From the Research
A protruding xiphoid process in a newborn is typically a normal anatomical variant and usually requires no medical intervention. The xiphoid process is the small, cartilaginous extension at the lower end of the sternum (breastbone) that may appear more prominent in some newborns. Parents should be reassured that this protrusion generally becomes less noticeable as the child grows and develops more subcutaneous fat. No specific treatment, medication, or manipulation is recommended, as attempts to push or flatten the xiphoid can actually cause harm to the underlying structures. If the protrusion causes skin irritation in rare cases, protecting the area with soft clothing may help. Medical attention should only be sought if the protrusion is associated with pain, significant skin changes, or if it appears to be increasing in size. The prominence occurs because newborns have less fat covering their chest wall, making normal anatomical structures more visible. As the child grows and develops more subcutaneous tissue, the xiphoid process will typically become less noticeable and blend with the surrounding chest contour.
Some studies have reported rare cases of xiphoid syndrome, where the xiphoid process can cause pain or other complications 1, 2. However, these cases are extremely rare and usually do not apply to newborns. In fact, the study by 1 reported a case of a xiphisternal ulcer secondary to a protruding xiphoid process, but this was an adult patient and not a newborn. Another study by 2 discussed the treatment and management of xiphodynia, but again, this was not specific to newborns.
It's worth noting that the position of the xiphoid process can vary among individuals, and studies have attempted to determine the normal position of the umbilicus in relation to the xiphoid process 3. However, these studies are not directly relevant to the question of a protruding xiphoid process in newborns. Other studies have focused on the optimal chest compression position for cardiopulmonary resuscitation 4 or developed noninvasive methods for evaluating experimental lung metastasis in mice 5, but these are not applicable to the current question.
In summary, a protruding xiphoid process in a newborn is usually a normal anatomical variant that requires no medical intervention, and parents should be reassured that it will likely become less noticeable as the child grows and develops. Medical attention should only be sought if the protrusion is associated with pain, significant skin changes, or if it appears to be increasing in size.