Is my newborn normal?

Therese Gracey, M.D.Specialty: Pediatrics with Edwards-Elmhurst Health shared in their Healthy Driven blog that 

Moms know what a big change it is to have a newborn at home. You’ve waited for months for your baby to get here. Now she’s here and you aren’t quite sure what to make of this tiny creature.

During the first couple of weeks after you give birth, you may wonder: is this how a newborn is supposed to look and behave?

Here are some common newborn traits you should know, and some not-so-normal things to look out for:

• Crying. All newborn babies cry, all the time. You’ll get familiar with your baby’s normal pattern of crying. Until then, make sure your newborn is fed, burped, has a clean diaper, and isn’t too cold or hot. You can also try holding, rocking, swaddling or singing to her.Contact your pediatrician: If your baby won’t stop crying after trying the above.
• Breathing. Newborns tend to breathe through their noses, and their nasal passages are narrow. Your baby may breathe noisily, sneeze, or sound congested even when she doesn’t have a cold. A bulb syringe can help with clearing out her nasal passages.Contact your pediatrician right away: If your baby has trouble breathing. When in doubt, go to the ER or call 911.

• Funny sounds. Your newborn will produce all sorts of funny noises, including squeaks, grunts, groans, snorts and hiccups. Noises are often caused by mucus getting trapped in her narrow nasal passages.Contact your pediatrician right away: If your baby is grunting with each breath or wheezing. When in doubt, go to the ER or call 911.
• Spitting up. Spitting up is common in healthy newborns. As long as your baby seems comfortable and is eating well and gaining weight, all should be okay.Contact your pediatrician: If your baby routinely gags during feedings, vomits (especially if there is blood), or if you notice any signs of dehydration (e.g., not enough wet or dirty diapers, no tears when crying, soft spot on the head has sunken).
• Crossed eyes. Newborns don’t focus well at first. Your baby’s eyes may seem out of line or crossed at times during the first few months.Contact your pediatrician right away: If your baby is still showing signs of crossed or wandering eyes by 6 months.
• Odd shaped head. Babies born by vaginal delivery often look elongated, stretched out, or even pointed at birth. The soft spots on the top of your baby’s head sometimes bulge out when she cries or strains. All of this is normal and will go away after several days as the skull bones close together.Contact your pediatrician right away: If you have any concerns about the shape of your baby’s head.
• Bluish skin. Newborns may have mildly blue hands and feet. When your baby cries hard, her face, tongue and lips may turn a little blue. Her color should quickly return to normal once she is calm and warm.Contact your pediatrician right away: If your baby has trouble breathing or skin or lips that persistently look blue, purple or gray. When in doubt, go to the ER or call 911.
• Rashes and bumps on the skin. Newborns are coated with a thick, pasty, white material, which is usually washed off during her first bath. Many newborns also have harmless skin rashes and bumps that look like acne, often on the nose, chin or forehead. These will go away on their own within a few weeks.Contact your pediatrician right away: If your baby develops a rash or hives along with a fever*.
• Jaundice. Many normal, healthy newborns have a yellowish tinge to their skin that is caused by a buildup of bilirubin in the blood. Jaundice is usually mild and goes away after two weeks.Contact your pediatrician: If jaundice doesn’t improve. Your pediatrician will check the condition and treat it appropriately if bilirubin levels get too high.
• Full belly. It’s normal for a baby’s belly to appear somewhat full and rounded, especially after feeding. Most of the time, her belly should feel quite soft.Contact your pediatrician: If your baby’s belly feels swollen and hard, or if she seems very uncomfortable when trying to pass stool. Babies often go several days without having a bowel movement. There is no need to be concerned as long as she is comfortable while having a bowel movement and is otherwise acting well. 
• Umbilical cord. Your baby’s umbilical cord will dry out, wither and darken in color, which is normal. When the cord begins to fall off, you may notice a tiny blood stain on your baby’s diaper.Contact your pediatrician: If your newborn’s navel area becomes red or if you notice a foul-smelling discharge.
• Swollen breast and private parts. Newborn girls and boys can have swollen breast tissue at birth as a result of being exposed to mother’s hormones in the womb. Boys may have a swollen scrotum and girls, swollen labia. The puffiness should go down in a few days.Contact your pediatrician: If the area continues to be red or swollen beyond the first few weeks or if your baby develops a fever*.
• Spots of blood in the diaper. In the first few days, your baby’s urine may be so concentrated it can be mistaken for blood. Spots of blood can also result from a rough bowel movement, a recent circumcision in boys, or spotting in girls.Contact your pediatrician: Any time you spot blood in your baby’s diaper, just to be sure.
• Spastic movements. Babies are born with a number of instinctual responses to stimuli which gradually disappear as she matures. Reflexes include sucking, grasping, and random jerks and limb flailing (startle reflex). These will start to settle down after 3-4 months. Swaddling can help her sleep more soundly.Contact your pediatrician right away:  If your baby shows signs of a seizure (rhythmic jerking and loss of consciousness).
• Poop. Newborn poop is mostly liquid and ranges from brown to green to yellow, with some mustard-seedy particles in it. Some babies will have a bowel movement with every feed, and the poop can be explosive.Contact your pediatrician: If you see any signs of blood in your baby’s poop.
• Sleepiness. Newborns spend most of their time sleeping (while moms are sleep deprived!). In fact, they can sleep up 16 or more hours a day! It’s normal as long as your baby wakes up every few hours for feedings, eats well, seems content, and is alert for part of the day.Contact your pediatrician:  If your baby is too sleepy to feed or is difficult to wake up.

*A fever can be a sign of something serious. The definition of a fever in the newborn period is a rectal temperature of 100.4 or higher.  A fever in a newborn is an emergency until proven otherwise, so bring your baby to the ER should she develop a fever as defined above.

As always, if you have any questions or concerns about your newborn, talk to your pediatrician.

If something doesn’t seem right with how your newborn looks or acts, trust your instincts if you believe they need medical care fast.