Oxygen-rich blood is red, which gives a normal and warm hue to the body. However, blood circulation issues or reduced bloodstream oxygen levels may lead to a bluish discoloration or tint in the skin. This condition is known as cyanosis and can affect different parts of the body, including nails, fingers, earlobes, and mucous membranes (mouth) (1). Additionally, the type of cyanosis is defined depending on where the discoloration occurred. If it is around the mouth, the condition is called circumoral cyanosis.
Keep reading this post to know about circumoral cyanosis in babies, its signs, causes, and treatment options.
What Is Circumoral Cyanosis?
Circumoral cyanosis is defined as the blue-grey discoloration around the mouth, especially the upper lip area. It is the most common type of cyanosis in babies and children. With dark skin, the tint may also appear grey or white (2).
Although the condition can be worrisome for parents, you may check a few things to rule out a medical emergency.
Main Categories Of Cyanosis
- Central cyanosis: It occurs in the central part of the body, including the mouth, torso, and head. In newborns, this condition is not considered normal and is usually associated with low oxygen levels in the blood. Central cyanosis can also occur due to a problem in the heart, lungs, or blood.
- Peripheral cyanosis: It occurs in the extremities, including toes, fingertips, and hands. It can also occur in the circumoral area. This type of cyanosis is usually not life-threatening, but understanding the cause can help prevent further complications.
What Causes Circumoral Cyanosis In Babies?
Circumoral cyanosis is usually considered a type of acrocyanosis, which is common in babies as long as it doesn’t affect the central parts of the body (1). In some cases, children may develop acrocyanosis after a swim or bath in cold water. However, it resolves as soon as the body is warmed up.
However, in some cases, the condition does not go away even after warming up and may be due to underlying heart or lung problems, such as tetralogy of Fallot, a type of congenital heart disease (4).
Cyanosis may also occur when the lungs do not properly oxygenate the blood or the body is not receiving enough oxygenated blood. It most commonly occurs (5):
- If the baby is crying incessantly and strongly
- Immediately after feeding, bowel moment, or waking up
- If the baby is dehydrated
Signs And Symptoms Of Circumoral Cyanosis In Infants
- Respiratory issues
- Blue discoloration around the mouth and face, earlobes and fingernails
- Discomfort and dizziness
- Fever and pain
When To See A Doctor?
If the cyanosis is visible on the lips, tongue, head, or torso, it is central cyanosis and should be immediately checked by the doctor (1).
Additionally, talk to your pediatrician or cardiologist
- If your baby has experienced cyanosis for the first time
- If the frequency of cyanosis increases, it may be due to a heart condition
- If the cyanosis condition lasted for more than one minute
How Is Circumoral Cyanosis Diagnosed?
The three primary steps that your doctor may perform to diagnose circumoral cyanosis may include (1):
- Medical history of the baby
- Physical examination
- Oxygen saturation level to determine whether the oxygen levels are low or normal
Depending on the above findings, the doctor may recommend further confirmatory tests or evaluation. Also, the urgency of the condition may warrant consultation with a heart or lung specialist or a visit to the emergency room.
How Can Circumoral Cyanosis Be Treated?
In most cases, if the cyanosis is due to acrocyanosis, babies may not require any treatment. However, if there is an underlying heart or lung problem, the treatment may depend on the condition (1).
If the blue discoloration is present around the mouth and not on the lips, it is not serious. Try to warm up the baby. On the other hand, if you notice any warning signs such as fainting, breathlessness, excessive sweating, and discoloration around the head, torso, and tongue, contact your doctor for medical consultation.
2. J Bernard; Blue Lips or Skin (Cyanosis): Symptoms & Treatment; K Health (2020)
3. P Pahal and A Goyal; Central and Peripheral Cyanosis: StatPearls Publishing LLC. (2021)
4. M. Ushay; Cyanosis; Textbook of Pediatric Care (Chapter 136)
5. M. Stack; Etiology and evaluation of cyanosis in children; UpToDate
6. Cyanosis; Boston Children’s Hospital
7. Cyanosis (Blue colouration of lips, feet, body): Diagnosis and Treatment; Narayana Health