A baby maybe born with a congenital heart defect that results in a blue colouration of skin due to cyanosis or deoxygenated blood. The blue colour is seen around the lips, and the tips of fingers and toes.
It can be caused due to a number of reasons like:
- Persistent truncus arteriosus – rare congenital diseases in which the embryological structure called the truncus arteriosus fails to properly divide into the pulmonary trunk and aorta.
- Transposition of the great vessels – a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels, superior or inferior venae cavae, pulmonary artery, pulmonary veins, and aorta.
- Tricuspid atresia – characterised by a absence of the tricuspid valve, leading to an absence of the right atrioventricular connection
- Tetralogy of Fallot – it is the most common cyanotic heart defect and the most common cause of blue baby syndrome. Involve four anatomical abnormalities of the heart.
- Total anomalous pulmonary venous connection – is a congenital heart disease affecting the pulmonary veins
In case of all these congenital defects, a large portion of the venous blood bypasses the lungs.
Under normal circumstances, deoxygenated blood from the veins is pumped from the right side of the heart to the lungs, where it is oxygenated by the body’s circulatory system. But in some blue babies, the pulmonary artery is too narrow to allow sufficient blood to pass into the lungs for oxygenation.
An incompatibility of the foetal and maternal blood types may also cause a bluish coloration in newborns. This occurs when red blood cells in the infant’s blood get destroyed by antibodies in the mother’s blood. This again reduces the quantity of oxygen-rich blood in the body and leads to cyanosis.
The syndrome is noticeable right at the time of birth and the doctor would test the baby for the severity of the issue. Surgical correction is necessary in most cases. Babies growing up with an undetected or untreated heart defect would end up facing a lot of physical complications and drawbacks in later life, along with suffering from breathless, chronic heart pain, and even higher chances of a heart attack.
Blue baby syndrome can also occur in later life, albeit due to a different reason. Nitrate-contaminated water given to infants either as drinking water, or as an infant formula can easily lead to infant Methaemoglobinaemia. Boiling water does not remove nitrate.
Nitrates get converted to nitrites in our body, which then react with haemoglobin in the red blood cells to produce Methaemoglobinaemia. Bottle-fed infants who are less than three months of age are particularly at risk because an infant’s haemoglobin is more susceptible and the condition can often be made worse by the presence of gastrointestinal infection.
Older people may also be at risk because of decreased gastric acid secretion. Other people at risk would be adults with a hereditary predisposition, people with peptic ulcers or chronic gastritis, as well as dialysis patients.
Infant Methaemoglobinaemia refers to a condition where the blood’s oxygen-carrying ability decreases severely, causing many vital organs in the body to not get sufficient fresh oxygen. This hampers their normal functioning and even development.
Symptoms would typically involve fever, malaise, lethargy, irritability, vomiting, diarrhoea, breathing difficulties, fussiness observed in infants, and an increase in the production of saliva, loss of consciousness and seizures.
More importantly the presence of a peculiar blue-gray tinge on the skin.
Unless detected and treated effectively, blue baby syndrome can lead to coma and even death in extreme cases. Once the symptoms show up and Methaemoglobinaemia is detected, urgent medical help must be sought. Breastfeeding is known to protect babies from Methaemoglobinaemia.