Skin conditions in newborn babies

An infant’s skin has many functions – it protects the body against ultraviolet radiation, provides a barrier against bacteria and toxins entering the body, and also prevents fluid and electrolyte loss from the body.

The skin enables the baby to experience the sense of touch.

The preterm infant has a more sensitive skin to that of a full term baby, as many of the skins’ layers are under-developed.

Even in a full term baby, much of the elastin fibres of the skin are formed after birth, and it may take 3 years before they are fully formed.

Birthmarks are commonly found at birth, and can be of concern to new parents. The most common birthmarks are:

Stork Bites

These appear as a pink stain over the forehead, eyelids and at the back of the head. This is due to dilatation of the tiny blood vessels under the skin (capillaries). Most will fade within the first year of life. They are usually present as a threesome (forehead, eyelids and neck).

Mongolian Spot

This looks like a deep blue-black bruise, usually occurring at the base of the spine just above the buttocks. Spots may be found on other areas of the body. They do not spread, and are likely to fade during childhood.

The most common rashes in infancy are usually found on the face and nappy area.

Contact Dermatitis

Most rashes are caused by direct damage to the skin from substances such as soaps or lotions. A red rash in the nappy area, is usually due to the presence of ammonia released by the breakdown of urine. Keep the nappy area clean and dry.

Environmental Factors

Dry winters can cause skin dryness; and extreme heat and humidity in summer can cause excessive sweating, especially in the nappy area, in ankle and knee folds, and at the back of the neck. Newborns have less pigment (melanin production), and will burn if exposed to direct sunlight, so keep babies out of the sun.

Infantile Acne

This is a common condition, and is usually found on the face, behind the ears and in the neck area. These pustules resemble acne, and may be exacerbated by heat. The intensity may vary from day to day. This acne is usually as a result of maternal hormones, and usually fades by 3 months of age.

Infections

Many skin disorders in newborns are caused by fungal or bacterial infections.

Candida or thrush, is caused by a fungal infection which causes a red nappy rash, over the genital area, and extending into the folds of the groin. Many little satellite spots are found in the area. Treatment is with an antifungal cream.

Impetigo is a bacterial infection which results in skin erosions, usually on the face, and nappy area, always covered with honey coloured crusts. Antibiotic treatment is required.

Most newborns have skin that is smooth and soft. From birth, the skin is able to fulfill most of its functions, providing that it remains intact. Damaged skin, due to whatever reason, is obviously more sensitive, so it is important that only skin products specially formulated for newborns be used to prevent complications.

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Ann Richardson

Qualified nurse and midwife Ann Richardson, co-author of Baby Sense, Sleep Sense and author of Toddler Sense, all bestsellers, has worked in the midwifery and paediatric fields for over 30 years. Ann has been in private practice for the past 22 years, and introduced the first private well-baby clinics, now a well-known phenomenon at Doctors’ rooms and pharmacies across the country.Passionate about her work and dedicated to ensuring that parents have the necessary knowledge to enjoy and rejoice in their children, she regularly lectures to both professionals and parents on various baby and childcare issues, in particular the effects of the sensory system on infant behaviour, and the management of sleeping disorders. Her specialisation is the treatment of “difficult babies and toddlers”, in particular those with feeding and sleeping disorders.She is a regular contributor to childcare publications, TV and radio. Ann is married with two daughters, and lives and practices in Johannesburg.

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