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Grey Baby Syndrome: Causes, Symptoms, Diagnosis and Treatment

Pregnancy is a time when most mothers put their heart and soul into being extra careful about their health and avoid everything that may compromise their baby's health, both inside as well as outside of the womb. From making lifestyle changes like proper diet and exercise to consuming health supplements and medicines, mothers take all the precautions possible.

But what if one of those medicines itself posed a risk to the baby's health? Arguably, there are scores of over-the-counter medications that are considered safe during pregnancy, and you might also have been told so by an acquaintance.

Yet, certain chemical compounds present in those medicines may not be suitable to all people and if consumed in medically unregulated amounts, may have dire consequences. One such disease is the grey baby syndrome caused by the presence of the antibiotic chloramphenicol. If you're an expecting mother, read on to find out how grey baby syndrome may affect your baby and how it can be treated.

What Is Grey Baby Syndrome?

Grey baby syndrome is a rare condition that is seen mostly in newborn babies - especially in undernourished, unhealthy babies. It is also seen in children around the age of 2 years, although the incidence isn't as high as in the case of newborns. As the name suggests, along with an array of other serious symptoms, the baby's skin develops a slightly greyish colour. It is a potentially fatal, yet treatable health condition which is caused by the presence of excessive amounts of an antibiotic - chloramphenicol - in the baby's body.


If Chloramphenicol Is Dangerous, Why Is It Given In The First Place?

Chloramphenicol is an antibiotic that is effective against a variety of bacterial infections. It is effective to the extent that, when potent agents like Penicillin fails, doctors may suggest the administration of chloramphenicol. This antibiotic is mostly given directly to the mother at some point of her pregnancy, but it could also be given to the baby if need be.

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The chloramphenicol may get passed on from the mother's body to the baby while inside the womb and also while outside through breast milk. It is when newborns are given the antibiotic in unmonitored levels within the first three days of their birth that they are posed with a greater risk of developing the grey baby syndrome.


What Are The Causes Of Grey Baby Syndrome?

The biological systems of a newborn baby are fragile and only-so-developed to handle the toxicity caused by high levels of chloramphenicol. Neither does their livers have the necessary enzymes to metabolize large amounts of the antibiotic, nor do their kidneys have the ability to filter and excrete out the same. As a result, the chloramphenicol starts to build up in their bloodstream, causing multiple complications leading to grey baby syndrome. However, chloramphenicol is not just dangerous for kids, but it can also cause side effects in kids and adults. These could be low-intensity - vomiting, headaches, fever and rash - or could be high-intensity - anaemia, bleeding, blurry vision, weakness, infections, etc.


What Are The Symptoms Of Grey Baby Syndrome?

The symptoms mentioned below are associated with the grey baby syndrome in infants, although it is not necessary that your baby will have all of them. It usually takes a week or less for the symptoms to appear.

1. Greyish skin colour

2. Bluish lips or skin

3. Greenish stools

4. Swelling in the abdomen

5. Breathing difficulty

6. Vomiting

7. Low blood pressure

8. Low body temperature or hypothermia

9. Body limpness

10. Irregular heartbeats

11. Refusing breastmilk

If you notice one or more of these symptoms in your baby, consult your doctor immediately. Grey baby syndrome can be treated with on-time diagnosis, yet causing any delay may lead to fatality.


How Is The Grey Baby Syndrome Diagnosed?

Once the doctors observe the symptoms and suspect the grey baby syndrome, they will conduct a physical examination on your baby. Even though the doctors will go through your medical history, treatments and medications provided, if they don't ask you themselves, you must make it a point to let them know that you or your baby have been exposed to chloramphenicol before.

This will help in easier diagnosis. The doctor will then perform the relevant tests and also measure the levels of chloramphenicol in the blood from time to time.


What Are The Treatments Available?

Thankfully, with prior diagnosis, grey baby syndrome can be treated successfully. First, your doctor would ask you to stop giving the chloramphenicol-containing medicines to your baby. Secondly, if you're required to take the antibiotic yourself, then the doctor would not ask you to discontinue your medications, although he will ask you to stop breastfeeding so that more of the antibiotic isn't transferred to your baby through the breast milk.

Since this specific syndrome can be fatal, your baby will most likely be hospitalized for optimum care and close, constant monitoring. Two of the treatments available for grey baby syndrome are exchange transfusion and haemodialysis.


1. Exchange Transfusion

This is a procedure carried out to neutralize the effects of most diseases or conditions that cause changes in the blood. Through this procedure, the components of the baby's blood will be slowly replaced with freshly-donated blood from healthy donors. Thin tubes called catheters placed into the blood vessels are usually used to carry out this process.

When it comes to babies, medical practitioners exercise even more care than they usually do, while performing the procedure. Exchange transfusion is an effective treatment even in the case of the grey baby syndrome wherein the chloramphenicol-affected blood can be successfully removed from the baby's body.


2. Haemodialysis

As the name suggests, this procedure involves the use of a dialysis machine to purify the baby's bloodstream. Haemodialysis or simply dialysis is performed on people whose weak kidneys aren't efficient enough to remove toxins from a person's body. It also helps in maintaining the salt-balance of the body.

Apart from the aforementioned treatments, your doctor may try different treatments like haemoperfusion, although all the treatments aim at one thing - reducing and removing the chloramphenicol from the baby's bloodstream.


What If The Treatment Is Delayed?

It is highly unlikely that you will not notice the symptoms on time, and also unlikely that your general practitioner will cause a delay in diagnosis. However, if there is a delay in administering counter-treatment against grey baby syndrome, you can expect a host of complications. Your baby may suffer cardiovascular problems like improper blood circulation, breathing difficulty, irregular heart activity, etc.

Another complication that may arise is bone marrow suppression which leads to serious infections and bleeding. In fact, if your baby is undernourished or suffers from a disorder, chances are that the effects of the syndrome will worsen. That's why you must make haste in seeing the doctor.

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As it is clear from the article, grey baby syndrome is treatable and also, avoidable, provided you and your baby stay away from chloramphenicol. If your doctor happens to prescribe you or your baby medications that contain the antibiotic, you can ask him or her to provide you with a safer alternative to it. Always check your medications for their contents. Never ignore the symptoms of this hazardous syndrome and take schedule regular appointments with your doctor.

Read more about: syndrome baby
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