We include this as a treatment option because sometimes it is very appropriate to see what happens.
This is very different than ‘leave it alone it will go away’. It is a conscious decision to wait for a pre-determined period of time to see what the birthmark is doing.
For example, we may have a 1 month old infant who recently developed a deep hemangioma of the upper back. Because it is so early we don’t know how much this lesion may proliferate. It would be very appropriate to watch it for a couple of months to see what happens. This would give the baby a chance to grow and gain weight.
If after a couple of months not much had happened or the hemangioma were proliferating slowly we may choose to wait another couple of months. On the other hand, were things to dramatically start to change, the baby could be seen earlier and other options considered. So, observation is an active process not passive neglect.