Why is my child blue around the mouth?

If you notice that your child’s lips or skin around their mouth appears blue or purple in color, it could be a sign of a serious medical condition that requires immediate attention. Some potential causes for a blue appearance around the mouth include:

Low oxygen levels

A bluish color around the lips or mouth often indicates that a child is not getting enough oxygen. Potential reasons for low oxygen levels include:

Respiratory distress

Conditions like asthma, pneumonia, bronchiolitis, croup, and respiratory infections can make it hard for a child to breathe properly. This restricts their oxygen supply and causes bluish lips and skin. Get emergency care if your child is struggling for breath or making noises when breathing.

Heart defects

Some congenital heart defects likeTetralogy of Fallot result in low oxygen levels in the blood. The bluish discoloration is most noticeable around the mouth, lips, and tongue. Seek medical help right away if an infant has bluish skin and you suspect a heart issue.

Allergic reactions

Severe allergic reactions or anaphylaxis can cause breathing difficulties, a drop in blood pressure, and restricted airflow. This prevents normal oxygen circulation, leading to a blue tinge around the mouth. Call 911 if your child is having an allergic reaction and their lips or face look blue.


If your child is choking on a foreign object or food, it can block their airways and prevent oxygen from entering the lungs. The skin around their mouth may turn blue or purple from oxygen deprivation. Give first aid for choking and get emergency help if they are unable to breathe.


Cyanosis is a condition in which the skin, nails, lips, and tongue develop a bluish tint due to lack of oxygen in the red blood cells. Causes include:

Lung disease

Lung disorders like cystic fibrosis, pneumonia, pulmonary edema can lead to cyanosis. The low oxygen levels in the blood cause the bluish color.

Heart defects

Structural defects in the heart present from birth may cause cyanosis. This includes issues like Tetralogy of Fallot and transposition of the great arteries.

Respiratory distress syndrome

Seen in premature babies, RDS causes bluish discoloration due to collapsing airways and difficulty breathing.

Get urgent medical help if your infant or toddler shows signs of cyanosis like bluish lips, tongue, nails or skin.

Raynaud’s phenomenon

Raynaud’s is a condition where blood vessels in the fingers, toes, lips, ears or nose constrict in response to cold temperatures or stress. This limits blood circulation, causing a pale blue or purple color. Attacks typically last a few minutes and cause numbness or pain until circulation improves.

See your pediatrician if Raynaud’s symptoms are impacting your child’s quality of life. Keep the child warm and avoid triggers like cold weather.

Low blood pressure

A drop in blood pressure reduces blood flow, potentially causing the lips and area around the mouth to appear blue or purple. Causes for hypotension in children include:


Inadequate fluid intake can lower blood volume and pressure. The skin may develop a bluish tinge. Give the child sips of water and contact the doctor if dehydration is suspected.

Allergic reaction

As mentioned earlier, life-threatening allergies can cause a sudden drop in blood pressure along with breathing issues. Both these factors can lead to a blue discoloration of the skin.


This severe complication of an infection can result in significantly low blood pressure. Bluish lips or skin may develop along with other symptoms like high fever, dizziness, and chills. It requires hospitalization.


Certain drugs like diuretics, sedatives, and beta blockers may cause blood pressure to drop too low in some kids. Discontinue the medication and report blue lips or skin to your pediatrician.


Prolonged exposure to cold temperatures can cause a dangerous drop in body heat or hypothermia. As body functions slow down, oxygen circulation is also reduced. This can give the skin a blue-gray appearance.

Always dress kids appropriately for cold weather. Call 911 if a child’s lips or face turn blue or if their body becomes very cold.

Blue nevus

Some children are born with blue nevi, which are small, flat, blue-black moles. Most often seen on the scalp or sacrum, these bluish spots are benign and don’t require treatment. However, keep an eye on any changes or spreading.

Blue vitiligo

This rare skin condition causes blue patches to appear on the face around the mouth, nose and forehead. It is a variant of vitiligo, which destroys pigment producing cells. Consult a dermatologist if you notice any abnormal blue spots.

When to see a doctor

Consult your pediatrician right away if your child develops a blue color around their mouth, especially if accompanied by other symptoms like:

  • Breathing difficulties
  • Wheezing or grunting sounds with breathing
  • Dizziness or fainting
  • Excessive sweating or shivering
  • Chest pain
  • Irregular heartbeat
  • Palpitations
  • Severe distress
  • Loss of consciousness

Call 911 or take the child to the nearest emergency room if the blue color persists for more than a few minutes or their condition appears life-threatening.

Diagnosing the cause

To determine the underlying reason for blue discoloration around your child’s mouth, the pediatrician will examine them and ask about symptoms. Tests may include:

Blood tests

These check oxygen and carbon dioxide levels to assess respiratory function. Other biomarkers associated with infections and inflammation may also be analyzed.

Chest x-ray

X-rays allow doctors to visualize the lungs and heart to diagnose issues like pneumonia, heart defects, etc.

Pulse oximetry

This non-invasive test measures oxygen saturation in the blood using a finger clip device. Low levels can confirm respiratory distress.

Electrocardiogram (ECG)

ECGs analyze the heart’s electrical activity. Irregular heart rhythms may be causing low oxygen circulation.


Sound waves create images of the heart’s anatomy and functioning. These can reveal congenital heart defects.

Identifying the root cause is crucial for prompt and appropriate treatment to resolve the blue lips and mouth.

Treatment options

The treatment for blue discoloration around a child’s mouth depends entirely on the underlying condition. Your pediatrician will recommend suitable therapies which may include:

Supplemental oxygen

If low oxygen levels are causing the bluish tint, the doctor may prescribe extra oxygen delivered through a nasal cannula, face mask or ventilator.


Drugs like bronchodilators for asthma, diuretics for heart failure, or epinephrine for allergies may be advised. Antibiotics are used for infections.


Surgical intervention can correct certain congenital heart defects and lung abnormalities to improve oxygen circulation.

Blood transfusion

A bluish color due to cyanosis may be treated with transfusions to increase oxygen carrying capacity.

Diet and lifestyle changes

Avoiding known triggers for allergies and Raynaud’s can prevent episodes of blue lips. Proper hydration and nutrition supplementation can help correct underlying deficits causing low oxygen.

The prognosis depends on the severity of the underlying disorder. With prompt diagnosis and suitable treatment, many children recover fully. Closely monitor the child and watch for recurrence of bluish discoloration which could suggest worsening of the condition. Seek emergency care if their lips or face turn blue without explanation.


While congenital heart defects and chronic lung disease cannot be prevented, the following measures can help avoid blue lips and mouth in children:

  • Ensure adequate intake of fluids and nutrition to prevent dehydration.
  • Dress appropriately for cold weather and avoid extreme cold exposure.
  • Be aware of any conditions like asthma and have rescue medications on hand.
  • Identify and avoid known allergy triggers.
  • Give age-appropriate first aid for choking.
  • Monitor for signs of respiratory infections and treat promptly.

Blue lips or skin around the mouth is always abnormal in children. Stay vigilant about your child’s health and do not hesitate to get emergency assistance in concerning situations where they appear blue or are having difficulty breathing. Timely evaluation and treatment can prevent complications in potentially life-threatening cases. With proper care, most children with bluish discoloration recover well.

Frequently asked questions

Why do babies turn blue around the mouth?

Common causes for bluish discoloration around a baby’s mouth include respiratory distress, cyanosis due to heart defects, low oxygen levels, Raynaud’s phenomenon, sepsis, low blood pressure, and hypothermia.

When should I worry about baby’s blue lips?

Seek immediate medical help if your baby’s lips, mouth or tongue turn blue. This could indicate potentially serious conditions like congenital heart disease, lung infections, low oxygen levels or cyanosis. Do not wait for the bluish color to resolve on its own.

What does blue lips indicate?

Blue lips most often indicate insufficient oxygen circulation in the bloodstream. This may be due to lung disorders, cardiac anomalies, choking, anaphylaxis, cyanosis, respiratory distress, or extreme cold exposure. The blue color results from low oxygen saturation.

Can anxiety cause blue lips?

No, anxiety itself does not directly cause blue lips. However, hyperventilation due to anxiety or panic attacks can alter oxygen and carbon dioxide levels. This may rarely cause lips to appear somewhat blue temporarily. But chronic cyanosis is not caused by anxiety.

How can I tell if blue lips are serious?

A healthy person’s lips should never appear blue. Any blue or purple discoloration of the lips, especially if it lasts more than a few minutes or keeps recurring, should be considered serious. It suggests an underlying problem is preventing adequate oxygen circulation.

Condition Symptoms Causes Treatment
Low oxygen levels Bluish lips, mouth, tongue, nails and skin; Shortness of breath; Wheezing; Gasping; Confusion Asthma; Pneumonia; Respiratory infections; Airway obstruction; Heart defects; Anaphylaxis Supplemental oxygen; Bronchodilators; Antibiotics; Epinephrine; Surgery
Cyanosis Blue or purple lips, mouth, hands, feet; Lethargy; Headaches; Chest pain Heart defects; Lung disease; Respiratory distress syndrome Oxygen therapy; Medications; Blood transfusion; Surgery
Raynaud’s Pale then blue lips, fingers; Numbness; Tingling; Pain during attacks Cold temperatures; Emotional stress; Autoimmune disorders Keep warm; Avoid triggers; Medications
Low blood pressure Blue lips, mouth, hands; Dizziness; Fainting; Dehydration; Nausea Dehydration; Septicemia; Medications; Allergic reaction Oral rehydration; Medication adjustment; Antibiotics
Hypothermia Blue or pale lips and skin; Shivering; Sleepiness; Confusion; Slow breathing Extreme cold exposure without adequate clothing Gradual rewarming; Warm environment; Warm fluids

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