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Newborn and Infant Care

Cold extremities

07/23/2007

Question:

My baby is almost 3 months old and she has had very cold hands and feet since birth. They still turn purple when she gets a bath and we cannot have her go without socks at all. It is summer and quite hot, yet they are still cold. At night, her hands get very cold because they are not covered, so we put mittens on her. The doctor checked her circulation and said it is fine and he has no idea why they are still cold since he thought she would outgrow it. Help!

Answer:

Persistent coolness of hands and feet is usually a problem of older adults due to poor circulation as a result of thickened arteries or significant diseases. There are a few problems that affect infants, producing coolness of the hands and feet. These include a disorder of her heart and blood vessels such that overall circulation was impaired. In this case your baby would also breathe rapidly, feed poorly, and grow poorly. Other problems include neonatal systemic lupus erythematosus (this tends to run in families as do other autoimmune diseases such as Type I diabetes), diffuse vasculitis (narrowing of the blood vessels due to irritation resulting in sluggish blood flow), and hyperviscosity syndrome (thickened blood due to too many cells or abnormal plasma components such as cryoglobins in the blood). These problems all cause widespread symptoms of health problems and are very unlikely to be the case with your child if she is otherwise healthy and vigorous. Real concern would be warranted if her fingers and toes turned blue or black, there was thickening, cracking, or the development of sores on the skin of her fingers and toes.

I hope this is helpful to you and that all is well with your new baby.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University