What Is A Stork Bite?

  • Nayla NaderMasters Public Health - Health Management, Public Health, American University of Beirut

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Overview

Looking at your newborn baby, focusing on every single detail, is one of the many joys of being a parent. While gazing at your baby, you might notice little marks on their skin, triggering questions and concerns. One such marking, often referred to as a "stork bite," is a vascular harmless birthmark that contains extra blood vessels and appears in an important number of infants. Understanding this normal and common occurrence can ease your fears and provide you with information about your infant’s health.

Read on to understand more about a stork bite, its prevalence, characteristic features, types, causes, diagnoses, management, and the impact of living with this birthmark.

Definition of a stork bite

A "stork bite” is a benign type of birthmark that manifests as a pale pink to reddish even purple patch on your baby’s skin with no clear borders.1 The name comes from its association with the legend of storks picking up and delivering babies to parents. This mark is typically flat and most importantly harmless and painless.2 

Common locations on the body

These distinctive birthmarks most frequently appear in specific areas. They are typically located:

  • at the back of the neck, often referred to as a “salmon patch” or a “stork bite”
  • on the baby’s eyelids, forehead or between the eyebrows and are therefore known as an “angel’s kiss”
  • or less frequently on the nose, upper lip, and lower back.2, 3, 4

It can be helpful for parents to become acquainted with these typical locations as it will provide them comfort and reassurance.

Prevalence in newborns

Stork bites are extremely common, occurring in around 40% of newborns. They are usually temporary and disappear with time, however scientific data shows that stork bites are still present in 50% of adults. These lesions are more frequently observed in Caucasians than in dark-skinned newborns and affect both males and females equally.1,3 While these birthmarks are generally harmless, it's important for parents to continuously observe their baby, look out for changes or unusual features, and to seek professional advice if needed.2

In the next section, we will go into the specifics of stork bites, exploring their causes and characteristics. Understanding this natural phenomenon will help parents go through the early stages of their baby’s development more smoothly.

Understanding stork bites

Having established what a stork bite is, we can now further explore the medical nuances of this common birthmark.

A stork bite (medically called a nevus simplex or a macular stain) is a term that refers to a group of birthmarks characterised by excess blood vessels in the skin – the vascular birthmarks. Stork bites are the most common type of vascular birthmark.3

Causes and development

During foetal development, tiny immature blood vessels, called capillaries, may concentrate near the skin surface. During their formation, these capillaries may not form or mature properly.They may stretch or dilate more than usual.1, 2 This results in the appearance of pink or red patches characteristic of stork bites.This phenomenon is not associated nor is it indicative of any underlying health condition.3

Appearance and characteristics

Stork bites are easily identifiable by their location (neck, forehead, eyelids) and distinctive pale pink or reddish colour. They are typically flat, thin, smooth and irregularly shaped, differing from other birthmarks. Your baby may be born with this birthmark, or it may appear after a couple of months.2,3  Parents should be aware that these lesions may become darker in colour and more noticeable when their baby is crying, when the baby is hot or cold, or straining to pass stool.3,4

Understanding the causes and characteristic signs of stork bites is crucial in reassuring parents and caregivers of their benign nature. In the following section, we will further discuss the different types of stork bites.  

Types of stork bites

As already mentioned, stork bites appear in different locations on a baby’s skin. Recognizing their particularities can help parents identify and differentiate them. There are two types of stork bites, “angel’s kiss” and “salmon patch”, categorised according to their location on the body:

TypeLocationCharacteristics
Angel’s KissAppears on the baby’s eyelids, forehead or between the eyebrows.3Distinctive pink or red colour, as if the baby was kissed by an angel.Commonly fades over time and becomes less. noticeable as the child grows.2
Salmon PatchTypically appears at the back of a baby’s neck.3Distinctive pale pinkTends to fade with time.2

Remember that no matter the type, stork bites are harmless and purely cosmetic.3 Let us take a closer look at how they are diagnosed, and what differentiates them from other birthmarks.

Diagnosis and recognition

Visual examination 

Right after birth, and during routine check-ups, babies undergo thorough physical exams, during which physicians inspect their skin and look out for patches, discoloration or unusual lesions.2 

A paediatrician or a dermatologist can easily diagnose a stork bite following a simple visual examination of the lesion. Healthcare professionals can recognize these birthmarks based on their distinctive appearance and their location on your baby’s body.5 

Differentiating stork bites from other birthmarks

Distinguishing stork bites from other types of birthmarks is crucial for proper diagnosis. It is important to differentiate these harmless transient birthmarks from other serious lesions. Stork Bites can be confused with other vascular birthmarks, port-wine stains (nevus flammeus) and infantile haemangiomas.2,6 The table below highlights the characteristic features of these birthmarks.1,2,7

Stork BitesHaemangiomasPort-wine stains
Thin and flatThick, raised, and bumpyFlat
Pale pink or redPurplish, bright red spotPurple or dark red
Different sizes and shapesOften smallOften large
Undefined, irregular shapeOften smallWell-defined borders
Mostly found at the back of the neck and on the forehead, between eyebrowsMost common on face, scalp, chest, backGenerally found on the face. Can sometimes appear on neck, arms, legs
Fade with ageRegress with timeAre permanent - Darken and thicken with age

Due to differences in management and prognosis, an accurate diagnosis is important to reassure the parents and spare the baby unnecessary treatment.4

Stork bites and association with certain conditions 

It is extremely rare for a Stork Bite to be associated with an underlying medical condition. Nevertheless, healthcare professionals must always consider these unusual potential associations. As previously discussed, stork bites are very common innocent marks that mostly appear on the back of the neck and the forehead. Stains in the sacral area (lower back), however, are less common and therefore require further investigation. They might be indicative of a spinal defect such as spina bifida or a very rare genetic disorder, Cobb syndrome.7   

Understanding that it is extremely rare for a stork bite to be potentially associated with a certain medical condition will help ease the parents’ minds. In the following section, we will discuss the treatment, proper management and prognosis of Stork Bites. 

Treatment and management

Understanding the natural evolution of stork bites and the potential for medical interventions offers parents valuable insights into caring for their babies.

Natural fading over time

It is reassuring to know that stork bites usually undergo natural fading over time. As the child grows, the coloured patches become lighter and less noticeable. By the age of 1 to 2 years, Stork Bites on the face would have faded entirely. Marks on the back of the neck fade with time but do not disappear completely.3 This natural fading process underlines the benign nature of stork bites and comforts parents. 

Medical Interventions 

Stork Bites do not require immediate medical attention or intervention. There are, however, certain situations where parents may consider treatment for cosmetic purposes. For instance, persistent patches can be effectively managed by laser therapy. Lasers can significantly reduce the visibility of the birthmark and the psychological impact on the parents and the child.1,2,5 

Any decision about the treatment should only be made following consultation with a healthcare practitioner and after careful consideration of the child’s and parents’ preferences. 

Living with a stork bite

The parents of a child with any birthmark, especially a visible one such as a stork bite, can experience a rollercoaster of emotions. To ease their worries and alleviate their anxieties, it is important for parents to learn how to navigate this journey.

Addressing potential concerns and questions

It is normal for parents to have concerns and questions about their baby’s Stork Bite. Educating themselves about this condition will help them face it with positivity. Communicating with a healthcare provider is important for addressing these concerns. Healthcare professionals can assess the lesion, accurately label the Stork Bite as nonsignificant, and therefore guide the parents, offer them advice, and reduce uncertainty and anxiety.5

Embracing individuality and uniqueness

The first step in helping your child cope with their birthmark is to accept it yourself. Embrace your child’s uniqueness and accept their Stork Bite as one of the attributes that makes them special. Accepting their distinctive trait will foster a positive self-image and teach them to face the world, wearing their birthmark with pride. 

Supportive resources for parents and families

Nowadays, parents can easily find supportive resources to help them navigate this journey. For encouragement and understanding, you can look out for online educational data, and local support groups. Directly contact the Birthmark Support Group if you need to talk to someone. They can also direct you to birthmark specialists in the UK.

Remember, you are not alone in this. It is important to connect with other parents and families who have similar experiences and are going through comparable challenges associated with stork bites.8  

When to seek medical attention?

While Stork Bites are usually innocent, parents must be vigilant about signs of complications or unusual changes. According to the National Health Service (NHS) it is advisable to get the birthmark checked if: it gets bigger, changes colour, becomes irregular, or causes pain or discomfort. 

Summary

A stork bite or “nevus simplex” is a very common, harmless, and transient birthmark that most commonly appears on your newborn’s forehead (“angel’s kiss”), or on the back of their neck (“stork bite”). Even though these types of lesions fade away naturally as your child grows and do not require any medical treatment, you need to be aware that a small percentage will persist into adulthood.

Seeking medical advice is the key to having the proper diagnosis, sparing the child from unnecessary treatment procedures, and most importantly reducing uncertainty and anxiety. Educating parents about Stork Bites will shed light on their benign nature and provide reassurance regarding their temporary presence on the baby’s skin. 

Living with a birthmark is never easy, especially when having to face other people’s reactions and intrusive questions. Remember to reach out and find support. Navigating through this journey with confidence and positivity will be much easier when you and your child are surrounded by kind-hearted, supportive, and accepting people.

References

  1. Ngan V. Dermnet . 2003. Capillary vascular malformation. Available from: https://dermnetnz.org/topics/capillary-vascular-malformation
  2. Wu W. Dermnet. 2019. Naevus simplex. Available from: Naevus simplex | DermNet (dermnetnz.org)
  3. Leung AKC, Barankin B, Hon KL. Persistent salmon patch on the forehead and glabellum in a chinese adult. Case Rep Med [Internet]. 2014 [cited 2023 Nov 7];2014:139174. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053299/
  4. Techasatian L, Sanaphay V, Paopongsawan P, Schachner LA. Neonatal birthmarks: a prospective survey in 1000 neonates. Glob Pediatr Health [Internet]. 2019 Mar 29 [cited 2023 Nov 6];6:2333794X19835668. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442070/
  5. KUTLUBAY Z, TANAKOL A, ENGÝN B, ONEL C, SÝMSEK E, SERDAROGLU S, et al. Newborn skin: common skin problems. Maedica (Bucur) [Internet]. 2017 Jan [cited 2023 Nov 9];12(1):42–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574071/
  6. Juem AM, Glick Z R, Drolet BA, Frieden IJ. Nevus simplex: A reconsideration of nomenclature, sites of involvement, and disease associations. JAAD [Internet]. 2010 Nov;63(5):805–14. Available from: https://www.jaad.org/article/S0190-9622(09)02111-2/fulltext 
  7. Gelmetti C. Vascular birthmarks: a hidden world behind a word. Indian Journal of Paediatric Dermatology [Internet]. 2018 Mar [cited 2023 Nov 7];19(1):1. Available from: https://journals.lww.com/ijpd/fulltext/2018/19010/vascular_birthmarks__a_hidden_world_behind_a_word.1.aspx
  8. Vivar KL, Kruse L. The impact of paediatric skin disease on self-esteem. International Journal of Women’s Dermatology [Internet]. 2018 Mar 1 [cited 2023 Nov 10];4(1):27–31. Available from: https://www.sciencedirect.com/science/article/pii/S235264751730093X

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Nayla Nader

Registered Pharmacist, Masters of Public Health

Nayla is a pharmacist and public health specialist with a passion for education, community work, and medical writing. She has several years of experience in academia, teaching pharmacology to nursing students, conducting data analysis and report writing. Whether in the classroom, the community or on paper, Nayla is committed to simplifying complex health concepts and translating them into information accessible to all.

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