Newborn Rashes

Having a newborn is so exciting. However, often a big source of concern for many parents is newborn rashes, which are very common. The good news is that most are benign and get better quickly with minimal treatment. There are some however that require treatment and if your baby seems unwell or you are concerned, call your pediatrician.

So how do you care for your newborn’s sensitive skin? I recommend minimal baths, two times per week and at most every other day. Tiny babies are not crawling around getting dirty at this age, so there is no need to bathe them daily, as this will actually just dry out their skin more.

Water is all that is necessary as well, as they have sensitive skin, especially on the face. Also, although parents often like to use lotions after the bath, even though lotions are entirely unnecessary. If you prefer to use a lotion, use only baby lotions and put on the baby’s skin while it is still wet, then pat dry.

Babies often are born with very dry skin, especially if born post due date.  The skin will peel, but the skin underneath is soft and the dry skin will get better without treatment.

Below are some of the other common newborn rashes that babies can develop in the first days and weeks of life:

Mongolian spots
Mongolian spots are very common, especially in dark-skinned babies, although they can be seen frequently in light skinned babies as well. My daughter actually had a few and both her dad and myself are light skinned individuals. These spots are flat and blue/gray in color, almost resembling a bruise. They are typically found on the back and buttocks, but you can see anywhere on the body. The size can vary. There is no treatment and most disappear or fade by age three.

Milia
Milia is very common in newborns. These are tiny white bumps found on newborn babies’ faces. These are typically found on the nose and cheek and sometimes the chin and forehead. They are each the size of a pinhead and are caused by blocked skin pores. There is no treatment necessary and they disappear typically in the first few weeks to the second month of life, when the babies’ pores open up.

Miliaria
Miliaria most often occurs when babies are too warm. They appear as clear or red bumps and often seen on the forehead and neck or covered areas. This rash typically goes away in the first week of life on its own, or when a baby is un-bundled if it was caused by over-warming.

Erythema Toxicum
This is a very common rash in newborns that appears typically on the second or third day of life. It is a blotchy, red rash that can be seen all over the body. The center has a little bump, making the rash looks like insect bites. The rash resolves in a few days or weeks and does not require any treatment.

Pink birthmarks (Salmon patches)
These birthmarks (also called a ‘stork bite’ at the back of the neck, or an ‘angel’s kiss’ between the eyebrows) are pink birthmarks commonly seen in newborns. It is basically a bunch of blood vessels. Most of these birthmarks will fade with time in the first weeks or months of life; however, the stork bites can persist and may not go away, although you may not even see them due to the hair covering the neck.

Acne of newborn
In the first month of life, some newborns may develop acne on their faces. This is due to the exposure of maternal hormones in utero. No treatment is necessary. This will resolve with time in the first weeks and months of life.

Temporary rash
Many babies have a rash on the cheeks or chin that is on and off. This is often caused from feeding or spit up. The best thing is to rinse your baby’s face with water after feeding or spitting up. Also, the baby may get the rash from the mom’s skin, for example while nursing. This again is a temporary rash. Moving your baby’s position frequently helps with this rash. Sometimes a washcloth with cool water helps the area of the rash as well.

Diaper care and preventing diaper rashes
Frequent diaper changes should be done, approximately every 2-3 hours or when you have a wet or dirty diaper. I recommend cleaning the diaper area with water and a soft, dry wipe (or soft paper towel) only. Since you are home most of the time with a newborn there is really no need to use pre-moistened baby wipes. These can irritate the baby’s sensitive skin if used frequently and are not necessary.  I would suggest having a bowl of water at the changing table to use to wet the dry wipe, since you should never leave the baby unattended at the changing table.

If on the go, pre-moistened baby wipes are a good option. Occasional air-drying the diaper area can help prevent diaper rashes as well. A diaper cream or ointment can be used to prevent a diaper rash as this provides a good barrier between the diaper and the baby’s skin. If the baby does develop a rash, I find Triple Paste works great, but any product with zinc oxide works well to heal the irritated skin. If the diaper rash doesn’t improve or gets worse, be sure to see your pediatrician.

In summary, although newborn rashes are very common and can cause a lot of anxiety to parents, the good news to remember is that most are benign and require minimal treatment.

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Ali is a board certified pediatrician who practiced general pediatrics for five years in a busy private practice in Manhattan NY.  She since has moved into the pharmaceutical industry and oversees and mentors many physicians globally.  She enjoys sharing her knowledge and experiences as a pediatrician with other moms and dads.  Ali’s outside interests include working out, acting, piano, guitar, dance and being a mom! Ali currently lives in NYC with her husband, two-year-old daughter and baby on the way.

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