Study note

Benign neonatal skin findings, pink diapers, and diaper rash

THE CONTEXT

Several newborn skin and urine findings are benign and can be recognized from their appearance, timing, and associated feeding history.

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Stork bites are benign capillary malformations appearing as flat red patches over the forehead and upper eyelids.

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Milia are benign tiny white papular cystic lesions, especially over the face and nose.

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Male neonates may pass pink-colored urine, usually on the second or third day of life, staining their diapers.

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The staining results from urate crystals and often accompanies feeding inadequacy causing dehydration.

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Hematuria, hemoglobinuria, myoglobinuria, and porphyria are infrequent causes in an otherwise normal neonate.

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The condition resolves spontaneously within a couple of days and requires no treatment; breastfeeding adequacy should be ensured.

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Skin peeling is normal, especially in post-term and IUGR neonates. Oil massage can decrease flaking, and no other intervention is required.

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Diaper rash causes redness, inflammation, and excoriation from maceration by stools and urine.

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Diaper rash is more frequent with commercial diapers than with domestic cotton diapers.

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Treatment consists of keeping the area dry, avoiding rubbing during cleaning, and applying a soothing cream.

NEETx

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