Blue baby syndrome is an environmentally-caused children’s health issue. Blue baby syndrome, or methemoglobinemia, is an illness that arises when an infant’s blood is unable to carry enough oxygen to body cells and tissue. It is caused by a rise in the level of methemoglobin in the blood. Methemoglobin is a non-oxygen-carrying enzyme that is continually produced in the body.
It is converted to hemoglobin, the oxygen-carrying enzyme in the blood, by a red blood cell enzyme called methemoglobin reductase. Because infants under that age of six months have little methemoglobin reductase in their systems, an excess of methemoglobin, or methemoglobinemia, can be fatal if left untreated.
Blue baby syndrome manifests as soon as the child is born or within the first few days of life. This syndrome is usually caused by a group of congenital heart diseases, called cyanotic congenital heart disease. In most cases, the patient is born with a structural defect or abnormality in the heart that prevents oxygenated blood from reaching the skin of the patient. In these patients, carbon dioxide, which is a bluish gas, builds up in the patient’s skin, causing a bluish discoloration.
Excessive nitrates in drinking water can adversely affect children’s health, sometimes causing blue baby syndrome. When ingested, these nitrates are converted to nitrite in the digestive system; these nitrites react with the hemoglobin in the blood, forming high amounts of methemoglobin. Since methemoglobin cannot carry oxygen, if enough too much of the enzyme is in the blood, the infant’s tissue and organs may be deprived of oxygen. This will cause him or her to develop a bluish coloring and possibly result in long-term digestive and respiratory problems.
This syndrome occurs mostly in babies six months or younger, but it can also be found in older children and adults. In cases of adults or older children, affected blood can easily return back to normal due to healthy levels of methemoglobin reductase in the blood; however, in the case of infants, this conversion can take much longer or sometimes not at all, resulting in development of serious health problems or possibly death if left continually untreated.
The skin of infants with blue baby syndrome may take on a bluish tint, so it is harder to detect in darker skinned babies. Often times, the symptoms resemble those experienced when they have other infections, such as diarrhea or vomiting and shortness of breath. If your infant is exhibiting these symptoms, doctors can test for the syndrome and can administer a medicine called methylene blue which can return the baby’s blood to normal.
Blue baby syndrome is most common in rural areas where nitrates are used in high levels for agricultural purposes. Leaching of nitrates generated from fertilizer or waste dumps can contaminate groundwater. The EPA regularly tests public drinking water to insure that healthy levels of nitrates are maintained. However, those who use well water may be at risk for high levels of nitrates, as they can be carried by rain or irrigation water through the soil and into the groundwater.
If drinking water is contaminated, boiling water will not reduce nitrate levels, and bottled water should be used as long as the nitrate levels continue to be unhealthy. Avoid giving infants water that may be contaminated. Tests can be performed on well water to insure that levels of nitrates do not exceed 10 parts per million. Due to increasing awareness of children’s health issues, county health departments can give information on obtaining tests, which typically cost around twenty-five dollars. Well water should be tested annually, as nitrate levels fluctuate over time.