Milk spots in newborns: causes, treatments, and how to prevent them

Milk spots in newborns, also known as milia, are a common skin condition in babies. Although you may feel concerned if you notice them on your baby, they are harmless. In fact, health professionals believe that around half of all full-term newborns will develop milk spots. NHS GP Thuva Amuthan explains: “Milk spots, or milia, are very small white or yellow spots that appear on a baby’s face in the first few days.”

Although they’re essentially nothing to worry about, milk spots can be alarming for new parents. This is because they usually appear in the early days of a baby’s life, when you are just getting to know your little one. So, we’ve put together everything you need to know about milk spots in newborns, from what causes them and how to treat them.

However, always follow the NHS advice about getting to know your newborn. If you are worried about a baby rash or you notice a change in their behaviour, such as not feeding well, being very sleepy, or very irritable, contact your GP or midwife immediately.

What are milk spots?

Milk spots in newborns are caused by a buildup of keratin underneath the skin. Keratin is a protein which is found in skin, hair and nails. The white milk spots generally appear on the face, around the baby’s eyes, nose and mouth. Pharmacist Anshu Bhimbat explains: "Although they're called milk spots, it's a common misconception that they're linked to the child's milk. They’re actually sacs of a protein called keratin which build up. The reason they’re called milk spots is just because they look like little tiny milk sacs, but there’s no real link to the milk."

What causes milk spots in newborns?

The reason why some babies develop milk spots and others do not is unclear. However, it is believed that they may be due to the mother’s hormones or because the child’s skin has not yet developed properly.

However, researchers believe they know what causes them. Hair follicles consist of several parts, including the hair shaft which is encased in two sheaths, the inner root sheath, and the other root sheath. The outer root sheath has a component called the bulge, which is a reservoir for hair stem cells. Researchers have suggested the bulge may be where milk spots originate. It's not only babies that can suffer from this keratin build-up, adults often have it as well.

Milk spots usually appear to be white or yellow, depending on your baby’s skin tone. Although milk spots in newborns may look concerning, it’s important not to change your feeding routine with your little one. Anshu says: "We don’t want people to stop breastfeeding or start worrying about the milk that they’re giving to their child.”

How long do milk spots last on newborns?

Milk spots on newborns do not last for long. Although it may feel like a bit of a worry when they first appear, they should last no more than a couple of weeks or months. Milk spots usually disappear on their own so there is no need to follow a particular treatment plan.

Scientists describe milk spots as a “self-limited disease”, which means it resolves spontaneously, without needing specific treatment. GP Dr Amuthan, who is also the founder of Dr.Derme Skin and Aesthetics Clinic, says: “Milia usually disappear within a few weeks or months on their own.”

What is the best way to treat milk spots in newborns?

Although it can be tempting to try to treat milk spots in newborns, the best thing to do is to leave them alone. If you do this they will clear up fairly quickly. While it is fine to use specific baby products on their skin if you wish, you should never ever try and squeeze the spots. This could end up damaging your baby’s delicate skin. Dr Amuthan says: “Milk spots do not need any specific treatment. Keep the skin clean with baby wash and a gentle moisturiser.”

Studies have shown that a newborn’s skin is still developing, as it becomes used to the relatively dry air after being in the uterus. As a result this makes it more susceptible to chemical irritation. So, if you do intend to use products on your baby’s skin, make sure they are suitable for newborns and wipe their skin gently with a soft cloth. The most important thing to remember is to never try to pop the spots. This could lead to permanent damage, such as scarring.

Does breast milk help milk spots?

Studies have shown that breast milk is often used as a natural medicine for skin conditions ranging from eczema to nappy rash. While no specific research has been carried out to discover whether breast milk helps milk spots, anecdotally some parents believe that it does.

Dr Amuthan explains: “Breast milk has been studied in treating conditions like eczema. It is suggested that the moisturising and antimicrobial properties can help skin conditions.”

If you decide to use breast milk on your baby’s milk spots you should apply it using a clean finger. Alternatively you could soak a cotton ball in breast milk and gently rub it over your child’s face.

Is it possible to prevent milk spots in newborns?

Unfortunately, it is not possible to prevent milk spots in newborns. However, they are usually very small and often not noticed by other people. Milk spots are very common and will not harm your baby’s skin. The best thing to do is to let them go away on their own naturally. Milk spots in newborns are caused by their developing skin. While they may look worrying to parents, researchers agree that they are “benign and self-limited”.

However, it is also possible for adults to develop milia and this is often caused by damage to the skin. Dr. Amuthan says: “In adults, milia is seen following damage to skin from sunburn, physical or prolonged steroid use. A gentle wash and non-greasy moisturiser may help soothe the skin.”

To avoid milia in adults it is a good idea to wear sun cream while out in the sun. Milk spots can also be lasered off in adults, using light and sound energies to repair the skin. The laser breaks down the keratin cysts, resurfaces the skin and improves the stability of the sebaceous glands, which are also responsible for acne. However, Anshu says the condition is not often treated in adults, as either people don't tend to notice it or don't have an active desire to get rid of them.

What’s the difference between milk spots and baby acne?

Sometimes milk spots are called 'baby acne' but this condition and milk spots are two different things. Acne spots have a head on them, whereas milk spots are just raised sacs on the skin.

Milk spots usually appear on the skin fairly soon after a baby’s birth. However, baby acne can appear within a month after birth. Although the specific cause is unknown, theories of what causes baby acne include hormones and blocked pores. The affected area around baby acne, which can appear on a baby's face, upper back or neck, also tends to get red and irritated. They can look worse if the baby is crying.

Much the same as milk spots, baby acne is normally harmless and resolves itself within a couple of weeks. To treat baby acne you can wash your baby’s face with water and use a mild moisturiser. However the NHS warns that you should never use acne medicines intended for older children or adults on baby’s skin.

Dr Amuthan says: “Milia are small cysts containing keratin, a skin protein and babies can be born with it. Baby acne, however tends to appear after the baby is born. With baby acne you tend to have white or blackheads which can be red and angry. They may even become infected and need medical treatment.”

If you're ever in doubt about your baby's skincare, visit your local pharmacist or call 111. Both will be able to offer more information.

When should you seek medical advice if you're worried about milk spots?

Generally milia will resolve itself within a few weeks. However you should always seek medical advice if you're worried about milk spots. You can always speak to a pharmacist or your midwife if you are concerned. But if the milk spots seem to get infected or you are not entirely sure what the rash is, you should call your GP or the NHS on 111.

Anshu says: “Milk spots are a perfectly natural skin condition that tends to heal on its own. However, sometimes they can get infected and that’s when treatment may be required, so it’s just about keeping the skin clean, using the correct baby bathing product on your child’s skin. Sometimes, water is enough. You don’t want to be rubbing the skin to irritate it."

But she warns, "Obviously if your child has other symptoms, so a fever or rashes on other parts of their body, if they’re systemically unwell, then you’ll need to go to A&E or call 111. You have to look at all the symptoms as a whole but generally [milk spots are] okay."

It can often be frightening when a rash appears on your child, but unlike the more worrying meningitis rash, which has red spots, milk spots will be white or yellow. If you are concerned about a rash you can always do the glass test recommended by Meningitis Now. You can also use a baby rash visual guide to help identify the rash.

Dr Amuthan says: “If you are unsure about what the lesions may be or are worried about the severity or number of spots, it may be worth getting medical advice.”

To research this piece about milk spots in newborns, we spoke to Dr. Thuva Amuthan:

Dr. Thuva Amuthan

 

Dr. Thuva Amuthan is an NHS GP in Birmingham, with a special interest in dermatology and minor surgery. He is also the founder of Dr. Derme Skin and Aesthetics Clinic and specialises in cosmetic skin treatments and aesthetics.