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Skin Color Changes in the Newborn

In newborns, skin color changes are often due to something happening inside the body. Some color changes are normal. Others are signs of problems. The changes described below can happen to any newborn. But skin color changes may be more obvious in preemies, who have thinner skin than term babies.

Baby with blue hands and feet.

Acrocyanosis

With acrocyanosis, the baby’s hands and feet are blue. This is normal right after birth. In fact, most newborns have some acrocyanosis for their first few hours of life. It happens because blood and oxygen aren’t circulating properly to the hands and feet yet. The problem goes away as the blood vessels in the baby’s hands and feet open up. Later, acrocyanosis can come back if the baby is cold (such as after a bath). This is normal, and will go away by itself.

Cyanosis

Cyanosis can be a blue color around the mouth or face, or over the whole body. It happens when there isn’t enough oxygen traveling through the baby’s body. It means the baby is not getting enough oxygen. If you notice cyanosis, tell a nurse right away.

Baby with mottled blue skin.

Mottling

Mottling occurs when the baby’s skin looks blue and blotchy. There may also be a bluish marbled or weblike pattern on the baby’s skin. The parts of the skin that are not blotchy may be very pale (this is called pallor). Mottling could be due to a congenital heart problem, poor blood circulation, or an infection. Tell a nurse right away if you notice mottling. 

Baby with yellow skin and whites of eyes that look yellow because of jaundice.

Jaundice

Jaundice is a yellowing of the skin and the whites of the eyes. It usually starts in the face, then moves down to the chest, lower belly, and legs. It often happens because the body is breaking down red blood cells (a normal process after birth). The breakdown releases a yellow substance called bilirubin, which causes the yellow color. This substance is processed by the baby’s liver. It leaves the body through the urine or stool. Jaundice occurs in about half of all babies after birth, and often goes away by itself. But sometimes a baby’s liver can’t process bilirubin as quickly as needed. This is especially true of preemies. Treatment may be needed to help the bilirubin break down and get rid of the yellow color. If your baby is jaundiced, alert a nurse.

Other Skin Color Changes

Also tell a nurse if you notice:

  • Redness around the baby’s umbilical cord, catheter site, IV site, or circumcision site. The site could be infected.

  • Bruising.

  • Red spots (caused by broken blood vessels). This is often a sign of trauma or infection. It could also be due to a problem with the blood’s ability to clot.

 

Special Notes for Parents of Preemies in the NICU

Cyanosis often happens if a preemie is overstimulated or stressed. When it occurs:

  • If the baby is still breathing, stop whatever you are doing (such as feeding or touching the baby). The baby will calm down and breathing should return to normal. The baby’s color should improve.

  • If the baby is not breathing (apnea), he or she needs to be stimulated to start breathing again. Gently stroke the baby as you were taught to do. This “reminds” the baby to breathe. If the baby doesn’t start breathing again, tell a nurse right away.

 

 

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