Questions on baby's color after birth

[Jilian]

I'm a labor doula, yet I don't really pay close attention to the baby's color after birth, so I have a few questions about DS2's birth. Here are the basics first:

He was born @ 40 weeks 1 day and weighed 6 lbs, 4 ozs and was covered in vernix. I am 100% positive of my dates, I was charting and that was the only possible day I could have gotten preg. MW commented that he looked like an early baby, his ears were still curled quite a bit too. DS1 was 7 lbs 5 ozs @ 38 weeks.

He was very dusky at birth. His limbs were blue and did not pink up for a long time. He was born @ home with a HB MW and she gave him a little oxygen and it helped. We did not suction and after the cord was cut (5 mins or so after birth - my choice) he became more dusky and seemed like he was having trouble breathing. He spit out lots of fluid when we gave him the oxygen.

He did not nurse for 5 hours, he would not latch. He sounded really congested. Looking back at pictures I see that his toenails and fingernails were still blue over an hour after birth. He was very sleepy shortly after birth too.

Are any of these things warning signs? I'm not looking to blame my MW at all, I love her. She saved my son's life 2 weeks after his birth. He ended up having a heart defect called "total anomolous pulmonary venous return" and needed emergency open heart surgery. Long story. But the nurses in the ICU said that he should have had obvious trouble at birth. I'm wondering if any of the issues he had were signs? I ask for future reference because I do want to have more children.

[rajahkat]

Hands and feet blue at birth is common and normal. These can last a few days. All three of my babies have had off and on blue hands/feet/nails for the first few days after birth. Nothing you mentioned is an obvious sign of something being wrong. Some babies are slow to start up and this can be exacerbated by early cord cutting (which 5 minutes usually is) So your midwife could have very probably assumed that his seemingly slight trouble at the beginning was related to that.

No, I wouldn't say that any of your baby's signs at birth were obvious symptoms. Most babies tend to be sleepy afterwards, some have trouble with latch, aren't interested in nursing immediately after birth, etc. And some congestion can be totally normal, is common and tends to clear on its own shortly after birth.

If you'd like to share though, how did your midwife save his life? Did she noticed other things over the next two weeks that didn't seem right and led to his diagnosis? Or did you notice them and bring them to her attention? Just curious.

And I'm sure you've already done bunches of research, but I found this:

"If obstruction to pulmonary venous return is not present, children with Total Anomalous Pulmonary Venous Return without obstructed pulmonary venous return may be asymptomatic. There may be mild to moderate rapid or labored breathing. There is often cyanosis, but it may be mild and difficult to detect.

Some children with this more common type of Total Anomalous Pulmonary Venous Return are first detected when a physician hears a heart murmur during a physical examination. It is not uncommon for these children to go undiagnosed for weeks to months."

http://www.cincinnatichildrens.org/h...lies/tapvr.htm

So, depending on the type of TAPVR he had, what the ICU nurses said might not be applicable to him at all.

Hope this helps!

Kat

[Jilian]

He developed a cough at about 7 days old that got worse and worse. He also had periods of rapid breathing that became more and more frequent. I became so paranoid and sent her an e-mail so she offered to come over and check DS out. When she came over DS was breathing fast with occasional retractions and his HR was around 200. She told us to go to the ER and have him evaluated immediately. We did and they were gonna send us home. There is a huge detailed story to it, but the ER F***ed up royally. We called the MW and told her they were sending us home and she told us not to go anywhere and that she would be right there. She came, and had them do tests. She spoke up for us. They finally found that his heart was so swollen on one side and his lungs were in serious distress. He was in heart failure. She stayed with us until after 1 am when the transport team arrived and our son was in having emergency open-heart surgery within a few hours of arriving. He came so close to death, yet the ER was ready to discharge him. I love her for what she did, he likely would have died within the next 24 hours if we had gone home

I have the whole detailed story on his carepage at carepages.com and his page is EvanTaylor It is a crazy story. But he's doing really well now.

[Jilian]

I spoke with my MW and sent some of the birth pics to her and she said his color looked great. She also confirmed that purpley limbs are fine for a few days and purplish nailbeds are ok too. It made me feel good that she thought his pics looked good. She's such a sweet MW : Thanks for answering my questions.

Its hard not to look back and feel like I missed something. I guess it is a normal part of the healing process. I guess if the ER staff didn't even know anything was wrong then there likely weren't many red flags.

[MsBlack]

There is something I'm not clear about: were his hands and feet blue/purple, or were his arms and legs blue/purple? You used the word 'limbs', which to me means arms/legs.

Because while yes, any normal baby's hands and/or feet might be bluish for a few days, nailbeds maybe too, I would not consider it normal for baby to have blue arms or legs.

So--what exactly do you mean?

[Jilian]

When he was first born his limbs were bluish. After a few hours his nailbeds were still bluish and his hands and feet were a tiny bit blue, but not too bad. The nailbeds is what scared me most in hindsight.