Newborn skin in the first six weeks

What the first six weeks look like

The first week

Your baby has just come out of fluid, and the skin adjusts to air over several days. Peeling and flaking is normal, particularly on the hands, feet and ankles, and it is most pronounced in babies born a little late. It does not need moisturiser and it is not dryness in the way adults experience it.

The vernix, the white waxy coating some babies are born with, is protective. There is no need to scrub off what remains of it.

Erythema toxicum, despite the name, is a harmless and very common newborn rash: blotchy red patches with a small pale or yellowish bump in the middle, appearing anywhere on the body, coming and going over days. It clears on its own within a week or two.

Weeks two to six

Milia are tiny firm white spots, usually across the nose and cheeks. They are blocked pores, they are not squeezable, and they disappear on their own over a few weeks.

Baby acne often appears at around two to four weeks: small red or white spots on the cheeks, nose and forehead, sometimes looking worse when your baby is hot or has been crying. It needs nothing done to it and clears by itself, usually within a few weeks. Do not use any acne product on it.

Cradle cap may start on the scalp: greasy yellowish scale, sometimes extending to the eyebrows. Harmless. Softening it with a plain emollient and gentle brushing helps if you want to; picking at it does not.

Newborn skin also mottles and changes colour readily. A bluish tinge to hands and feet in the early days, or a marbled pattern when your baby is cool, is normal circulation, not a problem.

The nappy area in the first weeks

Meconium and the change that follows

The first stools are meconium: black, tarry and remarkably sticky. A thin layer of plain petrolatum on clean skin makes them much easier to wipe away without scrubbing, which is the main thing to avoid.

Over the first week stools change to a greenish transitional colour and then, from around day five, to the yellow, seedy, frequent stools of a breastfed baby or the paler, firmer stools of a formula-fed one. Both are normal. Frequent loose stools in a young baby are also normal and are not diarrhoea.

How often to change

Newborns need changing around ten to twelve times a day, which is more often than most people expect. At this stage prompt changing is close to the whole of rash prevention. Wet nappy counts also matter clinically in the first days, so it is worth keeping track.

The umbilical cord stump

The stump dries, darkens and falls off on its own, usually between five and fifteen days. Keep it clean and dry, and exposed to air. Nothing needs to be applied to it.

Fold the nappy down below the stump so it is not covered or rubbed. Nappies with an umbilical cutout do this for you: Millie Moon Newborn and Size 1 nappies have one, and our newborn size guide covers the weight range.

Speak to your midwife, nurse or doctor if you are concerned about any changes.

Bathing a newborn

• Two or three baths a week is plenty. Top-and-tail on the other days: face, neck creases, hands and the nappy area.
• Plain water is enough for the first weeks. If you use a cleanser, make it fragrance free, and use very little.
• Short and warm, five to ten minutes, and always test the temperature yourself.
• Pat dry, paying attention to the neck, armpit and groin creases where moisture collects.
• Moisturiser is optional in the early weeks. Peeling skin does not need it. If you use one, apply it just after the bath and keep the ingredient list short.