Key takeaways: Cool, sometimes bluish hands and feet are common in newborns because circulation is still maturing. Check your baby’s chest or the back of the neck instead. Blue lips, face, or tongue, or cold, mottled skin with poor feeding or sleepiness need prompt attention.
Many parents notice their baby’s hands and feet feel cold even when the rest of the body is warm. Usually, it’s normal.
Why It Happens
Newborns’ circulation is still adjusting after birth. Blood flow is directed to vital organs, so hands and feet may get less. In the first day or two, many babies have acrocyanosis: bluish hands and feet. It usually fades within a few days but may return when babies are cold.
How to Check if Your Baby Is Warm Enough
Feel the chest, belly, or back of the neck. They should feel warm and dry.
- Too cold: the chest feels cool, skin looks pale or mottled, or your baby seems unusually sleepy or fussy.
- Too hot: sweating, damp hair, flushed cheeks, heat rash, or rapid breathing.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. My book covers common first-year illnesses and the warning signs that mean it’s time to call the doctor, explained the way I’d explain them at the bedside.
Keeping Your Baby Comfortable
- Dress your baby in one more layer than you’d wear.
- Use a sleep sack instead of loose blankets.
- Socks or footed sleepers can help with cool feet.
- Hats are for outdoors in cold weather, not for indoor sleep.
Mottling
A lacy, purplish pattern on the skin (cutis marmorata) is common when babies are cool. It should go away with warming. Persistent mottling, especially with other signs of illness, needs attention.
When to Worry
Call 911 or seek emergency care if your baby has:
- Blue or gray color of the lips, tongue, or face (central cyanosis).
- Trouble breathing.
- Limpness or difficulty waking.
Call your baby’s doctor promptly if:
- Your baby’s chest feels cold and doesn’t warm with skin-to-skin or an extra layer.
- Your baby has a rectal temperature below about 97.5°F, or 100.4°F or higher.
- Mottling persists, or comes with poor feeding, sleepiness, or fewer wet diapers.
The Bottom Line
Cool or bluish hands and feet are common in newborns. Check the chest or neck to judge temperature. Blue lips or face, or a cold, lethargic baby, need urgent care.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- What a Normal Newborn Looks Like: Cone Heads, Milia, Peeling Skin, and More
- Fever in a Newborn: Why 100.4°F Means Call Right Away
Sources
- Lewis ML. A comprehensive newborn exam: part I. General, head and neck, cardiopulmonary. Am Fam Physician. 2014;90(5):289-296.
- Altmann TR, Hill DL, eds. Caring for Your Baby and Young Child: Birth to Age 5. 7th ed. American Academy of Pediatrics; 2019.
- Moon RY, Carlin RF, Hand I; Task Force on Sudden Infant Death Syndrome; Committee on Fetus and Newborn. Sleep-related infant deaths: updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics. 2022;150(1):e2022057990.
- World Health Organization. Thermal Protection of the Newborn: A Practical Guide. Geneva: WHO; 1997.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
