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Evidence Library · What is normal

Five things you will notice that nobody has ever counted

Molding, caput, breast swelling, sneezing and irregular breathing have no published prevalence at all. That absence is worth knowing.

This guide has a rule: where no reliable figure exists, it says so rather than borrowing one from a textbook. This topic is that rule in action, because five of the things new parents notice most often have no published prevalence anywhere.

These five have no number. Searches of the medical literature for this guide found no study that puts a population prevalence, with a denominator, on any of them.

What you will seeWhat is knownPublished prevalence
Molding, the cone-shaped or lopsided headDescribed clinically as near-universal after a vaginal birth; resolves over daysNone found
Caput succedaneum, the soft puffy swelling on the scalpSearches returned only studies of forceps and vacuum outcomes, none reporting how often it happensNone found
Breast swelling in the newborn, sometimes with a drop of milkOnly single case reports of infection were found, which are not prevalenceNone found
SneezingNo prevalence literature located at allNone found
Irregular or periodic breathing in a healthy term babyEverything found concerned premature or intensive care babies, not healthy term onesNone found

You will find confident percentages for all five on parenting websites and in textbooks. None of them could be traced back to a primary study for this guide, so none is printed here. The absence is itself the finding: five of the commonest things parents notice about a newborn have never been properly counted.

Two things that do have a number, but not an American one.

Fast breathing in the first day. A German population study covering 239,971 single term live births in two federal states from 2001 to 2005 found 1,423 babies diagnosed with transient tachypnoea of the newborn, which is 5.9 per 1,000 term single babies. That is about 1 in 170 (that conversion is arithmetic done here). It is self-limited by definition. It was commoner after a cesarean done before labour started, at lower gestational ages, and in boys. No US population figure exists for it that could be verified, so this one is labelled German.

Vaginal bleeding in newborn girls. A 1976 German study of 350 newborn girls found visible bleeding in 3.3%, with traces detectable by laboratory methods in 25.4%. It occurred always in the first week, with its highest frequency on the 5th day of life and was regarded as a physiologic event. That paper's own safety rule, quoted exactly: if any genital bleeding lasts longer than one week or appears for the first time after that period, further diagnostic procedures are essential as a possible pathologic condition may be assumed. This is a 1976 study of 350 babies and it is the only prevalence figure that could be verified anywhere; no modern or US figure exists. Read it as its date.

What no number means and does not meanNo published prevalence does not mean rare and does not mean harmless. It means nobody counted. For all five, the sensible approach is the same as for anything else in a newborn: the finding on its own is usually unremarkable, and a baby who is feeding poorly, unusually sleepy, breathing hard, or has a fever should be seen, whatever else is or is not on the list.
Say this out loud"Is this normal, and how do you know?"
"Is there actually evidence on how common that is, or is it just something everyone says?"
"How long should it take to settle, and what would make you want to see us sooner?"
Where this comes from:
686. Tutdibi E, Gries K, Bücheler M, Misselwitz B, Schlosser RL, Gortner L. Impact of labor on outcomes in transient tachypnea of the newborn: population-based study. Pediatrics. 2010;125(3):e577-83.
687. Huber A. [The frequency of physiologic vaginal bleeding of newborn infants]. Zentralbl Gynakol. 1976;98(16):1017-20. German. PMID 973490.
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.

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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.