Skin Color Changes
What might skin color changes indicate in a newborn?
The color of a baby's skin can often help identify possible problems in another area of the body. If your newborn has any of the following skin color changes, tell your baby’s healthcare provider right away:
Increasing yellow color
Over half of all newborns develop some amount of jaundice during the first week. This causes a yellow coloring in their skin and eyes. This is usually a short-term (temporary) condition, but may be a more serious sign of another illness. Jaundice is caused by the breakdown of red blood cells. As the old cells are broken down, hemoglobin is changed into bilirubin and normally removed by the liver. In a newborn baby, this removal process is not fully developed. Because bilirubin has a coloring, it causes a yellowing of the baby's eyes, skin, and tissues. As liver function matures, the jaundice goes away. A premature infant is more likely to have jaundice. The yellow tint to the skin can often be seen by gently pressing on the baby's forehead or chest and watching the color return. There are several types of jaundice:
Physiologic jaundice. Physiologic jaundice occurs as a "normal" response to the baby's limited ability to excrete bilirubin in the first days of life.
Breast milk jaundice. A very small number of breastfed babies develop jaundice when they are 2 to 12 weeks old.
Jaundice from poor breastfeeding. Babies who are born early may have trouble breastfeeding at first and may also develop jaundice.
Jaundice from hemolysis. Jaundice may occur with the breakdown of red blood cells due to hemolytic disease of the newborn (Rh disease), having too many red blood cells, or bleeding internally.
Jaundice related to inadequate liver function. Jaundice may be related to poor liver function due to infection or other factors.
Treatment for jaundice depends on many factors, including the cause and the severity of the jaundice. Treatment often includes using special lights called phototherapy. Babies with severe jaundice may need hospitalization and blood transfusions.
Babies with jaundice may have feeding problems and be irritable or listless. Call your baby's healthcare provider if your baby has any of these signs.
Blue color that does not go away
When a baby is first born, the skin is a dark red to purple color. As the baby begins to breathe air, the color changes to red. This redness normally begins to fade in the first day. A baby's hands and feet may stay bluish in color for several days. This is a normal response to a newborn's immature blood circulation.
Blue coloring of other parts of the body is not normal. Occasionally, a baby's face or lips and mouth may turn purplish with very intense crying. But this should turn back to pink when the baby stops crying. If the baby's color does not turn pink again, or the baby has an overall blue tint, this may signal a problem. The blue coloring is called cyanosis. It is often seen in babies with a heart defect, because the heart can’t pump the oxygenated blood to the rest of the body. Breathing difficulties may also cause cyanosis. See your baby's healthcare provider right away if your baby has any blue coloring.
March 21, 2017
Clinical Manifestations of Unconjugated Hyperbilirubinemia in Term and Late Preterm Infants, from Up to Date, Etiology and Evaluation of Cyanosis in Children, from Up to Date, Pathogenesis and Etiology of Unconjugated Hyperbilirubinemia in the Newborn, Up To Date.
Adler, Liora C., MD,Freeborn, Donna, PhD, CNM, FNP