What Do Blue Lips Mean?

Sometimes parents will notice that their child's lips get purple or blue on occasion. This may happen when a child first awakens in the morning, when he is extremely active or at any time throughout the day. Of course, seeing your child with purple or blue lips is very alarming. Blue lips can be a sign of cyanosis or a variety of other health conditions.

Child with blue lips

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.

More about kids' health

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Getting to the bottom of your kids' health issues
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Comments

Comments on "Blue lips in children: Symptoms, diagnosis and treatment"

James March 03, 2014 | 6:10 PM

Please take illnesses serious,dont google for cures (DOCTORS VISIT!!!asap

tina February 09, 2014 | 11:54 PM

My son has been extremely fussy the last three days.his lips are a purple looking color. Coming tomorrow were going to the doc. Just reading these comments scares me. What should I tell them to look for?

Sheri January 13, 2014 | 5:54 PM

Blue lips can be a symptom of Patent ductus arteriosis another symptom is low birth weight and low weight gain as a newborn. PDA is a congenital disorder in the heart wherein a neonate's ductus arteriosus fails to close after birth. It may lead to congestive heart failure if not corrected.

Eliana December 16, 2013 | 4:23 PM

I can't help but wonder why some of the comments above were written, when an immediate call to 911 seems to me to be far more appropriate! However, as a child, I, and every other child I've ever known has had blue lips after swimming/playing in cold water for too long, but they turned pink just as soon as they warmed up and I am at a loss as to why no one else has mentioned this. Blue lips at any other time strikes me as a medical emergency, and I would immediately seek a second, third, and forth opinion if any doctor blew (no pun intended)them off! I certainly wouldn't sit around waiting for someone to reply to my comment here!

Caroline M October 07, 2013 | 11:40 AM

My daughter has an Innocent heart murmur, the doctor said she should be fine. But I've noticed that she gets bluish lips. The nurse did a test to see if she has pneumonia but it came out clear, did a nasal swab, chest x-ray and gave her inhalers. Don't know if I should bring her in for extra tests for her heart murmur.

juliexx May 16, 2013 | 9:10 AM

my granddaughter is 2/hlf she has been sickly on and off for three days and her lips and hands have been turning blue/purple she also looked like she was about to hav a seizure at one point and goes very lethargic afterwards

Alfonso April 02, 2013 | 6:19 PM

I used to get blue lips as a kid, apparently after eating chocolate. My parents never really took me to get any tests and just took away chocolate from me. They always said it was an allergy. I currently have no allergies and never stopped eating chocolate and am 44 years old now.

marylou April 01, 2013 | 9:23 PM

my son is 4 weeks old i keep taking him to the hospital cuz his lips keep turning blue an one night he wasnt breathing after tht he just keeps turnin the first doc said it was sinus well he keeps turn so why is he doing that the other two said he to young for tht and the first one didnt run no test to prove tht what it was he just looked at him well nobody will run test one him cuz he so lil but he keeps turning what should i do i really need help

S. Clower November 05, 2012 | 4:59 PM

i have a 3 year old son who has a innocent heart murmur or functioning heart murmur and recently his lips have been turning purple when hes really active i had him checked out by his doctor and he says he's fine but im still concerned any suggestions?

Theresa September 21, 2012 | 10:45 AM

Great article and it's so important to be aware and know the signs to look for. It's never a bad thing to be extremely educated when it comes to your children. Even if them having blue lips doesn't mean anything, it's good to make sure none of the other signs are present.

SHILPI SHARMA September 06, 2012 | 1:04 AM

my daughter she is 21 months old and her upper lip get darker so pls tell me the reason behind its and treatment of this problem

S.Elizabeth. August 04, 2012 | 5:05 PM

my lips started turning purple/blue this morning and I didn't think anything of it, but now they're becoming darker. and now they're burning and they hurt. I don't know what to do. SOMEONE HELP!

concerned April 14, 2012 | 3:02 PM

My husband and I just noticed last night that our 16 month old sons lips were dark. Extremely! We didn't think anything of it. Today struck my concern b/c one minute they are dark and the next not so dark. He has been very fussy. He was diagnosed with iron defficiency anemia. I don't know if that would play a part. Not sure if it's all in my head or not.

Gillian April 14, 2012 | 2:28 PM

Alauna, You should have them check again. It is a symptom of Pulmonary Hypertension, a lung diesease that often accompnies congenital heart defects, and goes misdiagnosed. Johana Lear- Did you get any answers?

Alauna April 01, 2012 | 1:30 PM

i have a very active 2 yr old. he had a heart murmur when he was born but doctors say it closed up and hes been fine hes very healthy and active..but i been noticing hes purple around his lips and sometimes his nails are purple . im really worried.

Joanna Lear September 11, 2011 | 12:15 PM

My 8 yr old daughter is usually a healthy happy little girl but over the last few months, she has collapsed, unresponsive for no more than a few minutes, sweated the most ridiculous amounts and her lips have gone very By this time her lips are not blue but she is very pale and exhausted. Does anyone have any ideas?

angela brown June 13, 2011 | 6:03 AM

My niece is visiting me in spain and everytime she gets in the pool her lips start going purple from the corners.It is very warm.

RelievedDad May 04, 2011 | 9:43 PM

I discovered another reason for blue lips tonight. As I was putting my 6yo to bed, I noticed that the skin around his lips was blue. After reading this article, I checked his tongue, gums and fingernails (thanks for the help!). All were quite pink. He had been at the neighbors playing for a while after dinner, & after a minute or so of thought, I realized the problem. "Did you drink blue Gatorade at Jake's house?", I asked. The diagnosis was confirmed, and I'll sleep well tonight!

Anne April 22, 2011 | 12:19 AM

My 3 year o;d grandson has been on steroids and antibiotics for a chest infection.He then developed a urine infection,and now has an ear and throat infection all within a two week period.He is very tired all the time.and coughs most of the time. Every night is a nightmare,with very little sleep for the household.Last night i noticed his lips were very dark,he has a slight heart murmer and seems to take chest infections one after the other.We are extremely worried about him.

Tracey January 24, 2011 | 3:09 PM

Sean, AROUND the lips is peripheral, ON the lips with bluing in the mouth is central, ON the lips without bluing in the mouth is usually circumoral cyanosis but you can have central on the lips without it in the mouth too. Parent of child with HLHS, post transplant x2, and child with lung disease (14yrs and 4yrs). Vet parent to two kids who are almost always BLUE to some degree weekly.

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