Most parents-to-be dream about what their baby will look like, picturing a tiny, sweet-cheeked little bundle.
If you’ve never seen a newborn baby, it can be a surprise to find out they look very different from what you imagined.
Babies are born in all different shapes and sizes. While most babies are born a reddish-purple colour, some are born blue.
This blue colour can be frightening, and sometimes it is a cause for concern.
Why Do Babies Look Blue When They Are Born?
Your baby’s skin colour at birth depends on a number of factors. Most babies are born a dark purple-red colour, but depending on how fair or dark your child’s skin is, this colour might be more or less obvious.
Your baby has been receiving oxygen from the umbilical cord and placenta, until she takes a breath. As she begins to breathe, her skin colour will change – often midwives refer to this as ‘pinking up’. The colour will lighten to something closer to dark pink or red.
It’s not unusual for your baby’s hands and feet to remain a bluish colour for several days after birth. This is because her circulation system is still quite immature and will eventually be resolved.
A blue colour in other parts of the body is not normal, however, and should be looked at.
What Causes A Baby To Be Born Blue?
There are two different reasons why babies can be born blue:
- Cyanosis: this is considered a true ‘blue baby’ situation and is a serious condition. Usually it is caused by a heart defect. A baby born blue in appearance, not crying or moving, is considered to be in respiratory or cardiac distress. The heart is not pumping blood efficiently and there is not enough available oxygen. The blue colour is due to the de-oxygenated blood, which appears much darker in colour than oxygenated blood.
- Acrocyanosis: this is usually when a baby is born with blue hands and feet, while the rest of the body, particularly the chest and torso, assume a pink colour. It is rarely a concern, especially if the umbilical cord is left intact until it stops pulsating, as blood and oxygen are still being pumped to the baby while breathing is established.
Sometimes babies are born quite purple in appearance, due to a minor oxygen deprivation in the last moments of birth, caused by cord compression or an odd position during crowning. Their colour will change to pink once their blood is fully oxygenated again.
If the mother has any health conditions, such as high or low blood pressure, this can have an impact on how well baby copes during labour and her condition at birth. If you are in this situation, your care provider will monitor your condition and check on baby to ensure there is no distress due to lack of oxygen.
If you have pain relief medication which contains narcotics or opioids, these can cause your baby’s heart rate to drop during labour, as well as depress respiration after birth. This can lead to a blue appearance in your baby’s skin.
What Happens If My Baby Is Born Blue?
If your baby is born blue and is floppy, is barely moving or not moving at all, and doesn’t cry or has a very weak cry, these are signs she is struggling. You will notice a sudden flurry of action as your care provider assesses baby and begins management to encourage breathing. This might include rubbing baby’s body vigorously, blowing on her face to stimulate breathing and adjusting her position to drain any mucus from the airways.
In many hospitals, immediate cord clamping is the norm, so that baby can be taken to the resuscitation table, which is usually fixed to the wall. If your hospital has a portable resuscitation unit, it can be brought to you. If you have birthed at home, your midwife will have a resuscitation kit close by.
If rubbing your baby doesn’t resolve her breathing, colour and movement, then your care provider will begin artificial ventilation, using a mask and bag to get oxygen flowing into your baby’s lungs. Again, depending on your birth setting, this might happen next to you or in a different part of the birth room.
The ideal situation for your baby at this stage is to keep her skin to skin, with the cord intact, and both of you covered to keep warm; unfortunately, this is not always possible. If your care provider can delay clamping the cord for as long as possible, this will allow your baby to remain oxygenated. If not, make sure your partner or support person goes with baby to keep you informed about what is happening.
What Problems Can Occur Long-Term?
Babies who are born blue and receive treatment immediately have a reduced risk of developing any severe outcomes of oxygen deprivation. They might require observation for several hours or days after birth, and will have check ups as they grow and develop.
If the situation isn’t immediately recognised and treated, there can be severe outcomes for the baby, including cerebral palsy, behavioural disorders, seizures, intellectual and cognitive disabilities and, in some cases, death can occur because of severe brain injury due to lack of oxygen.
It’s important to know babies can be born in all different shapes, sizes and even colours! Some babies appear covered in blood and vernix, others have dark purple or even bluish skin. It is usually not a concern if your baby has blue hands and feet, but your care provider will assess her condition and help you to ensure her circulation improves and she ‘pinks up’ nicely.