Normal newborn behaviours that can alarm but are usually harmless

Many common newborn behaviours such as sneezing, skin flakes, and arm reflexes are normal developmental signs, but parents should remain vigilant and seek medical advice if concerning symptoms arise, advises the American Academy of Pediatrics.

New parents often expect a newborn to be quiet, smooth-skinned and predictable. In reality, healthy babies can make surprising noises, sneeze frequently, jerk their arms and legs or develop patches on the skin that look alarming at first glance. According to the American Academy of Pediatrics, many of these behaviours are part of normal early development rather than signs of illness.

One common example is cradle cap, the yellowish or white scaling that can appear on a baby’s scalp. The Academy says it is usually harmless, not painful and not itchy, and it often clears on its own over weeks or months. Gentle washing with a mild shampoo and soft brushing can help, while oils such as mineral or coconut oil may loosen stubborn flakes before bathing. Parents should not pick at the scales, since that can raise the risk of infection.

Newborns are also far noisier than many people expect. The Academy notes that grunting, squeaking, sighing, sneezing and hiccupping are all common in the first weeks of life. Some of those sounds come from normal digestion, while grunting can happen as a baby has a bowel movement. But persistent grunting with every breath, breathing difficulty, long pauses in breathing or a blue or grey colour around the lips, tongue or face calls for urgent medical attention.

Frequent sneezing can also be normal. Rather than signalling a cold, it is often a protective reflex as the baby clears the nose of dust, fibres, smoke or strong smells. The same is true of many sudden arm and leg movements, including the Moro, or startle, reflex. If a baby’s head position changes suddenly or a loud noise shocks them, they may fling out their arms and legs before drawing them back in. The AAP says this reflex is normal, strongest in the first month and then fades gradually. If it seems uneven on both sides of the body, that should be mentioned to a paediatrician.

Another sight that can unsettle caregivers is swollen breasts in a newborn, which can happen in both girls and boys. The Academy says this usually appears in the first week of life because maternal hormones pass to the baby before birth. A small amount of milky fluid may even come from the nipple. The swelling usually settles within two to four weeks, although it can last longer in breastfed babies. The breasts should not be squeezed or massaged, because that can lead to infection. Redness, tenderness or fever needs medical review.

Even when these changes are harmless, very young babies deserve close attention. The American Academy of Pediatrics advises parents to contact a doctor if a baby younger than one month seems unusually sleepy, feeds poorly, has breathing problems or simply does not seem right. When in doubt, it is safer to seek medical advice early.