Pearls of Wisdom: Newborn Skin Conditions

shutterstock_28299541We’ve all seen pictures in books and magazines of the perfect newborn, swaddled in a hospital blanket, nestled into her parents welcoming arms. She is as perfect as a rose, with a tiny upturned nose and lovely, clear skin. It’s no wonder that parents are often surprised when their newborns present with a variety of rashes and skin conditions. The Majority of these rashes are harmless and self-limiting, and will resolve on their own or with appropriate treatment.

Normal newborn skin is thin and less hairy than older children and adults. Also, the ratio of skin surface to body volume is high which leads to increased absorption of topical medications.  Frequent manipulation, hot water and harsh soaps are some of the factors that lead to irritation and skin breakdown. Once there are breaks in the skin, these become portals of entry for bacteria, leading to serious skin infections.  Frequent use of moisturizers helps re-hydrate the skin and prevents excessive dryness and skin infections.

There are a number of benign skin changes that are seen in the first few weeks after birth. The more common ones include the following:

* Salmon Patches (also known as “stork bites”) are vascular stains frequently found on the nape of neck as well as the glabella (space between the eyebrows and above the nose) where they are called “angel’s kisses.”  They are found in 70% of white babies and 59% of African American newborns. Although these lesions may fade over time, 25-50% may persist into adulthood.

* Hemangiomas initially appear as flat red patches that darken and spread with time. They may be elevated , bright–red or violet in color, depending on how deep they are. Rapidly growing lesions may require steroids and/or laser therapy, although many will just fade and regress with age.

shutterstock_113526559* Infantile or Neonatal Acne usually appears at 2-4 weeks of age and resolves by 6-8 months. Experts believe that this is an inflammatory response to an organism called Pityrosporum yeasts.  This skin condition usually does not warrant therapy unless very severe in which case, a 2.5% benzoyl peroxide treatment as well as topical antibiotics may be prescribed.

* Atopic Dermatitis (Eczema) is an extremely common itchy scaling disorder that appears between 4-6 weeks of age. It may present on the cheeks, trunk, in bends of elbows and behind knees. Many babies either have a family history of eczema and/or allergies. A good 60% of babies who have eczema or atopic dermatitis outgrow it. Medications can help control flare-ups but does not cure it. I usually recommend avoiding long, hot baths and applying moisturizers daily. Sometimes, we recommend non-steroidal or steroidal creams and antihistamines for itch.

shutterstock_56934568* Seborrheic Dermatitis is the most common scaling skin disorder in infants. It appears immediately after birth, usually affecting the scalp (called “cradle cap”), behind ears, and on the face. It appears like well-demarcated, confluent red patches with greasy scales. This type of dermatitis does not itch and usually resolves by 3-6 months of age. Treatment depends on severity; usually your doctor may prescribe antiseborrheic shampoos that contains zinc and selenium sulfide. Using mineral oil before shampooing may help remove the scales. In the presence of a superimposed fungal infection with Candida, an anti-fungal may be prescribed.

* Diaper Dermatitis is a nonspecific term that pertains to all skin eruptions in the diaper area. Irritant diaper dermatitis is secondary to a variety of factors that include fecal enzymes that erode the skin barrier, prolonged exposure of skin to moisture, and the presence of ammonia in the baby’s urine. Babies with diarrhea and those taking antibiotics also are at risk. Mild cases can be treated with topical zinc oxide paste or a petrolatum emollient which acts as a protective barrier against soiling elements. Frequent changing of diapers is recommended to reduce moisture and time exposed to extrinsic factors. In severe instances, 1% hydrocortisone cream applied after diaper changes may be given.

Plain water with or without a mild soap should be used to gently clean the baby’s skin. Your infant does not require frequent bathing if you wash the diaper area thoroughly during diaper changes. Bathing babies too frequently dries out their skin especially if soap is used. Patting her dry opposed to rubbing hard, followed by application of a fragrance-free, hypoallergenic, moisturizing lotion immediately after bathing can help prevent dryness and eczema. In other words, be gentle with your baby’s skin and avoid substances that have triggered skin rashes or irritations in the past. When in doubt, do not diagnose and treat baby without visiting your pediatrician, who can decide whether the rash is a harmless, benign lesion or something that needs referred to a dermatologist.

 

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

 

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: What to Expect On Your Baby’s First Doctor’s Visit

BabyLegs BL BodyWear

Post By. Dr. Pearl Cenon

In my 15 years as a pediatrician, I’ve had the pleasure of being one of the first faces (outside of family) that new babies meet! A baby’s first visit to the pediatrician is always an exciting one: parents are full of questions about their precious little one. Even if it’s not a firstborn, each baby has her own unique personality so parents find themselves seeking new and different advice or trying to remember how things worked the last time around! Whether you are expecting your first or fifth child, this is a basic summary on your newborn’s first visit to the pediatrician.

New moms and dads should expect to see their family pediatrician the most during baby’s first year. Right after the baby is born, an appointment should be made for a visit. It’s a good idea for two people to accompany baby so that one parent can focus on the discussion with the doctor, while the extra caregiver attends to baby. This will give parents an opportunity to get to know their pediatrician and exchange questions and answers. Questions can range from medical issues to common childcare topics, parental support groups, and any other practical matters.  From this very first visit, a good pediatrician will make parents comfortable and assist them in every possible way.

Initially, your baby’s weight, height and head circumference will be measured and plotted on a growth curve that shows how your baby compares to other babies the same age. These measurements will be taken at all subsequent infant visits because they help track your baby’s growth.  Interesting fact: generally speaking, (though your baby’s milestones may vary; check with your doctor if you have questions), babies will double their birth weight by their sixth month of life and triple it by the age of one. Imagine if we tripled our weight within a year?!

Provincial health department, Bolu, Turkey Photo: Simone D. McCourtie / World Bank

Provincial health department, Bolu, Turkey Photo: Simone D. McCourtie / World Bank

Next comes a thorough, head-to-toe physical examination. In the head exam, the doctor examines the soft spots — called fontanelles – that are normally open and flat in the first few months. The posterior (back) fontanelle usually closes at two to three months while the anterior (front) fontanelle closes before the second birthday.

Though most newborn nurseries perform hearing tests before the baby is discharged, baby’s ears will be examined again during this visit. To assess hearing, the doctor may ask how your baby reacts to your voice or loud sounds. The doctor will use an otoscope that provides a good view of the ear canal and eardrum.

Everything Checks Out!- Lab212

Everything Checks Out!- Lab212

Using a bright light such as an ophthalmoscope, the doctor will examine your baby’s eyes to detect cataracts that sometimes form early in life. He or she will also track eye movements and check the pupil’s response to light.  Next is an exam of the mouth and neck, followed by use of a stethoscope to listen to the heart and lungs. The doctor is listening for murmurs, abnormal heart rhythms, and breath sounds.

The doctor will also gently apply pressure to your baby’s abdomen to check for any abnormal masses or tenderness. If your baby still has the umbilical stump, he or she will show you how to clean and keep the area dry until it falls off.  Genitalia are also checked for abnormal lumps or signs of infections. In baby boys, the doctor will examine the penis (and healing, if a circumcision was performed) and ensure that the testes are both down in the scrotum.

To assess for problems in the hip joints, your doctor will move your baby’s legs to detect any abnormalities such as congenital hip dysplasia; early detection of this condition is critical for correction later in life.

Lastly, your pediatrician will ask about your baby’s feeding, sleep patterns, and bowel/urinary frequency. It is crucial that you learn to recognize developmental milestones that your baby will reach; hence the doctor will discuss when you can expect your baby to smile, roll over, sit up, walk, and how he or she uses her hands and arms. During this visit, your pediatrician will also test the baby’s reflexes and muscle tone.

Prior to baby’s birth, consider asking your family members, friends, and even your ob/gyn for their recommended pediatricians; then make appointments to meet several.  Just as you would interview childcare providers, you will want to ensure that the pediatrician you choose for your baby is someone that you trust and with whom you have a good relationship.  You and your child will be in close contact with the family pediatrician for almost two decades… that’s good reason to be choosy!  A good pediatrician is one whose reputation is excellent, but also someone who can clearly answer your questions, is a good listener, instill confidence in you, and someone who always makes you feel welcomed!

Warm Wishes,

Dr. Pearl

 

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

 

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She’ll write basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Being a New Mom

There I was, checking into the hospital to deliver a precious new baby. I had waited nine months to meet our prince or princess and the time was now! I had planned and prepared for this day since I saw the double lines on the home pregnancy test, but nothing had me prepared for the flood of emotions I felt when I was walking to the labor and delivery floor. The thought of becoming a new mom had me feeling anxious, excited, and scared.

While checking into the hospital, I remember thinking to myself, “This is it! You are going to leave this hospital with a baby!” At that moment I became anxious and so many questions ran through my head —Would I be a good mom? Would my husband be a good father? Can I REALLY do this? Once I delivered my baby and my husband said “It’s a GIRL!”, all those questions went away. They placed my daughter in my arms and I instantly fell in love with her. As I held her, I couldn’t imagine life without her and she was only in my life for a few minutes. Any anxieties I felt about becoming a new mom were washed away with excitement of my new adventure.

BabyLegs newborn leg warmers

Most little girls dream of being a mommy and now I was one! I was so excited to have a new baby and couldn’t wait to get her home to love on her even more. While we were at the hospital I let them keep her in the nursery at night so my husband and I could get some rest, but I did miss her so much when she was gone. I was so happy when they wheeled that bassinet into my room. She was the best baby; she only cried when she needed to be changed, fed or burped and slept most of the time. I was eager for them to discharge us so I could take my baby home and start taking care of her on my own. Finally, they discharged us and we headed home…daddy, mommy and baby! On our first night home, my excitement was now mixed with scared feelings.

Being at home with my new baby was the most scared I had been in a long time. The first night I was scared that I had done something wrong because she would just cry all the time. She didn’t sleep that first night except for an hour and that was while I was holding her in the rocking chair. I was reassured by friends and family that it would get better and they were right. We just had to work with her and get her on a schedule. By night number six she would sleep for four hours and wake up for feeding, then go back to sleep. By two weeks, she would stay awake and look at us for a few hours before going back to sleep. When she was six weeks old we had her sleeping in her room for five to six hours at night and waking twice in the night to feed. We followed her schedule and she remained happy, as were we.

A new baby can be one of the happiest times you experience. When I think back to the day of delivery, I remember feeling anxious, excited and scared. I’m sure those feelings are normal for a new mother. I read all the books and asked experienced moms, but nothing really prepared me. I just had to learn my baby’s cries and go with my gut on what needed to be done.

Every new mom’s experience is different and for most of us, adjusting to this new life as a mom is a wonderful challenge. What was your new mom experience?

About the blogger:

My name is Stephanie.  My husband and I will be married 3 years in October.  We have a soon to be two year old daughter, McKenna, and a little boy due in January.

 

BabyLegs Spring 2011 Photoshoot

Quinn and I recently attended BabyLegs’ Spring 2011 photoshoot, as they needed some cute little legs to model the newborn leg warmers, and we were happy to oblige.  Here’s more about our experience and some other pictures from that day:

Here is Quinn with a dad (not her dad, a model dad.  He was a pro with her as he is a dad himself).

There were also shots of her with a mom (like me, only WAY more model-like) and an adorable little girl.

Here’s a photo of Quinn’s little friend at the hair and make up station before this shot was taken:

The shots of Quinn by herself required some self-sacrifice on my part.  Click here for a video that shows the behind the scenes action.

Yes, I'm lying on the floor to prop her up!

Here's a resulting photo

SO MANY adorable little kids that did such a great job!

Thank you to all of the great models and parents!

BabyLegs favorites like orange/aqua and rainbow are available now in both Newborn and original sizing and are 10% off this week.  Spring 2011 designs will be available in January!

Cheers, Amy

Leaving the House

After a requisite hunkering down with a new baby, there comes a time to get oneself out of the house.  This has been a gradual process for us, starting with walks around the neighborhood and a quick trip to the store for a missing ingredient.  Only now,  two months later, are we attempting longer errands and meeting people for coffee and such.  Why did it take so long?  And why does it continue to be so difficult sometimes?

One reason is that life is still very unpredictable, particularly when it comes to feeding: we don’t have a set feeding schedule yet.  There is still cluster feeding on some days, which can lead to screaming bloody murder in the produce department, even though I just fed her and I am sure I have a couple of hours to get things done.

Another reason that we have stayed in is that I was wary about my frumptastic appearance.  My hair color had grown out and I was sporting a perma-pony tail.  I was stuck in maternity clothes that I was SICK of.  (My mommy uniform had consisted of a nursing tank top, maternity jeans that were falling down, and a hooded sweatshirt.  Every day.  Lather, rinse, repeat.)  And I’m not even going to bore you with my anxiety about the extra 20 pounds.  While I have been lucky not to have experienced serious post partum depression, I was still suffering from low confidence.  I finally went in and got my hair re-colored and cut and purchased some reasonably-priced transitional clothes at the gap that I’m not embarassed about.  Something about suiting up in clothes that fit and a teeny bit of makeup to cover up the undereye circles- now I feel confident and ready to bump into people I know.

Quinn asleep in the stroller with our all-weather Woobee

Finally, I am just figuring out what to bring with us and how to manage an infant in public spaces.  I always bring our Woobee blanket, and it has been handy when we’ve been caught in the rain and to keep Quinn cozy in her stroller and car seat when it’s chilly.  BabyLegs leg warmers are always in the diaper bag of course, in case she needs an extra layer or has a diaper blow-out.  And way more diapers and wipes than you ever think you’ll need.  Feeling comfortable nursing in public and changing diapers wherever has also been an adjustment, though it turns out that nobody really  seems to notice much or mind.

So, we hope to see you out and about.  If you bump into me, I promise to have the confidence not to shrink off in the other direction, as long as you don’t give me dirty looks if Quinn is hungry or has a wet diaper!