Why do newborns have a marbled skin color and what does it mean?

Marble skin in a newborn is the appearance of vascular capillaries on a child's skin against the background of her pallor under the influence of certain factors. Such changes in the skin of a child can be in absolutely healthy children against the background of changes in the temperature of the environment, and this can also indicate different pathologies. Therefore it is important to understand when the marbling of the skin is a serious symptom, and when it is just a physiological reaction.

Causes of the marble skin in a newborn

The skin of a child is a means of contacting the baby with the environment. It performs many different functions, and although the skin of a child is thinner than that of an adult, the protective function is one of the main. The protective function is not only to create a barrier, but also that the skin condition speaks for the functioning of the whole organism. In this case, a discoloration of the skin, the appearance of a rash or other elements may indicate a pathology.

Marbling of the skin is the appearance of a vascular pattern that shines through the light and thin skin of the child. Marbling can be in separate areas, or cover the entire skin.

The causes of the marbling of the skin can be divided into two groups - physiological, when it is a normal skin reaction to stimuli, and pathological when it speaks of a problem.

[1], [2], [3]

Risk factors

Risk factors for the development of marbling of the skin are, first of all, prematurity. Children with a low body weight can not regulate the temperature regime, so they are more susceptible to the same skin changes. Also at risk are children with vegetative-vascular dystonia in their parents, which leads to a longer adaptation of the vegetative nervous system to the environment.

[4], [5], [6], [7], [8], [9]

Pathogenesis

The pathogenesis of the formation of a marble pattern on the skin is that the vessels that are most superficially placed on the skin begin to spasmodize and become dyed blue, which has the appearance of marbling. Such spasm of vessels can develop under the influence of various factors. Under normal conditions, the physiological vasospasm of newborns can occur against a background of a sharp change in the temperature regime of the environment. This is because the skin of a newborn can not immediately adapt to the conditions of the external environment, and therefore, when changing a child, the temperature of his body can drop dramatically, which is manifested by vasospasm. The vascular tone is restored when the child is dressed and the marbling disappears. This is considered to be the physiological marbling of the skin in newborns. Often you can see that the spasm of blood vessels can only be on the legs or arms of the child, which also does not indicate a pathology, but is likely the cause of child's hypothermia.

When the marbled skin of a newborn appears very often for no apparent reason, it is most likely that the cause may be a pathological condition. Most often such changes are observed in premature babies when they very slowly adapt to the conditions of the external environment. The cause of marbling the skin is often hypoxic damage to the central nervous system, which can occur during pregnancy or childbirth. Hypoxia, as is known, leads to cerebral ischemia. The lack of oxygen for brain cells is very dangerous, and it leads to a disruption in the function of many systems. The regulation of the vascular tone occurs with the participation of the autonomic nervous system. When hypoxia of the brain suffers and vegetative system, which can manifest as a violation of the tone of the vessels, and therefore there is marbling of the skin. Thus, the marbling of the skin in newborns can occur due to hypoxia and cerebral ischemia. Such symptoms can be the entire recovery period. Birth trauma can also often lead to disturbances in the tone of the vessels not only of the skin, but of the organs, which outwardly will be manifested by such skin color irregularities.

Marbling of the skin in more severe cases can develop with toxic shock. This condition, which occurs with the majority of infectious-septic conditions, is characterized by impaired vascular tone under the influence of bacterial toxins and blood stasis in the capillaries. This is the most serious cause of marbling of the skin in newborn babies, which requires urgent measures.

One of the causes of disturbance of the microcirculation of the skin may be the congenital pathology of the cardiovascular system. Any congenital heart disease can not immediately produce pronounced clinical manifestations, and marbling of the skin can be the first symptom. When the pumping function of the heart is disturbed, the blood is located in the organs, which primarily require oxygen. Therefore, the skin does not receive enough oxygen, and the blood vessels spasmodic to provide blood to the central organs. And thus, disrupting the heart from a newborn can cause marbling of the skin, as one of the manifestations of the disease. 

[10], [11], [12], [13], [14]

Symptoms of the marble skin in a newborn

When the child's marbling of the skin appears from the fact that the child's body temperature decreases, it will be accompanied by the cold extremities of the baby, with a light blue tinge of the skin on the legs or pens. All these symptoms and skin changes should disappear after the baby is dressed.

More often, marbling is observed in premature babies and in children born in hypoxia. If there are no other symptoms that can alarm, then such phenomena are already at the end of the first half of life.

There are symptoms that, together with the marbling of the skin, indicate the pathology or disease of the child. These symptoms include episodic or permanent changes in the area of the nasolabial triangle. The blue color of the skin in this place, which is combined with the marbling of the skin, as well as the cyanosis of the mucous membranes, can be indicative of hypoxia caused by the pathology of the heart. The first symptoms of circulatory failure are manifested precisely by changes in skin color in the newborn. Therefore, if the child besides this has episodes of rapid heartbeat, causeless subfebrile body temperature, you need to think about congenital heart defects and carefully examine the baby.

Symptoms of the marbling of the skin in the defeat of the central nervous system due to hypoxia and ischemia may be in the child for several more months. It is considered dangerous if the manifestation of marbling is combined with a delay in the development of the child's psychomotor development or severe muscle tone disorders. The recovery period after hypoxic damage to the central nervous system can last up to three months. In this case all pathological symptoms should gradually fade. If the baby's hypotension or hypertonia remains for a long time without positive dynamics and there are such skin changes, then one should think about chronic hypoxia for one reason or another. If the child does not begin to hold the head or reacts badly to irritants, then it is possible that this is a consequence of the hypoxia transferred and it is necessary to change the treatment or strengthen it.

Complications and consequences

The consequences of marble skin can be, if it is formed against the background of the pathology of the central nervous system. In this case, the transferred brain damage can lead to a delay in the development of the child, a violation of his cognitive functions. Complications of disorders of microcirculation of the skin are rare, but such children are more predisposed to the development of vegetative-vascular dystonia in the future.

[15], [16], [17], [18], [19], [20]

Diagnostics of the marble skin in a newborn

Very many parents such marble skin scares, because when the child is all blue, it causes fear for his health. But it is not always worthwhile to sound the alarm, but you just need to diagnose correctly when the child needs to be examined and examined.

The appearance of the marbling of the skin along with the symptoms of periodic or permanent cyanosis in the face requires the advice of a cardiologist. The probability that such a baby may have a congenital heart disease or other pathology of the heart is small, but it does exist. Such a child should be carefully examined and found out when symptoms appear. With auscultation of the heart, it is not always possible to note any changes, but there may be noises or changes in heart sounds. It is necessary to conduct instrumental diagnostics - electrocardiography and ultrasound examination of the heart. Any changes can confirm or disprove the diagnosis of cardiac pathology, in which case it is necessary to conduct differential diagnosis with other causes.

It is very important to consult a neurologist with a marbled skin and a psychomotor development disorder. When examined from a neurologist, the history of anamnesis is clarified, whether there were any problems in childbirth. When examining a child determine the tone of the muscles, reflexes, their symmetry, which speaks of the child's nervous system. If the birth was hypoxia and there are violations of reflexes, the marbling of the skin can be one of the symptoms of such a recovery period in a child after hypoxia. For a more thorough diagnosis, ultrasound is carried out through the fontanel - neurosonography. This study allows to determine the presence of pathological foci in the brain tissue, hemorrhages.

Analyzes that are carried out by a child with marbled skin are not specific. First, a general blood test, urine, is done. If there are any changes, then it is already possible to conduct a more thorough laboratory study.

[21], [22]

Differential diagnosis

Differential diagnosis of marble skin in the first place should be carried out with those states where this is not a symptom of the disease. For this, first of all, it is necessary to eliminate hypothermia in the child.

Treatment of the marble skin in a newborn

Treatment of marble skin in a newborn as the skin problem itself is not required. The main thing is to find the reason for such changes.

If a child has neurological problems and it is because of this that such skin changes appear, then vitamins and physiotherapy are a very important stage in the treatment, except for specific medicines.

Agvantar is a drug from a group of metabolic agents that is used in complex therapy for the pathology of the nervous system. The active substance of the drug is levocarnitine. This is a natural compound, which, entering the cell, carries the necessary metabolites into the mitochondria, which increases the amount of synthesized energy. In neurons, it helps to quickly restore connections and speeds up the myelination of the fibers. Therefore, the drug improves nerve conduction and normalizes the tone of the autonomic nervous system, which improves the reaction of the skin vessels. Dosage - 2 drops three times a day, for the full effect is required to apply the drug for at least a month. Side effects can be in the form of weakness, dyspepsia, which requires a dose reduction.

Massage is the main method in correcting the pathology of the nervous system after hypoxia, as well as a direct effect on the baby's skin can improve the condition of the vessels. When the massage improves the drainage function of the skin and increases its tone, which improves the tone of the vessels of the skin. This is very effective in combating the marbling of the skin and impaired local heat exchange in the baby.

Massage should be done in a warm room with a previous airing it. You need to start massage in the interval between feeding and sleeping. Massage on the back, and then on the limbs, taking into account the muscle tone of the child. To reduce muscle tone, you need to put the baby on the stomach in the "embryo" position. To relax the muscles, you can also put the baby on the big ball with the next rocking it. In this case, the handles and legs must be laid on the ball. After this, you need to massage the muscles of the limbs in conjunction with the removal of hands, and pressing on the chest.

If the tone is increased, then it is necessary to carry out acupressure by lightly pressing the fingers on the muscles of the back and limbs. Muscle tone is stimulated in a standing position with the child's support under the armpits. At the same time, you need to shake the child in different directions, holding the handles with smooth movements.

To finish the massage you need general strokes on the skin. All the techniques are not so complex, so after easy training, mom herself can conduct it.

Therapeutic gymnastics should be practiced after each bath, which improves not only the condition of the skin and muscles, but also the overall tone of the body.

Prevention

Preventing the appearance of marble skin in a child is a comfortable temperature regime and proper care. If the child's marble skin is a manifestation of neurological problems, then to prevent the delay in the development of the child and other complications, it is necessary to carry out complex and earlier treatment.

[23], [24], [25], [26], [27], [28]

Forecast

The prognosis for this pathology is always favorable. In case there are suspicions of congenital heart defects, it is necessary to clarify the diagnosis in a timely manner.

Marble skin in a newborn in most cases is not a pathology, but speaks of a normal adaptation of the skin of a newborn child to the environment. But if there are other dangerous symptoms or manifestations, then you need to consult a doctor to avoid complications.

[29]