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Blue baby syndrome, also known as simply blue baby, is a term used to describe infants with cyanosis, or blue-tinted skin. The condition develops when the organs, cells and tissues do not receive adequate oxygen, and the tissue begins to turn blue in color instead of pink, indicating poor oxygen levels. Although this syndrome can be fatal if left untreated, modern therapies can typically correct the problem. It occurs most frequently in infants under six months of age, but it can also affect older children and adults, in rare cases.
The most common cause of blue baby syndrome is Tetralogy of Fallot, a congenital heart condition in which four different abnormalities cause a reduction in blood oxygen. These abnormalities include ventricular septal defect (VSD), pulmonary stenosis, thickening of the right ventricle, and a displaced or deviated aorta. VSD is characterized by a hole in the wall of the two lower chambers of the heart. Pulmonary stenosis occurs when the pulmonic valve and the muscular area below the valve are narrower than normal.
Blue baby may also be caused by excessive nitrates in drinking water. When consumed, the nitrates are converted to nitrite in the digestive system. The nitrites then react with the hemoglobin, causing dangerously high levels of methemoglobin. This enzyme cannot carry oxygen through the blood like hemoglobin does, resulting in organs, cells, and tissues that are deprived of oxygen and skin with the characteristic bluish tint. Rural areas where high levels of nitrates are present in the ground water often produce higher numbers of infants born with this condition.
Other causes are also related to congenital heart problems. Transposition of the great arteries (TGA) occurs when the aorta and pulmonary artery are switched, causing oxygen-poor blood to be carried throughout the body instead of being sent to the lungs. Hypoplastic left heart syndrome (HLHS) can also cause this problem and is caused when the left side of the heart is underdeveloped, resulting in a left ventricle that does not pump enough oxygen-rich blood through the body.
Blue-tinted skin may be difficult to recognize in children with darker skin tones, but there are other symptoms to alert parents and healthcare professionals to a potential problem. These other symptoms include fatigue, low tolerance for exercise, rapid breathing and shortness of breath, difficulty breathing or eating, and heart murmurs. The child may also fail to gain weight and appear lethargic for no apparent reason.
Treatments for blue baby syndrome depend on the cause and severity of the condition. The problem is typically evident just after birth, and medical professionals will work quickly to correct any defect contributing to the syndrome. If the symptoms become apparent later, the infant should be taken to a pediatric cardiac center as quickly as possible, as a serious heart defect is usually the culprit. Medication may be prescribed to manage the symptoms, but in most cases, heart surgery will be required to fix the underlying cause of the disorder.