Caring for a baby’s skin is an important part of being a parent. This document has information about common skin conditions and what you can do about them, as well as some helpful hints on good skin care.

YOUR NEWBORN 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. Generally, it disappears over time.
Cutis marmorata is a condition where the skin looks like pinkish-blue marble when exposed to cold temperatures. It is not serious and will improve as your baby gets older.
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. The rash tends to come and go on different parts of the body. It is most common on the second day of life, but can appear at birth or within the first two weeks. The individual splotches may stay for only a few hours, or for several days. There is no treatment – it will gradually disappear.
Milia are tiny whiteheads on your baby’s face. They will disappear on their own.
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 buttocks. Mongolian spots are present at birth and most of them fade (at least somewhat) by age 2 and usually completely by age 5. They are very common in babies of African, Asian, Hispanic and biracial descent.
Vernix is a greasy white substance that coats and protects baby’s skin in the mother’s uterus. Some babies are born with lots of vernix still on their skin. It is 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.

CARING FOR THE UMBILICAL CORD

By the time you go home from the hospital, the cord will have started to dry. It should fall off within 1 to 2 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. Prevent the baby’s diaper from rubbing the area by folding it over. Contact your doctor if your baby has a fever (rectal 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 baby’s undershirt or sleeper.

BATHING YOUR BABY

Although the traditional advice has been to give babies a sponge bath until the area around the umbilical cord heals, today many doctors say a full bath is okay once you bring your baby home. You don’t need to bathe her every day. A warm cloth will help to 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 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.
• Remove any jewelry that might scratch your baby.

Skin care for 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. Don’t separate 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 a 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

Diaper rash, also called diaper dermatitis, is caused by wet or soiled diapers. It occurs when urine or stool in the diaper irritates the 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 occurs 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.

What can parents do to prevent diaper rash?

• Change your baby’s diaper often.
• Keep your baby’s diaper off for short periods of time to allow the skin to dry. This will help to prevent and treat mild cases of diaper rash.
• When changing your baby’s diaper, wash the area well with mild soap and warm water, rinse and let dry completely.
• Apply unscented petroleum jelly or a cream with zinc oxide to the skin of the diaper area to protect and lubricate it.
• Wipes can dry out a baby’s tender skin. If you do use them, be sure they are alcohol-free and unscented.
• Avoid using baby powder or talc.

CRADLE CAP

Cradle cap appears as crusty patches on a baby’s scalp. There may be some redness around the scales. You may also notice redness on other parts of the body, including the creases 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 it 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 this condition. 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 seborrheic dermatitis, a mild hydrocortisone cream (0.5%) is safe and usually effective. If this doesn’t help, see your doctor.

ECZEMA

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, although it can also 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.

• Avoid frequent baths.
• Keep your baby’s skin from becoming dry and itchy by adding nonallergenic oil to the bathwater.
• Use a gentle, unscented moisturizer on your baby’s skin to reduce dryness, especially after a bath when your baby’s skin is still moist.
• Dress your baby in loose cotton fabrics.
• If the rash persists and your baby is not comfortable, your doctor may prescribe medication.

CONTACT DERMATITIS

Contact dermatitis can develop when your baby’s skin comes into contact with something irritating or that she is allergic to. Examples include the following:

• metallic snaps on undershirts.
• 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 it be treated?

The treatment is the same as for eczema, but your doctor will also want to find the cause of the rash by taking a careful history.

HEAT RASH

Heat rash causes little bumps on the skin that can show up when your baby overheats. The bumps may appear red, especially in babies with light skin colour. 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 you might see it during winter if your baby has too many layers of clothing.

How should it be treated?

Remove any excess clothing. Keep your baby comfortable cool by dressing him in loose-fitting, light, cotton clothing, especially in warm, humid weather.