Why Do Newborns Lose Hair on Their Heads?

by Dr. Pamela Bandelaria, pediatrician

It may be alarming to see your baby losing their hair after birth. You may notice that your baby's hair falls out or find hair on the bed or pillow when you pick your baby up.  You may also notice bald spots in your baby's head.  If you are a first-time parent, you might wonder if hair loss is normal for infants. Read on to find out more about the patterns of hair growth and hair loss in babies and why hair loss occurs. You will also learn when your baby's hair will grow back and what you can do to prevent your baby's hair from falling out.

When do babies get a full head of hair?

Hair begins to form even in the womb. At three months of pregnancy, hair follicles have already started developing on your baby's skin.  At around five months of gestation, hair will begin to peak and sprout from these follicles. Hair growth occurs first in the eyebrow, upper lip, and chin regions. At 5 ½ weeks of pregnancy, hair will be seen growing on your baby's head. Melanin, the pigment which gives the hair color, is also produced around this time.

When your baby was born, you might remember that first cry that they made and your first glance at their face. Did you notice their hair at that time? Most of us were so in awe of the miracle of life that small details, such as the amount of hair on your baby's head, remain a blur.  Some babies are born with a thick head of hair, while others are almost bald. 

When your baby is born, your doctor won't be concerned by how much hair they have on their heads, but the fine hair distributed all over their body.    This delicate, immature hair is called lanugo and is usually found on the scalp, brow, face, and extremities, but rarely in the palms, lips, and soles of the feet.  Lanugo is generally abundant in preterm babies but is absent in term babies as it is shed during the seventh or eighth month of pregnancy. This is the only hair that doctors check for when your baby is born.

Why does my baby have bald spots?

Even when your baby is born with a full head of hair, you may notice the appearance of bald spots on your baby's head. This apparent balding can be due to a condition called neonatal occipital alopecia or transient neonatal hair loss. It is a non-threatening condition that leaves bald patches on parts of the head, most noticeably at the back or occiput. Usually, the hair loss forms an oval at the back of the head. Some babies may have more patches with more significant hair loss. However, it is essential to note that this hair loss is not associated with scarring or skin changes.

When and why does a newborn baby's hair fall out?

This condition is normally observed when your baby is around two or three months old. Although it was previously believed that hair loss might be due to the friction on your baby's head from sleeping on a pillow, or sleeping position, it has now been found that this is related to the normal cycle of hair growth.

The hair typically undergoes a cycle at different stages of your baby's development. Firstly, there is an active phase associated with cell division and growth, then a resting stage, followed by shedding.  In transient neonatal hair loss, the hair, especially the ones in the back of the head, undergoes this cycle, leading to bald spots in your baby's head.

Although it may not be the direct cause, some studies say that the pillow and sleeping position may aid or contribute to the hair shedding. Despite this, there is no direct relationship between sleeping position and hair loss. Therefore, it is still not recommended to change the baby's sleeping position to avoid hair loss because this may have more dangerous consequences.  Placing your baby in side-lying or on their tummies could compromise their airways and increase their chances of SIDS. 

Do all newborns lose their hair?

Neonatal occipital alopecia or transient neonatal hair loss occurs with a prevalence of around 9-12% and is seen more in Caucasian babies.  Sometimes, the hair loss is barely noticeable, and most parents will not be aware of the condition. Different studies claim that maternal age, maternal hair condition, gender, and other factors can affect neonatal occipital alopecia. Still, there is been no solid correlation other than that is a physiologic shedding of hair. 

How long does it take for babies’ hair to grow back?

If your baby has transient hair loss, the good news is that your baby's hair will grow back. The hair regrowth may be fast or slow, but it usually grows at around four to six months of age. A large proportion of babies with the condition will have most of their hair back by their first birthday. At the two-year mark, most babies will have a full head of hair.  If your baby still has patches or appears bald by the time they are two years old, it is best to have your baby checked. This condition may be caused by autoimmune diseases or fungal infections, or other conditions that may warrant further investigation.

How do I prevent my newborn's hair from falling out?

If your baby has transient hair loss, you cannot prevent it from happening. This is because some babies are predisposed to it more than others. However, some techniques can help lessen or aid in preventing hair from falling out. Although there is no direct or causal link between friction and hair loss, avoiding things that can cause further friction on your baby's head can help prevent the severity of hair loss.  These include avoiding placing anything on your baby's hair (caps, bonnets, or headbands if your baby is a girl) and avoiding tying or styling your baby's hair. Lessening the frequency of scrubbing the hair during baths as well as combing can also help. Caregivers should also use a  soft brush for combing the hair to avoid excessive pulling that can worsen the hair loss.

When should I be concerned about my baby’s hair loss?

Hair loss in babies is quite common, although there aren't many cases documenting it because it is usually not associated with severe symptoms. It also resolves spontaneously, so some parents may not even bring it to the physician's attention. This condition is also most likely observed if the baby does not have other signs and symptoms. It is important to note that transient neonatal hair loss does not have scarring, so if there are scars or wounds, or bleeding in your baby's scalp, this should be brought to the attention of your physician. Moreover, transient neonatal hair loss resolves spontaneously, so your physician must also examine persistent hair loss.

Hair loss is sometimes a telltale symptom of other illnesses such as malnutrition or signs of congenital, metabolic, or genetic disorders. These babies will usually be sickly, weak, inactive, and have other symptoms that warrant investigation.  If your baby has other symptoms in addition to hair loss, visit your doctor right away.

Conclusion

Hair loss is not as common a complaint as cough and colds, but knowing when to bring your baby to the doctor is essential to check if your baby may have other conditions.