Over the years as a doula, I've seen lots of variations around birth and babies!
I will never forget one dad's face when he saw the coned shape of his baby's head straight after birth. I could see he hadn't expected it to look like that. I gently reassured him that it was all normal and that it would reshape naturally over the next day or so. He was relieved.
Most births depicted in TV shows and movies tend to show newborns as clean, pink, and often the size of a one-month-old! But if you follow birth-related accounts on Instagram, you’ve likely seen a more realistic view.
For those who haven’t seen many real newborns, here’s a little heads-up on some common - and completely normal - features you may notice at birth.
1. HEAD
Your baby’s head may look slightly misshapen or elongated at birth - this is completely normal! It’s simply the result of molding, a natural process that helps the baby navigate through the birth canal. Since the cranial bones aren’t fused yet, they can shift to adjust the skull’s shape during birth. Pretty amazing, right?
Within a day or two, the head naturally rounds out on its own. And to answer a question a dad once asked me - no, massage or reshaping isn’t necessary. Nature handles it perfectly.
If a vacuum cup was used during birth, you might notice a circular swelling or some bruising on the scalp, which typically fades within a few days. If forceps were used, there may be visible marks where they were applied to baby's head.
You may also notice a soft, pulsating spot on top of your baby’s head - this isn’t their brain, don’t worry! It’s the fontanel, often called the “soft spot.” This diamond-shaped area near the hairline is where the cranial bones haven’t yet fused. It’s protected by a tough membrane, so it’s safe to touch and wash gently.
2. FACE
Your baby’s face may look a little swollen or puffy at birth - almost like a tiny champion boxer! This is completely normal and a result of the birthing process.
Their nose and ears might appear slightly flattened, but they’ll naturally return to shape within a day or so. If labour was particularly quick, there may be some mild facial bruising, which typically fades on its own.
3. MOUTH
A newborn’s mouth is one of their busiest features! Most of their early movements revolve around it.
You might notice them frequently opening and closing their mouth or turning their head from side to side - this is an instinctive reflex to find something to latch onto, ideally the breast!
They may also stick their tongue in and out, another natural reflex that helps them prepare for breastfeeding. And let’s be honest - it only adds to the whole cuteness factor.
4. SOUNDS
It’s completely normal for newborns to make sounds that might remind you of tiny animals! The very first sound I heard from my just-born son was a soft, lamb-like “baaaa, baaaa.”
Some consider the almighty cry the ultimate, but some babies come into themselves with a little more subtlety. I see this especially with waterbirths.
After the birth newborns often make squeaks, gurgles, and spluttering noises as they work to clear fluid from their lungs. Babies born vaginally get a natural assist from the compression of the birth canal, which helps expel some of this fluid before they finish the process on their mother’s chest.
Babies born via caesarean don’t experience this same squeezing effect, so they may need a little extra help clearing their airways, sometimes through gentle suctioning.
A big, hearty cry can speed up this process, but just like adults, every baby enters the world in their own unique way!
5. SKIN
Your baby may arrive covered in a little - or a lot - of vernix, often called “birthday frosting,” “baby cheese,” or simply “the white stuff.”
In the womb, vernix acted like a wetsuit, protecting your baby’s skin from becoming waterlogged.
Outside the womb, this biofilm has incredible benefits; from moisturising and protecting the skin, to supporting baby’s microbiome. That’s why it’s best to leave it intact rather than wiping or washing it away.
Your baby’s skin will naturally absorb the vernix over the hours following birth. In fact, the World Health Organization (WHO) recommends leaving it on for at least 6 hours, and ideally 24 hours.
If there’s a lot, you can gently massage it into your baby’s skin. It has a smooth, waxy texture and is thought to contribute to that irresistible newborn scent, which plays a role in bonding.
In some cases, if baby passed meconium (their first poo) during labour, the vernix may have a slight yellow-green tint - this is completely normal!
6. EYES
It’s completely normal (and often quite amusing) for newborns to appear cross-eyed.
At birth, their eyes and eye muscles are still learning to work together, adjusting to light and movement. While their vision is limited to about 30cm, this is the perfect distance for locking eyes with mum during breastfeeding and for recognising dad’s face and voice too.
As the weeks roll on, their eye muscles strengthen, and their movements become more coordinated and symmetrical.
7. GENITALS
At birth, a baby boy’s scrotum may appear quite large compared to the rest of him! This is simply due to the effects of pregnancy hormones and will gradually subside.
Similarly, baby girls may have slightly swollen labia and even some breast tissue, both of which naturally settle within the first week.
8. HANDS AND FEET
These may be mottled or slightly blue. It takes a few weeks for babies to sort out their body temperature systems so keep those toes warm with socks, and make the most of skin-to-skin opportunities with mum and dad.
9. LEGS
These may look bowed. This is pure adaptation to the cramped conditions of the uterus. As the muscles strengthen and lengthen the legs will slowly straighten themselves out over the weeks.
The feet may often look turned-in. Again, this is normal and anything too extreme will be noticed by the midwife or paediatrician anyway.
10. BIRTHMARK
About 1 in 3 babies will have one, with twice as many girls than boys being affected. Most don’t hurt the baby, cause health problems, or need any treatment. There are a few varieties and some creative names.
‘Stork bites’ (shown below) are flat, pink patches that are collections of blood vessels under the skin. They usually crop up on or around the forehead, neck, nose or eyelids. Most take about a year to fade.
‘Strawberry marks’ first appear as tiny red dots and may increase in size up until the end of the first year. Half will fade by age 5, and disappear by age 10.
‘Mongolian spots’ are blue-toned splotches on 80% of the lower backs or bums of babies with dark skin tones (such as African-Americans, Asians and Indian babies). These usually disappear by age 5 too.
‘Port-wine stains’ as the name suggests are the stubborn variety. With less than 1% in popularity, these tend to be permanent but can be sorted out later in childhood.
So there you have it, 10 newborn features to look out for at birth, that are normal.
It's a good idea to share this with your partner too so there's a lot less 'what the...?' when your baby finally arrives.
