Truth and myth of strawberry birthmarks

Strawberry birthmark, stork’s bite, café au lait spot and port-wine stain are all fanciful descriptions for the different kinds of birthmarks that a baby can have.

However, in the African culture these marks are called ibala, and are considered to be a terribly dangerous omen. Are they all harmless, or do these marks have a deeper significance?

What is a strawberry birthmark?

Capillary haemangioma is the medical term for this kind of birthmark, which is basically a non-cancerous tumour of dilated blood vessels in the upper-most layers of the skin. Simple, yes? No, not quite – because from here it gets a lot more complicated.

These marks may be small, or segmental, which means large and taking up a whole area, like one side of the face.  Pretoria-based general practitioner Dr Heike Frehse explains that 80% of these marks are found on the head and neck area and within the first 12 weeks they will grow to 80% of their total size, ‘Most will stop growing at 5 months, although some may grow until 18 months. After this period most will start to regress.’

There is the superficial kind, which is when only the uppermost layers of the skin are affected, giving the mark a pinker look. Then there is the deeper kind, which affects more layers of skin and has a bluish-purple colour and may even be raised to the touch. And finally, both kinds can be mixed together.

When should you be concerned?

Most of these marks are completely harmless, but Dr Frehse advises that multiple lesions could point to underlying congenital abnormalities and those located close to the spine could indicate a case of spina bifida.

‘Segmental haemangioma are less common and more serious. They occur at a younger age and grow much faster. They tend to look worse and can be associated with other congenital abnormalities,’ Dr Frehse warns.

Who is most at risk and what causes it?

According to an article written by Dr Amanda Oakley for the New Zealand Dermatological Society, ‘10% of babies develop one or more haemangioma, [and] localised haemangioma are more common if the baby has a low birth weight.’

According to this same article, risk factors include being female, having white skin, prematurity, being one of a multiple, advanced maternal age and a family history of infantile haemangioma.

A terrible omen?

Although not common, some of these birth marks can point to more serious conditions, which is most probably the reason behind the African cultural belief that ibala can kill a baby if the mark grows and reaches the fontanel at the back of the baby’s head.

African culture dictates that a baby born with ibala must be taken to a traditional healer, and often a new mother will be advised of this fact by elders in the family. In fact, in a report done for his master’s degree in paediatrics, for Wits University in 2008, Prosper Kwame Ayibor quoted ibala as one of the most common reasons why a baby will be taken to a traditional healer.

70% of babies taken to traditional healers have either ibala or inyoni (characterised by severe gastro and sunken fontanel). Both conditions are considered to make the child vulnerable to evil spirits, something only a traditional healer can combat, said the report.

The treatments often included the use of enemas, as well as cuts and lesions on the body into which a shoe-polish-type mixture called mohlabelo was rubbed. Because of the high rates of consultation with traditional healers, Prosper urged that healthcare workers should stress the normality of these kinds of conditions to parents and reassure them that their children would likely be fine.

While birthmarks are generally harmless and should not leave you worried sick, it is important to always consult your doctor if you suspect anything is out of the ordinary. Treatment is an option, especially for unsightly birthmarks, and will be based on the type, severity and position of the mark, says Dr Frehse.

Do you have experience of dealing with strawberry birthmarks?

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