Sacral Dimple in Newborn: Harmless or Dangerous?

What is a Sacral Dimple?

First off, what exactly is a sacral dimple? A sacral dimple is a tiny dent or pit usually found near the bottom of the spine, right above the little crease in the gluteal cleft, aka buttocks. They come in various sizes and are quite common in babies.

Here’s the cool part – most sacral dimples are harmless! They don’t go deep into the spine, and many babies are born with them. You might not even notice it until you take a closer look during diaper changes.

While most sacral dimples are just a cute part of your baby’s unique features, it’s a good idea to keep an eye on a few things. If the dimple is very deep or unusually large, or if it’s located above the crease between the buttocks, it’s worth mentioning to your doctor at your child’s routine office visits.

Remember, every baby is different, and these little dimples are just one of the many charming details that make your little one uniquely them!

How Common is a Sacral Dimple In Newborn?

At your baby’s first exam your child’s healthcare provider will do a newborn physical examination.  It will include a head to toe assessment.  During this assessment or at future assessments the presence of a sacral dimple may be uncovered.  Sacral dimples are very common in newborn infants and about 3% to 8% of babies are born with them. Personally, I have seen lots of babies with sacral dimples, so it’s quite common.

What Serious Underlying Abnormality of the Spine Could it Be?

A simple sacral dimple presents as a small and shallow depression above the crease of your baby’s buttocks. Most sacral dimples are small and don’t go too deep below the skin.  The difference between a simple dimple versus an atypical dimple is the potential for more-serious conditions.  Some conditions your medical provider may want to rule out include:

• Spina bifida occulta: This is a mild form of spina bifida and occurs when the spine doesn’t close properly around the spinal cord, and there is an opening between the bones of the spine.  It usually requires no medical intervention.
• Tethered cord syndrome: Your spinal cord typically hangs freely in your spinal canal.  In this case the tethered spinal cord (tissues attach to the spinal cord) restricts it’s movement.  Some symptoms could include weakness or numbness in the legs or bladder or bowel incontinence.  All of which could be hard to decipher in a newborn.

Causes of Sacral Dimples

• It’s a Congenital Condition: One of the primary reasons your baby might have a sacral dimple is simply because it runs in the family. Sometimes, these charming little dimples are passed down from generation to generation, making them a part of your baby’s unique genetic makeup.
• A Souvenir of You Baby’s Development:  In many cases, sacral dimples are just a normal part of a baby’s development. They form during the early stages of pregnancy as the spine and surrounding skin develop, creating these cute indentations. 
• Due to a Spinal Cord Problems: As discussed above any of these conditions can cause a dimple around the base of the spinal cord.

When to Call the Doctor?

Firstly, many sacral dimples are harmless and perfectly normal. Most babies with sacral dimples grow up happy and healthy without any issues.  However, there are some cases where these sacral dimples could be a sign of a serious spinal problem, and as such, requires a doctor’s visit.

• Deep or unusually large
• Redness, swelling, or discharge
• Nearby tuft of hair or skin tag 
• Discoloration

While most sacral dimples are innocent, there are instances where they might need a bit more attention, so please talk with your provider.

What are the Treatment Options?

If your baby has a sacral dimple, your doctor will likely keep an eye on it during regular check-ups. In some cases, if your doctor has any concerns about the sacral dimple, they might suggest additional tests or imaging such as: 

• Ultrasound: uses sound waves to produce images of structures of the body underneath the skin.
• Magnetic resonance imaging (aka MRI): takes cross-sectional images of the body like slices of bread.  It then takes those images and puts them together to give you a 3D image.  Your doctor does this not to worry you but to ensure a thorough understanding of your baby’s unique features and to rule out any potential complications.

Very rarely, if there are signs of an underlying issue, surgery might be considered. However, it’s crucial to emphasize that this is highly uncommon, and the majority of babies with sacral dimples grow up perfectly healthy without needing any surgical intervention.

Final Thoughts

Sacral dimples, those tiny dents near your baby’s adorable bottom, are a common and usually harmless feature. While most sacral dimples need no special treatment, it’s a good idea to mention them to your doctor during regular check-ups. I understand seeing this dimple may make you worry as to whether they are truly harmless or not and that’s completely fine.

It’s always best to let your doctor take a closer look. While extremely uncommon, in rare cases, surgery might be considered if there are signs of an underlying issue. However, the vast majority of babies with sacral dimples grow up healthy without needing interventions.