Is my newborn baby normal?

If you’ve just had a baby, there’s a good chance you’ve stared at them in the middle of the night wondering if what you’re looking at is actually normal. Nobody warns you properly. Films and adverts show babies arriving pink, calm and clean, blinking sweetly up at their exhausted-but-glowing mother. Real newborns are nothing like that, and the gap between expectation and reality catches almost every new parent off guard.

Real babies often arrive with puffy, squashed faces, a bluish or purplish tinge that fades within minutes as they take their first breaths, and a coating of vernix (that waxy, creamy-white substance) mixed with blood and amniotic fluid. It looks alarming if you weren’t told to expect it, but it’s completely normal and gets wiped away pretty quickly by the midwife.

Your baby has spent around nine months curled up in a warm, cramped, watery space, and birth is a genuinely rough journey out of it. It makes sense that they need a few days, sometimes a couple of weeks, to look and feel like the baby you pictured. Most of the odd little features new parents worry about are simply signs of a body adjusting to life outside the womb, not signs that anything is wrong. That said, if anything about your baby’s appearance or behaviour genuinely worries you, it’s always worth a quick call to your midwife, health visitor or GP rather than sitting up all night on Google. Trust your instincts, but don’t panic before you’ve asked.

The face, head and body shape

A squashed nose, a slightly crooked jaw, or ears folded over at an odd angle are all common after birth, especially after a vaginal delivery where the baby has been pushed through the pelvis and birth canal. These features usually settle down within the first week or two as the pressure eases off and the cartilage in the ears and nose relaxes into its normal shape.

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The head usually shows the most obvious effects of birth. A baby’s skull isn’t one solid piece of bone at birth. It’s made up of several separate plates that can overlap and shift slightly as the baby moves through the birth canal, which is what allows the head to squeeze through such a tight space at all. This can leave the head looking slightly pointed, lopsided or “moulded” for the first few days. It looks strange, but it corrects itself within a week or two as the plates settle back into a more rounded shape. Babies born by caesarean section usually skip this moulding altogether, since they haven’t been squeezed through the birth canal in the same way.

Because those skull plates aren’t fully joined, your baby will have two soft, slightly sunken patches on the top and back of the head, called fontanelles. Parents often find these worrying to touch, but they’re normal and are actually a useful thing for doctors to check at appointments. You might notice the fontanelle bulge slightly or pulse gently when your baby cries or strains, which is just blood vessels near the surface. A soft spot that feels tense and bulging when your baby is calm and upright, or one that looks sunken and dry, is worth mentioning to your health visitor or GP, as this can occasionally be a sign of dehydration or raised pressure and is best checked rather than left.

Newborn eyes

Some babies open their eyes within minutes of being born. Others keep them tightly shut for a day or two, often because of swelling from the delivery or from the antibiotic eye ointment sometimes given shortly after birth. If your baby hasn’t opened their eyes yet, try holding them upright rather than lying flat. Babies have what’s called the doll’s eye reflex, and they’re far more likely to open their eyes when held vertically than when lying down.

It’s also common to see red or bloodshot patches in the white of a newborn’s eye. This is a subconjunctival haemorrhage, a small burst blood vessel caused by the pressure of delivery. It looks a bit like a bruise on the eye and, like a bruise, it fades on its own over one to two weeks. It doesn’t affect vision and doesn’t need treatment, though your midwife or health visitor can take a look if you want reassurance.

Posture, movement and reflexes

For the first few weeks, most babies keep their fists clenched, knees drawn up, elbows bent and arms tucked in close to the chest, almost like they’re still folded up in the womb. This is called the “fetal position” and it takes time for babies to realise they now have room to stretch out. Premature babies often show a more floppy, less curled posture, since they haven’t had the same time in the womb to develop that muscle tone.

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Newborns are also born with a set of automatic, instinctive movements called primitive reflexes. These are checked by midwives and doctors as part of the newborn examination because they’re a good sign the nervous system is working as it should. The main ones you’ll notice at home are:

• Rooting and sucking reflex: stroke your baby’s cheek and they’ll turn towards it and start sucking motions, even in their sleep.
• Grasp reflex: put a finger in your baby’s palm and their fingers will curl tightly around it, sometimes with surprising strength.
• Moro reflex (startle reflex): a loud noise, a bright light, or even the sensation of being put down can cause your baby to fling their arms and legs out suddenly, often followed by crying.

These reflexes fade naturally over the first few months as your baby’s brain and movements become more voluntary and controlled. Their legs may also look bowed or curved when you first straighten them out, again simply from months spent folded up in a small space. This usually straightens out on its own over the following months as they start kicking, stretching and eventually bearing weight on their legs.

One practical bit of advice new parents often aren’t given: baby fingernails can be surprisingly long and sharp at birth, sharp enough to scratch their own face during those reflexive arm movements. Trim them carefully with baby nail scissors or clippers once the nail is long enough to catch, ideally while your baby is asleep or feeding, when they’re less likely to wriggle.

Sleeping and breathing

Newborns sleep a lot, often 14 to 17 hours a day, but rarely for long stretches, and their sleep is split into short cycles rather than one long block. This is completely normal, if exhausting for you.

Breathing is one of the biggest sources of anxiety for new parents, and understandably so. Newborns often breathe irregularly, a pattern doctors call periodic breathing: quick, shallow breaths followed by a brief pause, sometimes lasting several seconds, before breathing resumes normally. This can be unsettling to watch, especially at 3am, but short pauses of this kind are usually normal in healthy newborns. If you ever notice your baby’s breathing pausing for more than around 15 to 20 seconds, or if their lips, tongue or face turn blue or grey (rather than just hands and feet, which can be normal when babies are cold), treat this as an emergency and call 999 or your local emergency number straight away. If you’re ever unsure, it’s always better to get it checked than to wait it out.

The umbilical cord stump

The cord itself contains three blood vessels wrapped in a jelly-like substance, and it’s clamped and cut shortly after birth, leaving a short stump attached to your baby’s belly button. This stump typically dries out, changes colour from yellowish to brown to black, and drops off on its own somewhere between 5 and 15 days after birth, though it can occasionally take a little longer.

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Current NHS guidance is generally to keep the stump clean and dry rather than routinely swabbing it with alcohol, which used to be common advice but can actually slow down healing. Fold nappies down below the stump so it isn’t rubbed or covered, dress your baby in loose clothing, and avoid submerging your baby in a bath until it has fallen off (top-and-tail washing with a damp cloth is fine in the meantime). Your midwife or health visitor will show you what’s normal for your particular baby, so ask them if you’re unsure what “clean and dry” looks like in practice.

A small amount of blood spotting when the stump falls off is normal, similar to a scab coming away. What isn’t normal is redness spreading out around the base, swelling, a foul smell, or yellow-green discharge. Any of these can be signs of infection, and you should contact your GP or midwife promptly if you notice them, rather than waiting to see if it settles on its own.

A few other things nobody warns you about

Baby girls sometimes have a small amount of white or slightly blood-tinged vaginal discharge in the first week or so. This is caused by the mother’s pregnancy hormones, particularly oestrogen, passing to the baby before birth and then gradually leaving the baby’s system, and it settles on its own. Baby boys often have a swollen scrotum for similar hormonal reasons, and both boys and girls can have visibly swollen or puffy breast tissue, occasionally even leaking a little fluid, for the same reason. All of this is normal and temporary, but if swelling seems to be getting worse rather than better, or your baby seems unwell with it, mention it to your health visitor or GP.

Newborn skin has its own quirks too. Many babies develop a fine, blotchy red rash called erythema toxicum in the first few days, which looks worse than it is and clears up on its own. Peeling skin, especially on the hands and feet, is also common, particularly in babies born after their due date. Milia, the tiny white bumps that sometimes appear on the nose and cheeks, are blocked pores and also resolve without any treatment.

The first weeks with a newborn are a strange mix of overwhelming love and low-level panic, and most of what feels alarming turns out to be completely ordinary once someone explains it properly. If something still doesn’t sit right with you, even after reading all of this, ring your midwife, health visitor or GP. You know your baby better than any article ever could, and a quick check is always worth it for your own peace of mind.