Isla Bennett
Babies are born with fingernails, and they are often long enough to scratch their skin as they bring their hands to their faces. In some cases, babies are born with no nails, and this is usually due to a genetic disorder. The anatomy and embryology of the nail are well known, and nail abnormalities are a feature of many genodermatoses. Newborns' nails are most often soft and flexible, but they can hurt the baby or others if they are ragged or too long.
| Characteristics | Values |
|---|---|
| Fingernail Growth | Fingernails grow at 3mm per month |
| Toenail Growth | Toenails grow at 1 to 1.5mm per month |
| Nail Shape | Fingernails are oval-shaped or have flat curvature; Toenails are triangular or round |
| Nail Disorders | Koilonychia, onychoschizia, onycholysis, incontinentia pigmenti, epide, ectodermal dysplasias |
| Nail Development | Nails begin to develop at 8-9 weeks of fetal development |
| Nail Care | Nails should be kept clean and trimmed to prevent self-harm or harm to others |
| Reflexes | Newborns have a grasp reflex that causes them to tightly close their fingers when pressure is applied to their palms |
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What You'll Learn
Babies are born with fingernails
The shape of a newborn's fingernails can vary, with some having oval-shaped nails, while others have flat curvature. In contrast, toenails often have a triangular or round shape. In rare cases, babies may be born with nail disorders, such as ectodermal dysplasias, which can cause defects in nails, hair, teeth, and sweat glands. These disorders are usually the result of genetic factors.
In addition to fingernails, newborns may also have a fine hair called lanugo on their scalp, forehead, cheeks, shoulders, and back, especially if they are born prematurely. This hair usually disappears within the first few weeks of life. Newborns may also exhibit a variety of skin colour patterns, such as mottling, blueness of the skin on the hands, feet, and around the lips, and red marks, scratches, and bruises. These variations in appearance are normal and are typically not a cause for concern.
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Newborns' nails are soft and flexible
Yes, babies are born with fingernails. In fact, it is quite common for newborns to have long fingernails. Nails are an appendage of the epidermis and begin to develop at 8-9 weeks of fetal development. Toenails grow slower (1 to 1.5 mm per month) than fingernails (3 mm per month), which explains why fingernails are often longer at birth.
In addition to having soft and flexible nails, newborns may also have fine hair on their scalp, forehead, cheeks, shoulders, and back, called lanugo. This is especially common in premature babies. Newborns are also often covered in a creamy, waxy white substance called vernix, which protects their skin from the amniotic fluid in the womb. Both the vernix and the lanugo usually wash off when the baby has their first bath.
While most babies are born with the requisite number of toenails and fingernails, in rare cases, some or all may be absent due to a genetic disorder. One group of these inherited disorders is ectodermal dysplasias, which cause defects in nails, hair, teeth, and sweat glands. If a baby is born without nails, it is recommended that their parents consult a pediatric genetic specialist to determine the cause and whether any treatment is necessary.
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Nails grow in the womb
A baby's nails grow while in the womb, and they are born with fingernails and toenails. In fact, a baby's nails can be long enough at birth to scratch their skin. This is because nail growth begins at around 8-9 weeks of fetal development and progresses slowly. Toenails grow slower than fingernails, at 1 to 1.5 mm per month compared to 3 mm per month for fingernails.
The growth of nails in the womb is part of the process programmed into our DNA, and a mother's body produces hormones to ensure this happens. In rare cases, a baby may be born without some or all of their nails, and this is usually due to a genetic disorder. One group of these inherited disorders is called ectodermal dysplasias, which cause defects in nails, hair, teeth, and sweat glands. In a 1990 estimate, seven out of every 10,000 babies were born with one of these disorders.
The shape of a baby's nails can vary, with fingernails tending to be oval or have a flat curvature, and toenails often being triangular or trapezoidal, particularly the big toe. This is due to the more rapid growth rate of the nail matrix in its central portion, or the asynchronous onset of growth of the nail matrix, starting in the center and then proceeding outwards. The triangular shape is more evident at birth in toenails, especially the big toe, because of their slower growth rate.
In a study of 541 consecutively born neonates, the toenails of 64.1% of babies were triangular or trapezoidal, with the shape becoming rectangular within 45-90 days on average. The fingernails of newborns tend to have an oval or flat shape, and about half will have a lunula.
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Babies' nails grow quickly
Babies are born with fingernails and toenails. In fact, a baby's nail beds begin to form as early as week 11 of pregnancy, with the nails themselves starting to grow around week 12. By the 34th week of pregnancy, the baby's nails are almost ready for their first mani-pedi.
After birth, it is important to keep a newborn's nails short and clean to prevent scratches. Baby nails tend to be soft and quick-growing and can easily become long and ragged. They may need to be trimmed as often as once a week. Toenails grow more slowly and only need to be cut a few times a month.
When trimming a baby's nails, it is important to be careful to avoid nicking their skin. Pressing the finger pad away from the nail can help with this. If the skin is accidentally cut, clean, damp cotton wool can be applied to stop any bleeding. As baby nails can be difficult to trim, it may be helpful to have another adult assist with the process.
Like hair and skin colour, a baby's nails can continue to change and develop in the weeks and years after birth.
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Nail abnormalities
While nail disorders in infants and children are uncommon, they can be a source of anxiety for parents and caregivers. Nail abnormalities can be a cosmetic or psychological problem, or they may be associated with an underlying systemic condition.
One common nail abnormality observed in newborns is Beau's lines, which appear as a single transverse depression of the fingernails. Beau's lines occur in 92% of newborns, and they disappear with growth before 14 weeks. These lines are the result of intrauterine distress or physiological alterations during birth, causing mild trauma to the proximal nail matrix and temporarily reduced nail growth.
Another nail abnormality that can be observed in newborns is Koilonychia, commonly known as spoon nails. This condition causes the nails to become abnormally concave, giving them a scooped-out appearance due to their pliable nature. Koilonychia is prevalent in about 33% of neonates, and it usually resolves on its own within the first decade of life as the nail plate strengthens. In cases where it persists, Koilonychia may be caused by injury, inflammatory dermatosis, or iron deficiency anemia.
Onychoschizia is another nail condition that requires a thorough examination of all 20 nail units, including the nail plate, lunula, and proximal, distal, and lateral nail folds. It is important to look for any periungual scaling, erythema, or other cutaneous symptoms that may indicate an underlying dermatologic condition. Onycholysis and increased longitudinal or transverse nail curvature are also evaluated in the examination.
In addition, abnormalities in the capillaries of the proximal nail folds can indicate an autoimmune connective tissue illness, and ischemia and cyanosis can suggest poor circulatory flow. Onychocryptosis, or ingrown toenails, is a common nail condition that can cause discomfort and impact a child's everyday activities. It is characterised by redness and swelling around the nail folds of the toes, and it may be caused by genetic susceptibility, trauma, tight-fitted shoes, or incorrectly trimmed toenails.
It is important to note that nail abnormalities in newborns and infants are often transient and may resolve on their own. However, a careful and meticulous examination by a clinician is essential to rule out any underlying diseases or conditions.
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Frequently asked questions
Yes, babies are born with fingernails. In some cases, they can be long enough to scratch their skin.
Newborns' nails grow quickly, so you may need to trim their fingernails at least once a week. Toenails grow slower, so you may only need to cut them a couple of times a month.
You can use a nail file or emery board to shorten and smooth the nails. Alternatively, you can carefully trim them with baby nail scissors or clippers that have blunt, rounded tips.
