Strawberry hemangiomas are a collection of tiny capillaries that are typically located on the skin. Some are present at birth and others develop in the first few months of life. Hemangiomas have a tendency to get bigger over time, but most resolve without treatment by the time a child is 5 to 10 years.
If the hemangioma is very large or in a vulnerable location like the mouth or eye, it can be treated with a medication (propranolol) that hastens its resolution.
When a newborn’s penis is circumcised, the head of the penis (glans) will be red and wet looking for 3 to 5 days. During the healing process, it’s common for the glans to develop small yellow patches. These areas are part of the healing process and do not mean the baby has an infected circumcision. (If you’ve ever had a cut inside your mouth, you’ll recall that it heals with a whitish or yellow patch rather than a tradition scab. The same thing happens to a circumcised penis.)
I’ve been practicing pediatrics for over 30 years, and I have never seen an infected circumcision. If this were to occur, the redness would extend from the glans to the shaft and then towards the baby’s body. If you see this, call your doctor right away.
At the time of birth, a baby’s umbilical cord has a shiny, off-white color. Over the next few days, the cord will dry out and turn a dark brown or black color. As this happens, the cord will shrink and often looks like a scab on the baby’s abdomen. In the past, the umbilical stump was coated with a blue dye after birth and parents were told to clean the area with rubbing alcohol at every diaper change. These recommendations were discontinued because they were found to increase the time it took for the cord to fall off. Nowadays, parents don’t need to do anything special other than keeping the stump from becoming irritated by the baby’s diaper and avoiding baths until the cord falls off.
A few things may happen that worry parents during the 7 to 10 days that it takes for the cord to fall off.
If you spend time outdoors with children, you’ll need to keep them safe from mosquitos, biting flies and ticks. For young infants, the best approach is to protect them with clothing or nets that cover their strollers. For older children, you’ll need an insect repellent to get the job done. DEET can be used with infants as young as 2 months, but the American Academy of Pediatrics (AAP) recommends not using products with more than 30% DEET: http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx. Lower concentrations of DEET work well, but last for shorter periods of time. A 10% concentration lasts for about two hours. I prefer an ingredient called picaridin because it works almost as well as DEET, but feels nicer on the skin. If you want a natural product, the soy-based repellent in Bite Blocker lasts about 90 minutes.
If you use a product containing DEET or picaridin, a lotion or pump spray is safer than an aerosol. Don’t apply it to your child’s hands and be careful to avoid the eyes, nose and mouth. It’s also a good idea to wash it off when you come inside.
You should not use products containing insect repellent and sunscreen. Instead, apply the sunscreen first, wait until it’s absorbed, and then apply the insect repellent. Keep in mind that sunscreen should be used liberally and reapplied every two hours. Bug sprays are applied sparingly and many should not be reapplied. Always read the instructions that come with the product you’re using.
One of the frustrations that comes with itchy rashes is something doctors call the “itch scratch cycle.” The process goes like this: A rash itches so we scratch it. Although the scratching makes the itch go away, it can irritate the skin causing the itch to recur. This can lead to itch-scratch-itch-scratch, etc. Eventually, the skin can become so irritated that scratching the area actually hurts. The best way to deal with this is to put something cold on the itchy/painful area for 5 to 10 minutes. Of course, not getting into this bind is even better.
If your child starts to scratch a bug bite, you can use 1% hydrocortisone ointment (not cream) and a “dot” Band-Aid to stop the itch. First, put a small amount of the ointment on the bite. Second, open the Band-Aid and briefly stick it to your shirt or pants. (This takes some of the adhesive off the bandage so your child is less likely to complain when you remove it.) Third, place the Band-Aid on the bite and leave it in place for about 15 minutes. You can repeat this up to three times a day for four or five days if necessary. Facial skin is thinner than skin on the rest of the body, so don’t use Band-Aids for facial bug bites. The hydrocortisone can still help, but you shouldn’t use it for more than three days.
If the bite gets very red or develops discharge, call your doctor to make sure it hasn’t become infected.
Many childrearing books tell you not to use soap on a baby’s face. One of the reasons for this is because soap may irritate a newborn’s sensitive facial skin. Another is that a newborn’s skin is slightly acidic, which helps prevent infection. Soap can reduce the natural acidity of a newborn’s skin.
The problem with not using soap on a baby’s face is that some of them will be more prone to newborn acne and other rashes because of dead skin, saliva and regurgitated milk that accumulates on their face. The answer to this problem is to wash the baby’s face with a ph-neutral soap substitute like Cetaphil Gentle Skin Cleanser. Using Cetaphil with a washcloth helps remove dead skin, etc. without harming the baby’s skin.
I get lots of calls that children complain when parents use either prescription or non-prescription creams to treat eczema and other rashes. In many cases, parents think their kids are just being difficult, and there is no way a cream can sting. Your kids are not making this up.
Most creams contain a substance called propylene glycol. Although propylene glycol is not dangerous, it can sting if a child has tiny cuts or cracks in his skin. The best way to deal with this is to use ointments instead of creams.
I prefer ointments not only because they don’t sting, but also because they do a better job moisturizing the skin. Parents are often hesitant to use ointments because they are greasy. You can manage the greasy quality of ointments by being careful to only apply a thin layer to the skin. The best way to do this is to rub some ointment onto your palms before applying it to your child’s skin.
Howard J. Bennett - Pediatrician and Author in Washington, D.C. 