Cafe au lait spots in children are not uncommon. Thirteen percent of white children and 27% of black children have cafe au lait spots. Although it is believed that these spots are present from the time a baby is born, they are often hard to see until the child is two or three years old. These spots are darker than the surrounding skin. The are flat, and often have ragged edges. The word "cafe au lait" translates to "coffee with milk." Cafe au lait spots get their name, as you would expect, from their color, which can range from light tan to dark brown.
In general, cafe au lait spots are harmless. There is no need to treat them. If your child has up to three or four cafe au lait spots, there is almost certainly no need to worry. They do not cause any harm on their own, and are probably not signs of any other underlying issues.
However, children who have five or more cafe au lait spots are more likely to have other health issues. Ninety-five percent of people who have the neurological disease Neurofibromatosis (NK1) have six or more cafe au lait spots. Other symptoms include freckling in the armpits and colored bumps on the irises. About 50% of kids who have NK1 have some sort of developmental disability. NK1 is also more common in children who have a relative who has the condition.
Cafe au lait spots in children have also been associated with McCune-Albright syndrome, Fanconi anemia, and tuberous sclerosis. If your child has several cafe au lait spots, discuss your concerns with his or her pediatrician.