What is Blue Baby Syndrome? Causes, Symptoms and Treatment

Many children are said to be blue babies at the time of birth. A careful look at their lips, nails and tongue reveals blue/dusky coloration. This is a medical condition called Cyanosis.

The word ‘cyanosis’ comes from the Greek cyanoses meaning dark blue. In this situation, there is deficiency of oxygen and the amount of deoxygenated hemoglobin in blood is more than 5G/deciliter.

Often cyanosis is caused by serious heart or lung or hemoglobin (blood pigment) problem. These babies need thorough and careful examination and prompt treatment.

The resulting condition is called Congenital Cyanotic Heart Disease. It is actually not one single disease but a group of diseases where baby is blue and is born with defect in the heart.

Blue Baby Syndrome

Identifying the Condition:

There are several signs by which a baby can be identified as being a blue baby:

• Baby’s lips and fingers are blue.
• Even if the baby is warm, this bluishness persists.
• Breathing difficulty.
• Baby has very fast breathing or the chest is moving up and down with each breath.
• Uncontrolled crying.
• Baby is very cold.
• Any other defect in the baby.
• If your pediatrician is giving oxygen to the child, hearing an abnormal heart sound (murmur), unable to feel good pulse, or says your baby is in shock.

Cyanotic Heart Disease can present itself in older babies as well. The signs in such cases are:

• Usually bluishness starts by 2-3 months of age.
• In the early stages, cyanosis appears when the baby is irritable or crying on passing motion; in the later stages, bluishness is always seen.
• Baby cannot walk beyond a short distance and sits down (in squatting posture).
• Get drowsy or lethargic or has fits after prolonged exertion or crying.
• Fingertips get swollen. Medically this is called as ‘Clubbing’.
• Suffers from fever, headache etc.
• Has joint pain.

Common Heart Diseases in Children with Cyanosis:

The most commonly found heart diseases are:

• Tetralogy of Fallot – This is the commonest heart disease in babies. It usually presents by 2-3 months of age with bluishness, crying and irritability. Characteristics of this condition are:

1. Ventricular sepal defect (hole)
2. Pulmonary stenos is (obstructed blood circulation to lungs)
3. Right Ventricular Hypertrophy (thick right lower chamber of heart)
4. Overriding of Aorta (main artery of body is partially committed to right side)

The defines treatment is a surgery called ‘Total Correction’. The hole is surgically closed and obstruction to the lungs is corrected. It is an open heart surgery, which takes six to eight hours. Done under general anesthesia. The usual recovery time is two weeks.

• Transposition of Great Arteries (TGA) – This is a heart disease where the two main arteries of our body arise from opposite cardiac chambers. In normal circulation, deoxygenated blood passes through right side of heart and goes to lungs for oxygenation.

This oxygen rich blood from lungs returns to left side of heart and is then distributed throughout the body via aorta. In TGA, aorta is connected to the right heart and pulmonary artery is connected to the left side.

So, bad cloud (deoxygenated) circulates throughout the body and oxygenated blood keeps returning in a closed circle to the lungs. There is not mixing of bad and oxygen rich blood. Baby remains intensely blue after birth.

TGA is a medical emergency and immediate treatment is necessary.

Treatment procedure for this condition consists of:

1. Immediate admission in a cardiac care NICU.

2. IV prostaglandin infusion is started to improve the oxygenation.

3. Sometimes, if saturations are less than 70 per cent, the cardiologist will try to enlarge a natural hole in the baby’s heart. This procedure is called Balloon Atrial Septostomy. This is done in the cath lab under anesthesia. This causes more improved mixing of deoxygenated and oxygenated blood.

4. By two or three weeks of age, the cardiac surgeon does the final treatment called Arterial Switch Operation. He puts back the lung artery to the right side of the heart and Aorta to the left side. This interchanging of place restores the normal circulation. It is best if this is done within one month of age.

Apart from these two conditions, other disease where the baby turns blue includes:

  • Persistent Truncus Arteriosus
  • Tricuspid Artesia
  • Total anomalous pulmonary venous connection

Another type of blue baby syndrome is caused by Methemoglobinemia. This is caused by high nitrate levels in water, which leads to decreased oxygen carrying capacity of the baby’s hemoglobin.

It is a serious condition that can be fetal. Learn to recognize the warning symptoms of blue baby syndrome and rush your child to the pediatrician if you are worried.

SOURCE: B-Positive Health Magazine

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