jelly, to protect the skin.
How can I treat diaper rash?
- When you change your baby’s diaper, wash her bottom with mild soap and warm water (just water if there is no stool), rinse and pat dry. If the skin is really sore and red, it may hurt less if you wash the area in a warm bath.
- Use an unscented barrier ointment, such as petroleum jelly or a cream with zinc oxide, to protect and lubricate the area after each diaper change. If you use a cream, clean it off with soap and water after each change and then reapply. Do not share creams and ointments with other children and don’t touch the affected skin and put your fingers back into the jar. Use a different finger if you need more ointment.
- Using wipes can dry out your baby’s skin. If you use wipes, be sure they are alcohol-free and unscented.
- Do not use baby powder or talc.
- If possible, keep your baby’s diaper off for short periods to expose his skin to open air. This can help your baby feel better and heal the rash faster.
- If the diaper rash is severe, contact your doctor.
Cradle cap appears as crusty patches of scaly skin on your baby’s scalp. There may be some redness around the scales. You might also notice redness on other parts of the body, including the folds of the neck, armpits, behind the ears, on the face and in the diaper area. This is called seborrheic dermatitis and will usually disappear on its own.
How should cradle cap be treated?
Cradle cap will go away on its own and does not need to be treated. If you want, you can wash the hair with a mild baby shampoo and gently brush out the scales to help control it. However, shampooing your baby’s hair too often will also cause dry scalp.
Baby oil or mineral oil may help soften the scales. When applying the oil, rub only small amounts into the scales. Then shampoo and brush out the oil about an hour later to avoid more build-up.
If your baby has dry, scaling, thickened skin over the forehead, cheeks and behind the ears, this is called seborrheic dermatitis. An unscented moisturizer can be used 2 to 3 times a day on the skin. A mild hydrocortisone cream (0.5%) is safe and usually effective. If this doesn’t help, see your doctor. This will usually improve by 4 months of age.
Eczema is a skin rash that shows up as dry, thickened, scaly skin, or tiny red bumps that can blister, ooze, or become infected if scratched.
Eczema usually appears on a baby’s forehead, cheeks or scalp, though it can spread to the arms, legs, chest or other parts of the body. Often — though not always — it occurs in babies who have allergies or a family history of allergy or eczema.
How should eczema be treated?
Although there is no cure for eczema, it can usually be controlled and often will go away after several months or years.
- Daily warm baths, letting your baby soak can help. After a bath, always apply a non-scented moisturizer to your baby's skin to trap water in the skin.
- Use a gentle, unscented moisturizer instead of a lotion on your baby’s skin to reduce dryness. You can use it 2 to 3 times a day.
- Dress your baby in loose cotton fabrics.
- If the rash persists and your baby is not comfortable, your doctor may prescribe medication.
Contact dermatitis can develop after your baby’s skin touches something irritating or that she’s allergic to. For example:
- metallic snaps on undershirts, or
- dyes in clothing.
These may cause rashes in areas where the clothing rubs or where there is sweat.
Contact dermatitis rash is usually only found on the part of the skin that came in contact with the item your baby is allergic to.
How should contact dermatitis be treated?
The treatment is the same as for eczema but your doctor may want to find the cause of the rash by asking if there is anything new or different your baby came into contact with.
Heat rash causes little bumps on the skin when your baby overheats. The bumps may be red, especially in babies with light skin color. You can usually see it in the folds of baby’s skin and on parts of the body where clothing fits snugly, including the chest, stomach, neck, crotch and buttocks.
Hot, humid weather is prime time for heat rash, but it can happen in winter if your baby has too many layers of clothing.
How should heat rash be treated?
Remove any excess clothing. Keep your baby comfortably cool by dressing him in loose-fitting, light cotton clothing, especially in warm, humid weather.
Reviewed by the following CPS committees:
- Community Paediatrics Committee
- Public Education Advisory Committee
Last Updated: February 2012