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Ever heard of cafe au lait or strawberry hemangioma? No, […]

Ever heard of cafe au lait or strawberry hemangioma? No, these aren’t the latest espresso varieties on the Starbucks menu—these names refer to some of the most perplexing things new parents have to decipher: birthmarks. Although birthmarks are as common among infants as diaper rash, most parents still worry about the effect they could have on their baby.
It may be hard for a new mother to think so far ahead, but your infant’s birthmark will probably be gone by the time you wave your child off for their first day of school! Here’s what you need to know about your baby’s angel kisses.
birthmarkBirthmark 101
Birthmarks are simply areas of discolored skin that appear on a baby’s body at birth or show up a few months after delivery. They come in a wide range of shapes, colors and sizes and can be found anywhere on the body. Birthmarks can be categorized as vascular or pigmented—vascular birthmarks are an accumulation of blood vessels underneath the skin, while pigmented birthmarks are simply discolored patches of pigments.
Some marks are permanent, while others fade almost immediately and others only become visible when your baby cries or when there is a temperature change. Although there are many different skin markings commonly labeled birthmarks, here are a few of the most familiar marks seen by mamas everywhere:
Mongolian spots
A thick collection of melanin-packed skin cells. They appear as brown patches, although the deeper the birthmark goes the more bluish and bruise-like the spot may appear. They’re likely to appear on the buttocks and back, although they sometimes show up on a baby’s legs and arms. Most fade before the age of 2, but those that are large or in uncommon locations may hang around through adulthood.
Port-wine stains
Like the name suggests, these spots look as though someone has stained your baby’s skin with red wine. Although, as Dr. Anne Comi, Director of the Hunter Nelson Sturge-Weber Center, Kennedy Krieger Institute notes, “There is an effort to change the name to port-wine birthmarks and drop the word ‘stain’ due to its negative connotation.”
Ranging from small to large, they can occur anywhere on the body and have a high tendency to remain a permanent fixture from infancy through adulthood. How will you know if your baby has a port-wine mark? They’re relatively common. “About 1 in 300 infants are born with one somewhere on the body,” explains Dr. Comi. “If the birthmark is pressed lightly it will lighten and then darken again when released as the blood vessels refill with blood.”
Port-wine stains on the eyelids can be a precursor for glaucoma or Sturge-Weber Syndrome and should be checked. “When the birthmark is on the upper part of the face (forehead or eyelid) then the child has a 15-35 percent risk of brain and/or eye involvement,” says Dr. Comi.
“If the birthmark is in that area, the child needs to be monitored for life for the onset of glaucoma, and he or she remains at risk for brain involvement for the first several years of life, even with adequate neuroimaging.”
Most, though, are physically harmless and only pose psychological issues if they’re large or in a visible place. New laser treatments and skin-grafting techniques may allow for the stain’s removal if necessary.
A grouping of excess blood vessels on the skin (strawberry) or under the skin’s surface (cavernous). Strawberry hemangiomas are soft, red or purple and generally appear on a baby’s upper body. Cavernous hemangiomas are usually on the neck or head and because they’re deeper have a bluish look. Hemangiomas can come about pre- or post-birth, and they’ll usually go away on their own. If they haven’t disappeared by the time your kiddo heads to preschool, they’ll almost certainly be gone by puberty. Very large hemangiomas should be monitored, because they can cause physical harm and/or skin disfiguration.
Cafe au lait spots
The color of these flat, sharp-edged spots range from a light, milky cappuccino to a dark roast. While a couple of these little marks are fine, if your babe has more than three distinct cafe au lait spots of notable size be sure to point them out to his pediatrician—multiple markings can be a sign of a disfiguring disorder called neurofibromatosis.
Salmon patches
Flat and pink, these are thick capillaries left over from your baby’s growth in the womb. All babies have salmon patches, but some disappear before birth. Usually they appear on the back of the neck, just below the hairline or on the face—which is why they’re commonly referred to as “stork bites” or “angel kisses.” They’re likely to disappear during your baby’s first year and those that hang around are generally covered by hair.
Almost everyone has at least one! Colored anywhere from light brown to black, the moles your baby is born with could be located anywhere on his body. Like freckles, they may fade and disappear through childhood, or stay put for a lifetime. No matter what, if your babe is born with moles he’ll probably acquire a few more throughout his life. To combat melanoma, be sure to always use sunscreen and have a doctor check any odd-shaped or discolored spots.
When to worry
While most birthmarks are harmless and disappear in the first few years, there are some that do require medical attention. It’s important to have your pediatrician check all of your child’s birthmarks for irregularities in size, color or texture. Depending on where they are located or how deeply they’re connected, some could cause problems with vision, eating or breathing and should be removed. Depending on the type and size of the birthmark, the various treatment options range from surgical removal, laser therapy, skin grafting and oral or injected steroids.
If the mark isn’t causing physical harm, pain or disfiguration, many parents opt for the “wait-and-see” approach. Although dangerous skin spots and tumors should be dealt with immediately, rest assured that most birthmarks will fade and can simply be left alone.
The most important thing to remember is that no one is to blame for these random skin spots and most birthmarks are physically harmless. However, a prominent mark in a noticeable area can give rise to concerns about a child’s self esteem or peer acceptance later in life. Dr. Milton Waner, Co-Director of the Vascular and Birthmarks Institute of New York at Roosevelt Hospital, gives his insight on birthmarks and what parents can do to help: “The most important thing is to make the child aware of [their mark] and teach them coping skills.
I think it’s very important for a child to realize this is not a defect. Some people have them, some people don’t.”
As a new parent, coming to grips with your baby’s birthmark can be very difficult. Research and find out all you can about the type of birthmark your baby has so you’ll be more comfortable dealing with it, and talk to your kiddo about it when she’s old enough to understand. If you’re comfortable with your baby’s birthmarks, she will be, too!

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