Pediatric Heart Expert Forum
Purple lips and mottled skin in 21 month old
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Purple lips and mottled skin in 21 month old

My daughter is 21 months old. I've noticed on and off that when she is cold or crying her lips turn purple and her whole body becomes mottled. She was hospitalized once when she was 13 months old for pneumonia and the flu. These symptoms, I noticed, were worse during that time. She's never been diagnosed with any caridac anomalies nor is her physical activity level ever restricted because of these symptoms. She is otherwise a healthy child. I would just like to know if this is something I need to worry about.
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Dear Jil,

Without evaluating your daughter, I cannot say for sure if this is benign, or not.  However, I can say that we do frequently see infants and toddlers have bluish skin around their lips as well as having some mottling when cold, when crying, when in a bath, or when getting up from a nap.  This usually resolves by age 2, or so.  However, if she is blue inside her mouth (i.e. her gums or her tongue), this is not a normal finding and needs further evaluation.  An easy way to check this is for her primary care provider to assess her oxygen saturations in the clinic.  However, if your primary care provider does not feel comfortable with this, then evaluation by a pediatric cardiologist may be indicated.
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