Babies and skin color: Changes and genes

A newborn baby can have a variety of skin colors. The color of their skin when they are born may change as they get older. Some skin colors in babies can be normal, while others may be due to certain conditions.

When a baby is born, they may have red, purple, yellow, or blue skin. Skin color variations in babies do not usually signify an underlying condition. But some skin colors in babies can be the result of underlying conditions.

This article will go into detail about how and why a baby's skin color can change, as well as what different colors of skin can mean.

When a baby is born, they can have a range of skin tones. Generally, a baby will have dark red to purple skin when they are born. Once the baby takes their first breath, their skin color typically changes to red. This red shade usually fades over the first day.

Yellowish skin can also be typical when a baby is born. But yellow skin can also be a sign of an underlying problem, especially if it worsens.

Learn about infant jaundice here.

A baby may be born with bluish hands and feet. Over the next few days after birth, this blue tint should fade. Blue skin on other parts of the baby's body warrants a visit to the doctor.

Learn about blue baby syndrome here.

Research from 2017 found that babies' skin changed significantly as they aged.

Researchers noted that babies' skin became lighter and less red between 2–20 months old. Additionally, babies' skin was found to increase in yellow pigment until they reached 20 months old.

But this research was performed on a small sample size, and the racial and ethnic backgrounds of the babies in the study is unclear. Various ethnic skin tones may transition differently, becoming either darker or lighter over time.

There is limited research available on when exactly a person will know their baby's true skin color. If a person has questions or concerns about their baby's skin color, they should speak with their healthcare professional.

There are several reasons why a baby's skin color may vary.

Dark red

When a baby is born, they have thin, see-through skin. This means that the baby's blood and vascular structure may be seen through their skin, causing a dark red hue.

Yellow

Jaundice can be a cause of a baby having yellowish skin. Jaundice is very common in newborn babies and will usually go away without treatment.

Newborn jaundice is a side effect of their liver breaking down old red blood cells. As the old blood cells break down, they produce a yellow substance called bilirubin. A newborn's liver may need to develop over a few days before it can remove the bilirubin by itself.

Blue

Blue hands and feet can also be typical in a newborn baby. A newborn does not yet have a fully developed circulatory system. Having an immature circulatory system can mean they have reduced blood flow to their hands and feet.

A person usually has 23 pairs of chromosomes. Each of a person's chromosome pairs has one chromosome from each parent. This means that a baby receives half of their genetic makeup from each of their biological parents.

Some of a baby's physical characteristics will come from dominant genes from either biological parent. For example, if one of a baby's parents passed on the gene for blue eyes and the other parent passed on one for brown eyes, their baby would have brown eyes. This is because the gene for brown eyes is dominant.

A baby's skin color is a polygenic trait. This means that the skin color a baby has depends on more than one gene. When a baby inherits skin color genes from both biological parents, a mixture of different genes will determine their skin color.

Since a baby inherits half its genes from each biological parent, its physical appearance will be a mix of both. A baby may look more like one parent than the other, or it may look like neither.

It is typical for a newborn to have blueish hands and feet for a few days after birth. But if a baby has blue skin all over their body or around the lips, it can mean they have an underlying condition.

Cyanosis

Cyanosis is a symptom of certain conditions. A baby with cyanosis will have bluish skin or mucous membranes. Cyanosis can occur due to conditions of the heart, lungs, and central nervous system.

Cyanosis generally occurs due to a lack of oxygen in a baby's blood. There are various conditions that can cause cyanosis, including:

Tetralogy of Fallot: Tetralogy of Fallot is a condition that causes a variety of heart abnormalities. These heart abnormalities lead to oxygen-poor blood traveling around a baby's body.
Tricuspid atresia: Tricuspid atresia is a genetic abnormality that causes a valve to be missing from a baby's heart. This missing valve means that blood cannot travel from the baby's heart to their lungs to receive oxygen, causing cyanosis.

Total anomalous pulmonary venous return (TAPVR): TAPVR is a heart abnormality that causes oxygen-rich blood to mix with oxygen-poor blood inside a baby's heart. TAPVR occurs when oxygen-rich blood from the lungs returns to the wrong side of a baby's heart.
Methemoglobinemia: Methemoglobinemia is due to an overproduction of a protein called methemoglobin. Methemoglobin carries oxygen in the bloodstream, but does not release it. Too much methemoglobin means there is not enough oxygen in the baby's blood.

If a person notices a baby has blueish skin and is having difficulty eating, breathing, or waking up, they should seek emergency medical care.

Although mild jaundice can be typical in a newborn, longer-lasting yellow skin can indicate a more serious problem.

Jaundice that occurs in the first few days after a baby is born is called physiologic jaundice. Other health conditions that can cause jaundice include:

blood type mismatches between biological mother and baby
an underactive thyroid
a urinary tract infection
a blockage in the gall bladder and bile ducts

A person should contact a doctor if the jaundice remains or worsens 72 hours after birth or the child begins to seem reluctant to feed.

Learn more about infant jaundice here.

Unusually pale skin can be a sign of certain conditions in newborn babies. Conditions that can cause unusual paleness in babies include:

Anemia: Anemia is a condition that occurs when a baby does not have enough red blood cells. Anemia can also develop due to red blood cells not functioning correctly. Having reduced or defective red blood cells means that the baby may not get enough oxygen in their bloodstream.
Albinism: Albinism is a genetic condition that causes low levels of the pigment melanin in a baby's skin. This results in a baby having pale skin and hair.
Phenylketonuria (PKU): PKU is an inherited disorder that results in a baby being unable to break down the amino acid phenylalanine. Amino acids help make up proteins in the body. Phenylalanine then builds up in the blood, leading to health problems such as seizures. PKU also interferes with the production of melanin, leading to pale skin and eyes.

If a person notices a baby has particularly pale skin, and they are concerned about it, they should seek medical attention.

Learn more about causes of paleness.

It is typical for a newborn baby to have red skin. Red skin in newborn babies should gradually fade.

But reddish skin in the face may be a sign of a rare blood disorder called polycythemia vera.

If a baby has redness that is accompanied by symptoms such as trouble breathing or bleeding gums, a caregiver should take them to a doctor.

Learn what might be causing a red rash in a baby.

Babies can have a variety of skin colors when they are born. A baby's skin color can change over time and should settle fully at around 20 months old.

Due to the nature of genetics, a baby may look more like one parent than the other, or may not look like either.

Certain skin colors are typical for a newborn baby. But there are various health conditions that can cause a baby to have a particular skin color. If a person is concerned about their baby's skin color, they should contact their doctor.

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Jaundice in Newborn