Blue baby syndrome: A guide for parents

Fei Hong’s baby was around six months old and had started solids. He seemed to like beetroot, spinach and broccoli, so Fei Hong made sure to feed him plenty of these vegetables. Eventually, she noticed a blue tinge on his skin. It was more noticeable on the delicate skin of his lips and ears. Anxious and worried, she checked with the pediatrician. The diagnosis was that her little one had “blue baby disease” or “blue baby syndrome”.

If you think your baby also might have blue baby disease, should you be worried? What causes it and how is it treated and managed? Can you prevent blue baby disease?

Blue Baby Disease

Some babies are born with blue baby disease (or syndrome) while others might develop it later. It is very clearly indicated by a blue or purplish tinge on baby’s skin — known as cyanosis. The color is more obvious where the skin is thin, such as on the lips and earlobes.

What causes blue baby disease?

While this syndrome is not common, it may be caused due to:

• Genetic reasons
• Environmental causes

The blue hue is simply explained by the lack of well-oxygenated blood. In a healthy physical system, the heart pumps blood to the lungs, where oxygen is added to it. This oxygenated blood is then sent back to the heart, and through the body.

However, if there is an issue with the blood, heart or lungs, the oxygenation process does not happen properly. And it is this that causes the skin to turn blue/purple.

Reasons for poor oxygenation of blood

1. Tetralogy of Fallot (TOF) 

This is a rare congenital heart defect. But it is the main cause of blue baby disease. TOF isn’t limited to one heart defect. Instead, it’s a combination of several issues that slow or reduce the blood flow to the lungs, enabling poorly oxygenated blood to circulate.

2. Methemoglobinemia

This can occur due to nitrate poisoning and is a condition more common in babies around and under six months of age.

Some examples of how methemoglobinemia may occur: a baby is given formula that is mixed with nitrite-contaminated well water. Or baby is given too much nitrate-rich food, like beetroot or spinach.

So, what exactly happens?

A young baby’s gastrointestinal tract is still immature and sensitive. As such, it is likely to convert an overdose of nitrate into nitrite. 

When nitrite enters the body, it produces something known as methemoglobin.

Methemoglobin is oxygen-rich. But, this oxygen is not released to baby’s blood. This gives babies with the condition that typical bluish hue that indicates blue baby disease/syndrome.

3. Congenital heart defects

By now you know that when the heart does not function properly, blue baby disease can occur. So, if a baby is born with any kind of heart condition, they could suffer from blue baby disease.

For example, a baby born with Down Syndrome often also has heart issues. Or if a pregnant mother has health problems, such as poorly controlled Type 2 diabetes, the baby’s heart could get affected.

Symptoms of blue baby disease

The most obvious symptom, as stated before, is blue- or purple-tinged skin. But other than this, there are some other symptoms to watch out for, according to HealthLine:

• irritability
• lethargy
• feeding issues
• inability to gain weight
• developmental issues
• rapid heartbeat or breathing
• clubbed (or rounded) fingers and toes

Diagnosis

If the doctor suspects your baby has blue baby disease, she or he will conduct a thorough physical test. A number of tests may also be performed, including:

• blood tests
• chest X-ray to inspect the heart and lungs
• electrocardiogram (EKG) to monitor the heart’s function and activity
• echocardiogram to view the heart’s anatomy
• cardiac catheterization to see and check the heart’s arteries
• oxygen saturation test to find out levels of oxygen in the blood

Treatment of blue baby disease

The treatment depends on what caused blue baby disease in your baby. Surgery is usually needed if the cause is a congenital heart problem.

Medication will be prescribed by medical professionals if the cause is methemoglobinemia. According to HealthLine, a drug named methylene blue is injected via a needle inserted in a vein. This helps oxygenate the blood.

Preventing blue baby syndrome

If your baby has a genetic predisposition to heart or lung issues, then it’s hard to prevent blue baby disease.

But environmental causes can most certainly be avoided, preventing the disease.

• Never use well water to prepare baby’s food or formula. Boiling this water will not eliminate nitrates.
• Do not go overboard with nitrate-rich food: These include broccoli, beetroot, carrots and spinach. Limit giving an excess of these vegetables especially before your baby is seven months old.
• Practice a healthy pregnancy lifestyle. Avoiding alcohol, smoking and illegal drugs will help prevent congenital heart and lung issues in your baby. If you have diabetes, ensure that you control it well.

Reference: HealthLine

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