A concerned query about the blue feet and hands of a newborn is among the most frequent questions we hear in the immediate newborn period. Luckily, this is such a common thing that we expect to see it to some degree in almost every baby we catch in our Colorado midwifery practice.

Acrocyanosis is a bluish discoloration of the extremities that occurs when there is reduced blood flow and hemoglobin in the capillary beds. This may happen to anyone when they are under stress or have cold hands, but it happens to many newborns simply because their circulatory system is adjusting to new patterns as they acclimate to life on the outside of the womb. If you think about it, your hands and feet need blood and oxygen less urgently in trying times than your heart and lungs, so naturally, your body would rush the blood to vital organs when extra support is needed – the immediate period after birth is one of those times.

Acrocyanosis can last for 24-48 hours, on average, and usually involves just the hands and feet, though it can also happen around the mouth. A good way to differentiate between normal acrocyanosis that is presenting around the mouth and more concerning central cyanosis is to check inside baby’s mouth – the tongue, cheeks and gums should be nice and pink. If not, this baby requires more evaluation.

Though newborn acrocyanosis is usually gone after a couple of days, it can pop up again now and then if baby gets cold, such as after a bath. A good snuggle skin to skin under a warm blanket should solve that problem in short order.

So, blue hands and feet in the first couple of days are normal, but don’t hesitate to reach out to your pediatric care provider if you think your baby has bluish color on their body that does not fall within normal parameters.

Photo credit: Monet Nicole Birthing Stores