Your baby will change dramatically in appearance over the course of their first week of life, usually looking very different once they have had time to 'uncrumple' - so to speak! You may wish to take a photo every day of your new baby at this time, and then look back at how they 'changed' after the birth.
The following is a summary of some of the normal physical aspects of a newborn baby, as well as some common behaviours that parents often ask about, with the question "Is that normal?"
Head shape and moulding
Face
Nose - breathing, sneezing and coughing
Eyes
Ears
Mouth- quivering lip and hiccups
Body
Arms, legs, hands and feet
Skin
Umbilical cord
Genitals
Head shape and moulding. A baby's head is around one quarter of their total body length and looks quite big in relation to the rest of their body size. A new baby may be bald or have a thick mass of hair, either straight or curly. (This 'baby hair' will usually not last, but be replaced in the baby's first year of life, probably with hair of a different colour and consistency).
The average head circumference measurement of a newborn baby born at term (or 37 to 42 weeks) is about 34 to 36 centimetres. This initial measurement soon after birth will often be about 1 to 0.5 cms less than when the baby's head is measured again, usually a few days later. This is due to the baby's head changing back to a rounded shape after being 'moulded' during the birth.
As the baby's head passes through the woman's pelvis and vagina during labour, the bones of her baby's skull naturally overlap. This makes the diameter (or width) of the baby's head smaller (by as much as 1cm), giving it a 'moulded' appearance. A newborn baby's head will usually look a little 'out of shape' or 'lopsided' soon after birth.
The amount of moulding will often depend upon the length of the woman's labour and the position of her baby inside the uterus. A baby whose head has been in the birth canal for a while during the pushing and birthing phases will usually have quite a lot of 'moulding'. This is often referred to by some parents as a 'cone head' shape.
Image 10-05 shows the moulding of a newborn baby's head.
It is also normal for babies to be born with an area of swelling on their head, known as a 'caput'. A caput is caused by the baby's head pressing down on the dilating cervix during the labour. Babies born vaginally will generally have some degree of caput and moulding. A caput will gradually disappear in the first 12 to 24 hours after the birth. Their head shape will return to being more rounded within 24 - 72 hours after the birth.
If the baby has been in a posterior position during labour, they will usually have a 'high-domed' forehead. Fast labours can cause a baby's head to look very sloped back (or elongated) or lopsided.
Babies in a breech presentation (bottom first) will often display a 'flat-top' shaped head soon after birth. This is due to pressure from the top of the mother's uterus during the pregnancy. The baby will have this type of head shape even if born by Caesarean. Babies born in a face presentation can have a very bruised face from pressure on the mother's cervix and vaginal examinations by caregivers.
Babies born by Caesarean will usually have more rounded heads, but can have a degree of caput or moulding if the Caesarean was done during the labour. If a baby is born using an assisted delivery (such as forceps or a ventouse), there can be pressure marks (and sometimes bruising) on their head from the instruments used.
Scratch marks may be seen on a baby's scalp if an internal CTG monitor has been used or a fetal blood sample was taken during the labour (these are both discussed in monitoring). Occasionally a baby can be scratched or cut during a Caesarean operation.
If your baby is bruised, handle them gently. Try to limit how much your family and friends hold them. Babies can be unsettled and irritable with a headache in the first couple of days after the birth. Some women have been known to take the homoeopathic remedy Arnica, to pass onto their baby through their breast milk (aimed at helping with bruising).
Babies have a 'soft spot' on the top of their head (called a 'fontanelle'). The membrane covering this is quite strong and protects the baby's brain. This spot can pulsate in time with the baby's heartbeat or bulge when the baby cries. The fontanelle can look depressed or 'sunken' at times, and is not necessarily a sign of dehydration if the baby is alert when awake, feeding and having wet nappies. The fontanelle closes around the time that the baby is 18 months of age.