Normal Newborn

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. It is important for you to detect and notify your baby's physician if the following skin color changes should occur:

• increasing yellow color
  Over half of all newborns develop some amount of jaundice, a yellow coloring in their skin, during the first week. This is usually a 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 removed by the liver. The build-up of bilirubin in the blood is called hyperbilirubinemia. Because bilirubin has a pigment, or coloring, it causes a yellowing of the baby's skin and tissues. As liver function matures, the jaundice goes away. A premature infant is more likely to develop 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
    About 2 percent of breastfed babies develop jaundice after the first week. Some develop breast milk jaundice in the first week due to low calorie intake or dehydration.
    
    
  • 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.
    
    
  • jaundice related to inadequate liver function
    Jaundice may be related to inadequate 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 physician 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. However, this should turn back pink when the baby stops crying. If the baby's color does not turn pink again, or there is an overall blue tinge to the baby, this may signal a problem. The blue coloring is called cyanosis and is often seen in babies with a heart defect, because the heart cannot pump the oxygenated blood to the rest of the body. Breathing difficulties may also cause cyanosis. Consult your baby's pediatrician immediately if your baby has any blue coloring.