Any first-time parents expect a silky-skinned and delicate-featured cherub at birth. Surprise! Plenty of babies are born with wrinkles, strangely hued skin, not to mention misshapen heads and puffy faces. You'll love yours regardless, but here's a realistic head-to-toe guide to prepare you for what to expect.
What's normal: Meet your little conehead! Don't be alarmed if your newborn's skull has an elongated shape; it's made up of multiple soft, movable, bony plates that allow the head to be molded during labor so it can pass more smoothly through the birth canal. His oblong head will return to normal in one or two days.
But nature's work isn't complete. Your newborn has two areas on her head, known as soft spots or fontanels, where the bones haven't joined yet. The larger, diamond-shaped area on the crown persists until about 18 months, while a much smaller, triangular soft spot on the back of the head usually disappears between 2 and 6 months. The larger fontanel should be flat or slightly depressed when the baby is held upright. Because the brain is also protected by a thick, sturdy membrane, you can gently wash and comb the hair over this area.
Bruising and swelling of the scalp are common after vaginal deliveries, especially if forceps or vacuum extraction were necessary. (Baby's journey out of the womb isn't always without a little turbulence!) You may feel a soft, squishy swelling over the part of the head that emerged first or notice small abrasions from the fetal scalp monitor.
Although it is rare, the pressures of labor can also result in bleeding just above one of the skull's bones. This causes a well-defined lump to form over the back of one side -- sometimes both -- of the head after birth. This lump, known as a cephalohematoma, will go away but it may take weeks.
What's not: If the large soft spot is deeply sunken, dehydration, a typical result of vomiting or diarrhea, may be to blame, while a bulging fontanel may signal a serious illness, such as meningitis. Your pediatrician will measure baby's head during well visits to make sure it's not excessively large or growing too fast or slow.