Your Newborn Might Be Blue. Should You Be Concerned?

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Parents are curious about how their baby would be complexioned until it is born. Often they are surprised at how the baby might out. Interestingly, babies are born in different shades ranging between reddish-purple to even blue! Should this be a concern? Well, when it is blue, it could, at times, be a matter of concern.

The color of your baby’s skin is determined by several factors. While most babies are dark purple-red complexioned, it might be camouflaged by whether your baby is fair or dark skinned and the purple hue could become less obvious. However, the reasons the purple tinge occurs are:

  1. Your baby had been deriving its oxygen from the placenta and umbilical cord until it starts breathing through lungs. The color of the skin begins to change with her normal breathing. The transition color is called ‘pinking up’, which refers to the color getting closer to red or pink. While the body pinks up, your baby’s hands and feet could still retain the bluish hue for several days after birth, due to the immature circulatory system.
  1. Cyanosis is also called ‘blue baby’ condition, which is serious. It is a sign of a heart defect. If a blue baby is not moving or crying, it is a sign of cardiac or respiratory distress. It’s likely that the heart is not pumping blood optimally, and the blue color is due to the de-oxygenated blood, which is darker than the oxygenated blood.
  1. Acrocyanosis is a condition characterized by blue hands and feet, while the chest and torso bear a pink tinge. This is not a major concern if the umbilical cord has not been severed as oxygen and blood are still pumped until baby’s breathing is established. It’s then that the pulsations would stop. At times, a baby might be born with an obvious purple appearance due to oxygen deprivation during the last moments as the cord gets compressed during birth, or because of odd position during crowning. In cases as these, pinking up occurs once the blood is fully oxygenated.
  1. Mother’s health conditions also has an effect on the color of the baby when it is born. If the mother suffers from low or high blood pressure, it can influence the baby during labor and at the time of birth. The care providers would monitor your baby to ensure there is no distress due to lack of oxygen.
  1. If mothers are on pain relief medication that contains opioids or narcotics, it might drop baby’s heart rate during labor. These could also cause distress after birth, thereby, leading to a blue appearance.

What to do when your baby is born blue?

You should be concerned if your baby is blue and seems like it is slack, is hardly moving and does not cry or cries very weakly because these signs mean that your baby is distressed. Your caregiver would first encourage breathing by rubbing the baby’s body vigorously, blowing on it face to stimulate breathing or removing any mucus from the airways by adjusting the baby’s positions.

Ideally, the cord should be intact until your baby starts breathing normally, but practically it might not be possible. Several hospitals do not wait to clamp the cord so as to enable the baby being taken to resuscitation table. It might be a good idea to have a portable resuscitation table so that the baby doesn’t have to be shuttled around. Also, if you have had a homebirth, it’s likely that your midwife would have a resuscitation kit handy.

Are there long-term effects on babies born blue?

While delayed cord-clamping is the best solution as your baby remains oxygenated for long, you might wonder whether there will be any long-term effects of being born blue. Your baby will receive immediate treatment to reduce any serious outcomes due to oxygen deprivation and might be put under observation for hours or days after birth. Your baby might also need to be checked often by doctors at various phases of growth.

If the baby isn’t attended to immediately, it could lead to severe conditions such as cerebral palsy, seizures, behavioral disorders, cognitive and intellectual disabilities, or brain injury due to lack of oxygen, eventually leading to death. However, your midwife or caregiver will be able to assess the situation well.