![]() ![]() Moving on to the head, expected findings and normal variations. None of those are harmful or bad in any way. It has papules, but it disappears within a first few weeks. And then erythema toxicum, this is a transient rash. This is not harmful in any way, but this is going to be lifelong. Nevus flammeus or a port-wine stain, this is going to be like a purple or red discoloration, and you'll often see it on the face or the neck, and this is permanent. There is nothing bad or harmful about them at all, but your job as the nurse is going to be to document these, right? It's important to document this finding so that in the future, we can look back at the chart and say, "Yep, that's been present since birth," and not a sign of abuse, right? That would be important to know. ![]() So if I already have darker skin, I already have a higher number of melanocytes, and therefore, I am more at risk for having this melanocytosis, right? Again, these will fade within a couple of years. But these are common in infants with darker skin because it has to do with more melanocytes in that area than normal, and melanocytes are the cells that produce melanin. This is essentially a blue or purple pigmentation of the skin that is typically found on the back or the buttocks of the newborn, and they kind of resemble bruising. ![]() Now Mongolian spots or congenital dermal melanocytosis. Nothing that needs to be done to treat them. Now milia, milia are little white cysts, and these can be found on the face of the newborn. It's completely gone now, but these are just from dilated capillaries. My daughter had one kind of right here above her eye. And these will disappear with time, usually within 18 months. So these are kind of like a pink discoloration, and you'll see them a lot on infants on the eyelids, in between the eyes, on the neck, maybe the back of the head. So telangiectatic nevi or the word that I would prefer because that was a mouthful, are stork bites. ![]() So these are not necessarily things that are expected findings, but they are not abnormal findings, either. Now let's talk about some normal variations of the skin. That can indicate that meconium was passed inside the uterus, and that could indicate fetal distress. Some other things would be green or brown discoloration of the skin and nails. You know that that means that we think it's pretty important for you to understand. But within the first 24 hours, it's always abnormal. If we develop jaundice later on, then we can talk about that in a little bit. So the first 24 hours after an infant is born, jaundice is always abnormal. Abnormal findings, though, when it comes to the skin, a big one is going to be jaundice in the first day of life. But remember, if you've seen the new Ballard video, we were talking about the fact that a premature infant will have abundant lanugo. You will typically find this in specific areas such as the sides of the face, the upper back of the newborn, and the shoulders as well. And with a full-term baby, it is normal to still have some lanugo. It helps with warmth and thermoregulation. Now remember, lanugo is that fine downy hair that covers the fetal body. They're not going to be covered in it, but they will have it in creases of the skin so maybe in their armpits or kind of in their neck rolls. So it is normal to find that, especially if we're talking about a full-term baby. It protects the skin while they are in utero. Now, vernix and lanugo, so vernix is that sort of thick, creamy, almost like cheesy white substance that covers the infant. It's really tough to have had mom circulating your blood for you and having a different circulatory setup, and now you're doing it all on your own and your circulation is the way it's going to be for the rest of your life. And also this can happen in response to cold. This is normal as they adjust to extra-uterine life. So it is expected for them to either have pink color or to have acrocyanosis, meaning that their trunk is pink but their extremities are a little bit bluish. So expected findings when it comes to the newborn, remember that they are adjusting to being alive on earth, right? It's a big task we have asked of them, and it's going to take some time. So first up, we're talking about the skin and expected and abnormal findings. And if you already have a set, I would invite you to follow along with me. I'm going to be following along using our maternity flashcards, which are available on our website,, if you want to get a set for yourself. Hi, I'm Meris with Level Up RN, and in this video, I'm going to be talking to you about expected and abnormal findings in the newborn following birth. ![]()
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