Acrocyanosis is cyanosis of the hands and feet and is a normal finding in infants under what condition?

• A. Infants younger than 2 months when cold.
• B. Infants with fever and dehydration.
• C. Term infants with normal oxygenation.
• D. All infants with delayed cord clamping.

Answer: (A)

Peripheral cyanosis of the hands and feet in a newborn is usually a normal finding when the infant is cold. The key idea is that newborns have immature thermoregulation, so in response to cold their body redirects blood flow to the core to conserve heat. This peripheral vasoconstriction reduces blood flow to the extremities, making the hands and feet appear blue even though the overall oxygen level in the blood remains adequate. Warming the infant typically improves the color, and there are no signs of respiratory distress or central (tongue/lip) cyanosis.

This helps distinguish physiologic acrocyanosis from signs that would worry you about low oxygenation. Central cyanosis would involve the lips or tongue and indicate systemic hypoxemia, not just the extremities. Fever and dehydration don’t cause this isolated, cold-induced peripheral change, and delayed cord clamping isn’t a cause of normal acrocyanosis in this context.