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Skin Color Changes

What might skin color changes mean in a newborn?

The color of a baby's skin can often help find possible problems in another area of the body. If your newborn has any of the following skin color changes, tell your baby’s healthcare provider right away:

Increasing yellow color

Over half of all newborns develop some amount of jaundice during the first week. This causes a yellow coloring in their skin and eyes. This is often a short-term (temporary) condition. But it 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 normally removed by the liver. In a newborn baby, this removal process is not fully developed. Because bilirubin has a coloring, it causes a yellowing of the baby's eyes, skin, and tissues. As liver function matures, the jaundice goes away. A premature infant is more likely to have 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.

  • Breastmilk jaundice. A very small number of breastfed babies develop jaundice when they are 2 weeks to 12 weeks old.

  • Jaundice from poor breastfeeding. Babies who are born early may have trouble breastfeeding at first and may also develop jaundice.

  • 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 internally.

  • Jaundice related to inadequate liver function. Jaundice may be related to poor liver function due to infection or other factors.

Treatment for jaundice depends on many things. These include 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 healthcare provider if your baby has any of these signs.

Blue color that doesn't go away

When a baby is first born, the skin is a dark red to purple color. As the baby starts to breathe air, the color changes to red. This redness normally starts to fade in the first day. A baby's hands and feet may stay blue-colored for a few days. This blue coloring on the hands and feet is called acrocyanosis. This is a normal response to a newborn's immature blood circulation.

Blue coloring of other parts of the body is not normal. Sometimes a baby's face or lips and mouth may turn purplish with very intense crying. But this should turn back to pink when they stop crying. If the baby's color does not turn pink again, or the baby has an overall blue tint, this may signal a problem. The blue coloring is called cyanosis. It's often seen in babies with a heart defect. This is because the heart can’t pump the oxygenated blood to the rest of the body. Breathing problems may also cause cyanosis. If your baby has any blue coloring, have them checked by a healthcare provider right away.

Medical Reviewers:

  • Stacey Wojcik MBA BSN RN
  • Tracy C. Garrett RNC-NIC BSN