[breastfeedingRN]

hi all. i have a question for you. i had a baby the other day that came to the floor with his mom about 2 hours pp. i was with him during transition, did his bath and then he had an assessment done about 5 hours pp. i noted nothing abnormal on his skin. at around 11 hours pp, i took him to delee suction him and when changing him noted bruising on his arms and legs. i am positive this wasn't there when i first assessed him. his mom did have a pretty fast labor and he was out with 2 pushes and was almost 9 pounds.

anyone seen this happen before?

[BittyBabyGrower]

Usually bruising happens quickly and doesn't take 11 hours to show up. Did he have petechiae too?

[breastfeedingRN]

not that i saw. they were not huge bruises either, pretty faint. the nurse i was orienting with didn't seem worried about them. just told me to note them in the chart, which i did.

i just didn't know why i hadn't seen them before. the only thing i can think of is that he was crying when i was assessing him and was acrocyanotic. i just can't see how i would have missed it and it is driving me crazy. what kind of nurse will i be if i can't even see bruises on a baby?

[BittyBabyGrower]

Ah..if he was acrocyanotic then you can miss them! They sort of blend in Don't fret too much about it, we all miss something sometimes and find it later

[unknown99]

I really do not know much about newborn nursing. So, I am just making a guess based on my own children. Could the bruising actually be mongolian spots? Usually they occur in children of darker skin, and usually occur on the buttocks and lower back.
However, one of my children had the spots on his upper arms also. He kept them for about 15 or16 months.

[breastfeedingRN]

Originally Posted by sagarcia210

I really do not know much about newborn nursing. So, I am just making a guess based on my own children. Could the bruising actually be mongolian spots? Usually they occur in children of darker skin, and usually occur on the buttocks and lower back.
However, one of my children had the spots on his upper arms also. He kept them for about 15 or16 months.

don't think they were mongolian spots. my daughter them on her back and they are still there. thanks though!! although a friend of mine told me that she has seen them "appear" 12 hours+ after birth of the baby.

[breastfeedingRN]

Originally Posted by BittyBabyGrower

Ah..if he was acrocyanotic then you can miss them! They sort of blend in Don't fret too much about it, we all miss something sometimes and find it later

thanks. i hope that is why i didn't notice them. i probably wasn't look for them when he was under the warmer and when i was really looking was during the bath and he was screaming and during his assessment when he wasn't too happy to be messed around with and was hungry.

[veteranRN]

This happened to my 4th child. She was 8 13 and cam rather quickly. My husband noticed bruising, said she was bruised head to toe. I never noticed it. The only thing I would caution you on is a high bilirubin level later on as a result of breaking down of the RBCs. When she left the hospital her bili was normal. When we went to see the nurse for follow up she was a little orange but the nurse wasn't concerned (this was 5 days after birth). When we went to see the DR. at 1 week he decided to check her bili because she was slightly orange (he checked it for my sake as I was concerned by this point). He sent us home and a couple hours later we got a call from the Dr. with a bili of 31!!!!!!!. She was in the hospital for several days while it went down but they it was because of the bruising.

[breastfeedingRN]

we do a bilichek on all before discharge (and an MBR if it is in a certain range) and it is part of our teaching. i am very thorough when i do my teaching and always talk about jaundice and reporting it ASAP to get it checked. thanks for the reminder. so glad they caught your daughters and got her treated. i never saw one that high before. yikes.