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Evidence Library · What is normal

Almost everything you will see on your baby's skin is normal

In 594 US newborns examined by skin specialists in the first 48 hours, most had at least one finding parents mistake for illness.

Nobody prepares you for what a newborn looks like. You are handed a baby and left to interpret its skin yourself, and much of what you see looks, to an untrained eye, like disease.

The best US source is a study of 594 babies in San Diego, examined in the first 48 hours of life by paediatric dermatologists rather than by parents or general clinicians. Here is what they found, with that denominator attached to every row.

What you may seeAlso calledFound in 594 US newborns
Nevus simplexSalmon patch, stork bite, angel's kiss83%
Sebaceous gland hyperplasiaTiny yellow-white bumps on the nose42.6%
Dermal melanocytosisFlat blue-grey patch, often on the lower back20%
MiliaWhite pinhead spots8%
Erythema toxicum neonatorumBlotchy red rash with small pale centres7%
Infantile hemangioma (by 3 months)Strawberry mark4.5%
Congenital melanocytic neviBrown birthmark present at birth2.4%
Cafe-au-lait maculesFlat light-brown patch2%

Four in five newborns in that study had a stork bite. More than two in five had the little yellow bumps. These are not conditions. They are what newborn skin is.

One rate this guide deliberately will not give you as a single number. Erythema toxicum, the blotchy rash that appears in the first days and frightens parents most, was found in 7% of those 594 US babies. In two Brazilian studies of 2,831 and 2,530 newborns, also examined by dermatologists in the first 72 hours, it was found in 21.3% and 23%. Two careful prospective studies differ threefold and neither explains why. So: somewhere between about 1 in 14 and about 1 in 4 (those conversions are arithmetic done here), depending on the population, and it is benign and self-limited in all of them. In the Brazilian data it was actually more common in babies with good Apgar scores, no pregnancy risk factors and no intensive care admission. It is a finding of the well baby.

The two numbers that settle the whole question. In that Brazilian study of 2,530 newborns examined in the first 72 hours, 95.8% had some skin finding. Of the whole group, 0.5% had a skin malformation and 0.1% had a skin infection. Five in a thousand, and one in a thousand. Everything else visible on a newborn's skin was normal or temporary.

This is not a substitute for someone lookingCommon findings are common, but a newborn who is feeding badly, breathing badly, unusually sleepy, or has a fever is a different question entirely, whatever the skin looks like. Rashes that blister, spread quickly, or come with a baby who seems unwell should be looked at the same day. The point of this topic is to take the fear out of the ordinary, not to talk you out of asking.
Say this out loud before you go home"Can you walk me around my baby and name the things I am going to see?"
"Which of these will go away on their own, and roughly when?"
"What would look different enough that I should call?"
Where this comes from:
682. Kanada KN, Merin MR, Munden A, Friedlander SF. A prospective study of cutaneous findings in newborns in the United States: correlation with race, ethnicity, and gestational status using updated classification and nomenclature. J Pediatr. 2012;161(2):240-5.
683. Reginatto FP, DeVilla D, Muller FM, Peruzzo J, Peres LP, Steglich RB, et al. Prevalence and characterization of neonatal skin disorders in the first 72h of life. J Pediatr (Rio J). 2017;93(3):238-45.
684. Reginatto FP, Muller FM, Peruzzo J, Cestari TF. Epidemiology and predisposing factors for erythema toxicum neonatorum and transient neonatal pustular: a multicenter study. Pediatr Dermatol. 2017;34(4):422-6.

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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.