Blue lips in children: Symptoms, diagnosis and treatment

Causes of blue lips in children

A child's lips should be nice and pink. In fact, you usually don't want to see any part of a child's face or body turn purple or blue, which can indicate cyanosis.

Cyanosis is a sign that a child doesn't have enough oxygen in her blood. While often caused by congenital heart defects, it can also be caused by septic shock, seizures or lung issues such as pneumonia, asthma or croup.

Not all cyanosis is necessarily bad, though. Newborns and young infants can normally have acrocyanosis — blue lips and a bluish discoloration of their hands and feet. This is called peripheral cyanosis and usually goes away as a child's circulatory system matures.

Central cyanosis

Central cyanosis, where a child's face or trunk turns blue, can be indicative of a more serious problem and needs proper diagnosis and treatment from a doctor. While blue lips can be a symptom of central cyanosis, it can sometimes also be normal for a child to get blue around his lips and mouth, especially when he is crying, screaming or eating. You also may notice that the area around your toddler or young child's lips turn blue after a tantrum or when he is active. In these cases, the actual lips themselves should not be blue however — just the area around the mouth. His tongue and inside of his mouth will also remain pink.

To see if that is the case, get a close look at his lips, tongue, and nail beds to see if they are pink, blue or purple. If they are pink, then your child may just have circumoral cyanosis — blue discoloration that can occur around the mouth and chin area. Circumoral cyanosis is generally not something to be concerned about. If the lips themselves, the tongue and nail beds are blue or purple, however, you should seek immediate medical attention.

Normal or a true concern?

Some specific things to consider to help determine if your child's blue lips are normal or an indicator of a more severe problem include:

• Is your child growing and developing normally? Weight loss or poor weight gain would be a sign that this is a more serious problem.
• Has your child ever been diagnosed as having a heart murmur? If so, you should contact your doctor as soon as possible.
• Does your child have any other symptoms, like a cough or trouble breathing, during these blue lips episodes? If so, it could be a sign of asthma.
• Is your child not very active? Does he tire out very easily and before other children of his same age? If your child is often fatigued easily, his blue lips may be an indicator or a more serious issue.
• Does he get weak and sleepy after these blue lips episodes? If so, he may not be getting enough oxygen to his brain and other organs.

Blue lips diagnosis and treatment

Whether or not your child has any of these other signs or symptoms, he should have an evaluation by his pediatrician as soon as possible. Your pediatrician may decide this is normal, especially if your child has a normal physical exam and the pattern of the cyanosis seems to indicate that it is just circumoral cyanosis. If you doctor believes that it is normal, he may not do any further testing.

If there is any question that this could be a sign of a more serious disorder, your pediatrician may do extensive testing, such as pulse oximetry to measure the oxygen level in your child's blood. Other testing may include a complete blood count, chest X-ray, and perhaps an EKG if he is worried about your child's heart. Treatment for your child's blue lips depends on the cause. If it is found to be circumoral cyanosis, no treatment should be necessary. If there is a problem with the child's heart or other organs, treatment will vary depending on the exact diagnosis.

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