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What is Blue Baby Syndrome & How is it Treated?

What is Blue Baby Syndrome?

Blue Baby Syndrome which in medical terms is known by the name of methemoglobinemia is an extremely rare condition found in newborns, in which the color of the baby’s skin is blue tinged. Blue Baby Syndrome is a type of a blood disorder, in which the blood is not able to be oxygenated enough. Under normal circumstances, the blood flows from the right atrium of the heart to the right ventricle from there it gets pumped into the lungs for oxygenation.

This oxygenated blood then flow to the left atrium and is pumped to the left ventricle from where it goes to all parts of the body. The oxygen present in the blood is used for various bodily functions before it goes back to the heart for oxygenation again.

In Blue Baby Syndrome, this process of oxygenation does not take place or even if it takes place, it is very little and hence the parts of the body are deprived of the oxygen that is required to run bodily functions resulting in a variety of symptoms. Unusually high amount of nitrates present in drinking water is presumed to be the main cause of Blue Baby Syndrome.

What is Blue Baby Syndrome?

What Causes Blue Baby Syndrome?

As stated, the main cause of blue baby syndrome is significant amount of nitrates present in the drinking water of the baby. There are several factors associated with occurrence of blue baby syndrome. The first of this is excess amount of nitrates in an infant’s drinking water. The nitrates once inside the body gets converted to nitrites, which react with oxyhemoglobin, a protein that carries oxygenated blood, resulting formation of methoglobin which does not have the ability to carry oxygen. This results in the body receiving less oxygenated blood causing blue baby syndrome.

Certain congenital heart defects may also cause blue baby syndrome like tetralogy of fallot, which is the primary cause of blue baby syndrome. Certain respiratory infections may also cause infants to develop respiratory distress such that they are not able to take enough oxygen in, hence causing Blue Baby Syndrome.

What are the Symptoms of Blue Baby Syndrome?

Some of the symptoms of Blue Baby Syndrome are:

  • Skin discoloration: The infant’s skin will have a bluish tinge to it due to insufficient oxygen in the blood.
  • Breathing Difficulty: The infant will also have problems with breathing normally such that less oxygen will get in the body.
  • Failure to Thrive: The infant with Blue Baby Syndrome will have severe developmental delays and will not be able to reach his or her milestones on time.

How is Blue Baby Syndrome Diagnosed?

The best and the most trusted way to diagnose blue baby syndrome is a test called Co-Oximetry, which can be followed by further tests like blood draws to measure the levels of oxygen in the blood, which in the cases of blue baby syndrome will be very low.

How is Blue Baby Syndrome Treated?

Blue Baby Syndrome can be treated effectively provided that the condition is diagnosed accurately and early and the cause of it is determined. Blood test to measure the level of oxygen in the blood is done before formulating a treatment plan. The treatment of blue baby syndrome depends on the cause of the condition. If the condition is caused due to consumption of water rich in nitrates, then this can be treated with medications and recommending safe drinking water for the baby.

Surgery is required for treating babies with inherited heart conditions like Tetralogy of Fallot. Blue Baby Syndrome may be a rare condition, but in many places around the world where people still rely on underground drinking water, especially in rural areas there are many cases of Blue Baby Syndrome still being reported.


  1. MedlinePlus. (2022). Methemoglobinemia. https://medlineplus.gov/ency/article/001565.htm
  2. Cleveland Clinic. (2022). Methemoglobinemia (Blue Baby Syndrome). https://my.clevelandclinic.org/health/diseases/17403-methemoglobinemia
  3. Medscape. (2021). Methemoglobinemia. https://emedicine.medscape.com/article/204178-overview
  4. Healthline. (2022). Methemoglobinemia (Blue Baby Syndrome). https://www.healthline.com/health/methemoglobinemia

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 24, 2023

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