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My Baby’s Fingernails Are Blue

    Whether it’s your first time, second or third, becoming a parent is the most amazing feeling in the world. However, it can also be scary and mind-wrecking if your child gets sick. As a parent, you can attest to panicking every time your child starts to cough or develops a rash.

    Blue fingernail in babies is also known as cyanosis. It is prevalent in newborns or the early life of a child. If your baby has blue fingernails, the chances of you noticing the bluish appearance on the lips and earlobes are very high. This is because the skin in these areas is thin.

    Although cyanosis is not common, it can happen because of a heart problem, genetic factors, or environmental factors, such as exposure to too much cold.

    Why your baby has blue fingernails

    Babies develop a bluish color on their fingernails if the blood does not have enough oxygen. Poor blood oxygenation occurs when there is a problem with the baby’s heart, lungs, or blood. Lack of proper oxygenation can be due to the following conditions.

    Tetralogy of Fallot (TOF)

    TOF is a severe congenital heart problem and is the primary cause of blue fingernails in babies. This condition causes four heart defects that reduce blood flow into the lungs, allowing for poorly oxygenated blood to circulate in the body.


    Nitrate poisoning causes methemoglobinemia. This occurs if you use well water to mix your child’s formula. Or if you feed your baby with nitrate-rich foods such as beets and spinach.

    Babies under six months are more prone to this condition as their gastrointestinal tract is not fully mature. The immature digestive system converts Nitrate to Nitrite, which circulates in the body and makes methemoglobin. Although it is rich in oxygen, Nitrite does not release oxygen into the body, causing the babies’ bluish coloration.

    Cold Temperatures

    Exposing your child to cold temperatures can also cause your baby’s finger to turn blue. This is because your baby’s blood vessels constrict, restricting blood flow. This does not call for concern as it is not cyanosis. Your baby’s fingers can return to their pinkish hue if you wrap them in a blanket. You can also hold your child against your skin so that he/she can absorb your heat.

    Symptoms That Call for Immediate Doctor Attention

    Sometimes, you might assume that your baby’s blue fingernails are due to exposure to cold. But later find out that it is cyanosis, which is dire to your child’s future health. Please call or visit your pediatrician if you notice that your child has blue fingernails for an extended period. You may also notice that your usually bubbly kid is cranky and irritable.

    Often, cyanosis can cause your baby not to feed well due to lack of appetite, resulting in no weight gain or weight loss. Some of the other symptoms of blue fingernails are regularly having breathing difficulties and feeling dizzy.

    In more severe cases, a case of blue fingernails in babies may result in death.

    How Doctors Diagnose Blue Fingernails or Cyanosis

    Doctors begin their blue fingernail diagnosis by taking a deep dive into the child’s medical history. The doctor will then conduct a physical exam on the baby by observing the bluish hue and listening to the heart and lung rhythm. 

    The doctor will then order several tests such as a chest x-ray to observe the heart and lungs’ size. An echocardiogram and electrocardiogram to check the anatomy and electrical activity of your baby’s heart. The doctor will request an oxygen saturation test to determine oxygen levels in the blood. And finally, a blood test to check nitrate levels in the blood system.

    The doctor may also request the lab to test for nitrates levels in the water to determine the cause for blue fingernails.

    How to Help Your Child by Easing the Symptoms of Blue Fingernails?

    Do not panic if you notice that your child has blue fingernails. Kids are very sharp and may pick up cues when upset, making it harder to comfort them. 

    Please lay your child on his back. Then bring his knees up to his chest and hold them in place. Do this while holding your child to enhance their comfort.

    Treatment for Blue Fingernails

    If blue fingernails because of exposure to cold, swaddle your baby with a warm blanket. Your child fingernails will return to their normal color, pink or red. However, if it is cyanosis due to congenital disorder, surgery can correct the abnormalities.

    If the condition is due to Nitrate in water, a toxicologist can advise on the best to treat your child. Avoiding water with high levels of Nitrate is also important.

    NOTE:  It is possible to treat blue fingernails in babies. And they can live a normal life without any health complications.

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