Talk:Blue baby syndrome

Wiki Education Foundation-supported course assignment
This article is currently the subject of a Wiki Education Foundation-supported course assignment, between 10 January 2022 and 4 February 2022. Further details are available on the course page. Student editor(s): Wikimedstudent.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 18:11, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 October 2019 and 6 December 2019. Further details are available on the course page. Student editor(s): Stephhads. Peer reviewers: Keo1274.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 15:59, 16 January 2022 (UTC)

Can
That baby looks PINK not BLUE..... bad example there. — Preceding unsigned comment added by 2601:40F:400:5A17:DD3B:5B0D:3A34:32D5 (talk) 09:17, 14 August 2017 (UTC)

Can we get a picture of a blue baby on here? -Matt

I'll add a photo for the article, but not sure that it will stay a very substantial article. The correct term for "blue baby syndrome" is actually "cyanosis" or "cyanotic congenital heart defect". This article should be not much more than a description of what is meant by "blue baby syndrome" and links to these other articles. bcatt 01:36, 5 February 2006 (UTC)

I have removed the following from the article because I think it belongs somewhere else, I just need to work it out and put it there. I think the info itself is very good and should be used, just not in this article.


 * In 1944, the Johns Hopkins Hospital was the first to successively perform an operation to relieve this syndrome.


 * On November 29, 1944, Drs. Alfred Blalock and Helen B. Taussig decided to proceed with the anastomosis, or joining, of the subclavian artery to the pulmonary artery in a cyanotic child. The procedure is now known as a Blalock-Taussig shunt.


 * Dr. Taussig was convinced that the operation would help the patient,and despite the technical problems of operating on a very small and very ill child, Dr. Blalock's skill was equal to the task. Blalock worked with his surgical team and his assistant Vivien Thomas, who stood behind Blalock and offered a number of helpful suggestions in regard to the technique employed.


 * The tiny child who had been at such great risk survived the operation and slowly improved. Over the succeeding days she gradually became less blue. By the end of the second postoperative week it was clear she would recover.


 * Alfred Blalock Biography
 * Vivien Thomas Biography
 * Helen Taussig Biography

bcatt 06:18, 18 November 2005 (UTC)


 * Perhaps not all of it belongs there, but at least the first paragraph does -- it provides some important links to follow for people researching this syndrome. Replacing that part &mdash; Catherine\talk

fo sho —Preceding unsigned comment added by 208.189.247.254 (talk) 13:49, 4 September 2008 (UTC) hi people —Preceding unsigned comment added by 208.39.164.211 (talk) 14:19, 7 October 2010 (UTC)

rh factor
"Blue Baby" used to describe a child of parents with different rhesus factors. Pokerpoodle123 (talk) 18:53, 17 July 2016 (UTC)

Atrial septal defect?
Atrial septal defect - is this not also a cause? (Expert needed.) - Leonard G. (talk) 03:46, 28 April 2012 (UTC)

ASCII art
What's up with the two instances of crude ASCII text art in the "Tetralogy of Fallot" section, added by user MelanieN on April 30. 2012? It is visually jarring. This is not up to Wikipedia standards and should be replaced with proper graphics, created with Inkscape or a CAD program and uploaded as Scalable Vector Graphics (SVG) files. — QuicksilverT @ 07:43, 17 March 2014 (UTC)
 * I make no claim of authorship or ownership of anything in that section. I simply moved it there from another article where it didn't belong. If anyone wants to improve it or replace it, feel free. I do think SOME kind of bloodflow description is helpful for the article. --MelanieN (talk) 16:15, 18 March 2014 (UTC)

I don't believe that The linkage between nitrates in drinking water and blue baby syndrome has been disputed
The edit made by Jermakka does not seem to be sound to me. It's the first time I hear about it. The two references given have no URL with them so are not easy to check, also they are not recent or reputable sources. I suggest to delete this or to add more substantial evidence. I am not an expert on this condition though. The edit said "The linkage between nitrates in drinking water and blue baby syndrome has been disputed, and elevated drinking water nitrate concentrations most likely do not have any connection to the occurrence of blue baby syndrome. Instead, the syndrome outbreaks are presumably due to pathogen contamination of drinking water" EvM-Susana (talk) 07:06, 11 May 2015 (UTC

More sources on the disputability of the blue baby syndrome This is an answer to EvM-Susana to provide more substance for the change. The dispute about the origin of blue baby syndrome originally came to my notice writing scientific research papers on nitrogen removal from wastewater - blue baby syndrome is regularly mentioned as a proven result of nitrate in drinking water, but following the sources leads to not so clear conclusions. Here's an article by American Scientist on the matter: http://www.americanscientist.org/issues/pub/the-blue-baby-syndromes. The blue baby syndrome is currently very rare and contemporary articles usually deal with single cases, typically locating a rural well in bad condition as the source, with a slightly higher nitrate concentration (which is typical to wells contaminated by surface waters).

Some more sources disputing the phenomenon: Avery 1999 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1566680/ Avery 2001 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1242065/pdf/ehp0109-a0012a.pdf Fewtrell 2004 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247562/ Manassaram et al. 2005 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392223/ Ward et al. 2005 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310926/ van Grinsven et al. 2006 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1586190/ Churchill 2007 https://elibrary.asabe.org/azdez.asp?JID=1&AID=23980&CID=icss2007&T=2 Richard et al. 2014 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171798/

The conclusion from these sources is that while they cannot completely de-link the possibility of nitrate having a role in blue baby syndrome development, they indicate that there are no support for the link either. Fewtrell 2004, a study conducted by behalf of WHO, concludes that: "given the apparently low incidence of possible water-related methemoglobinemia, the complex nature of the role of nitrates, and that of individual behavior, it is currently inappropriate to attempt to link illness rates with drinking-water nitrate levels." Jermakka(talk) 12:46, 12 May 2015 (UTC)


 * Ah, Wikipedia at its best!! Thanks for highlighting these studies to me, I wasn't aware of them. My background is in sanitation and wastewater treatment and I was taught about the blue baby syndrom and nitrate levels - and took it as a given. Is it perhaps a myth? The papers that you listed made me think... We should find an expert on this. Meanwhile, I have tried to select those from your list that are most recent and appear most reputable (and which have a DOI number; the DOI number in itself is not a sign of reputation but it helps with the citation template, so it's easier to put in the citation correctly). But perhaps someone with more of a medical background can take another look and pick out those that are not regarded as primary sources but rather as review articles? - We should in that case also modify the related content on the pages of pit latrine and groundwater pollution (have already started to do so). Any thoughts by user Doc James and JMWt? EvM-Susana (talk) 09:13, 12 May 2015 (UTC)
 * Good 2008 review here
 * A lot of things do cause methemoglobinemia such as a number of meds. Doc James  (talk · contribs · email) 01:26, 13 May 2015 (UTC)
 * This 2001 review states "Outbreaks of methemoglobinemia have occurred due to nitrite poisoning from water contamination"  Doc James  (talk · contribs · email) 01:28, 13 May 2015 (UTC)


 * That 2001 review might be a review of methemoglobinemia but it's not a review of nitrate as a cause... The sentence that you highlighted doesn't convince me, it provides as a source just one situation in New Jersey in 1992 (nitrite is different to nitrate, too, though related). That publication from 2008 that you provided is interesting (although I only have access to the abstract): "Given the lack of consensus, there is an urgent need for a comprehensive, independent study to determine whether the current nitrate limit for drinking water is scientifically justified or whether it could safely be raised." So it seems to be fairly clear that there is no clear consensus on this issue, unless we can find more recent good publications?EvM-Susana (talk) 06:45, 13 May 2015 (UTC)


 * I am in no sense an expert, but I'd just note that the link between nutrient enrichment and human health has been disputed to my knowledge for at least 20 years, so I support what User:Jermakka has said above. It seems to me that there is very little evidence of a direct link between blue baby syndrome and nitrates, most of the talk about it is spurious. It is one of those internet memes which are repeated without any real scientific basis, as far as I can see. JMWt (talk) 07:25, 13 May 2015 (UTC)


 * The US' Environmental Protection Agency and the World Health Organization both consider high levels of nitrates to pose a health risk -- They both (and other sources) mention Blue Baby Syndrome as a potential effect. The US EPA tries (under law) to keep the contaminants under certain levels in drinking water, so it seems to be broadly accepted and acted upon. I reworded the article in that context and included that some studies indicate that other factors may contribute to the syndrome. -Whatsit369 (talk) 22:04, 14 July 2018 (UTC)

Is the image in the lead a good one?
It's been mentioned before but let me bring it back to people's attention: Is the photo in the lead a good one? At least as a layperson I cannot see anything "blue" in that baby. Is it a typical photo of this condition?EMsmile (talk) 20:32, 27 August 2017 (UTC)

WikiProject Med Work Plan
Weekly Work Plan
 * 1) Fri 11/1 WP-WIP #1: I will have improved the definition of Blue baby syndrome in the introductory paragraph and checked the citations.
 * 2) Fri 11/8 WP-WIP #2: I will have added the definition of cyanosis, and augmented the heart disease section, and refined the section on nitrates.
 * 3) Fri 11/15 WP-WIP #3: I will cover the treatment section and incorporate peer review comments.
 * 4) Fri 11/22 WP-WIP #4: I will finish incorporating peer review comments and add history of blue baby syndrome.

I studied congenital heart disease during my research year, so this topic is very interesting to me. It is rated as an article that is of high importance but at a "start" level, so I think improving it could reach many people. The article is certainly still in its beginning stages. There is very little information about cyanosis, the reason why babies may appear blue, congenital heart lesions, and very few references. It is difficult to grasp the concept of the syndrome by reading this page.

I think I first need to better define the syndrome, the add several sections about the pathophysiology of appearing cyanotic, then add a treatment section. I also don't like the appearance of the page and want to restructure it to be more visually appealing. In addition to the items I mentioned above, I will add a significant amount of information to the "heart disease" section of the causes. I also want to add two entire new segments: Treatment and History. I will augment the introductory paragraph, and the section on Heart disease need much more information.I would also like to decrease the emphasis on nitrates, particularly due to drinking water, as this is a more minor cause of Blue Baby Syndrome.

One question I have that I would love other editors' thoughts on is the addition of "Blue Baby Syndrome" history (with Blalock and Taussig) as well as epidemiology and treatment sections. Given that this page is much more highly frequented than the Cyanotic Heart Disease page, I feel like it is important to have basic information about these subjects, but still link to the individual disease pages for more detailed information.

— Preceding unsigned comment added by Stephhads (talk • contribs) 19:46, 29 October 2019 (UTC)

Stephhads (talk) 18:19, 7 November 2019 (UTC)


 * I like what you have done so far! The following is a peer review. With regards to the introduction, I found it very easy to read, with a clear introduction into what blue baby syndrome is, and what it is historically referred to. I do not think the introduction section needs any changes, and I think the picture along the side is excellent.


 * The causes section is also very good - and the pictures are excellent in providing an overview of each congenital cyanotic heart defect. Perhaps each one of these defects could have a brief sentence describing what each one is, but it is honestly very good the way it is now. Under "other causes" I would also add in a link to ARDS.


 * The rest of the article (diagnosis, treatment, history) looks excellent! for other ways to flesh out the article, the history section could be greatly expanded upon! (although it is still very good the way it is now. On the wikipedia page for the Blalock–Taussig shunt, there is a lot of historical information that may be good to incorporate into your page. There may be a well to pull this information directly into your blue baby syndrome page. All things notwithstanding, I like the direction of your page, and I am excited to see what future edits you have in store.Keo1274 (talk) 21:59, 15 November 2019 (UTC)

UCF COM WikiProject
Hi, I am a 4th year medical student at the University of Central Florida, currently a part of a Wikiproject Medicine course. During the next 4 weeks I will be working on editing this article by improving the existing sections, adding sources, and ensuring that it is a cohesive, comprehensive article that can be easily understood. The hope is that this article can be useful for both patients and providers who are looking for a basic understanding of blue baby syndrome.

Organization: I will be formatting this article according to the recommendations by the Wikipedia manual of style and adding sections for signs and symptoms, mechanism, outcomes, and epidemiology.

Signs and symptoms: This will be a new section and will include the main symptom of cyanosis but will also include other common symptoms such as shortness of breath and failure to thrive. If found I will include information on the prevalence of each symptom among patients with blue baby syndrome. If additional images are found of potential physical exam findings they will be added to this section.

Causes: This section is currently well organized into cyanotic heart disease, methemoglobinemia, and other causes. It currently does a great job of explaining these causes and it provides a table with illustrations showing the cardiac defects that could lead to cyanosis. In this section, I would like to include some of the risks factors for developing blue baby syndrome such as anemia, UTI, etc. I would also like to include an area that mentions perhaps in a list format the most common causes.

Mechanism: This section will be added to the article to explain how an infant develops blue baby syndrome expanding on the most common causes that will be mentioned earlier in the article. For example, there will be information on the pathophysiology of tetralogy of fallot (TOF) and methemoglobinemia. There will also be an explanation of how hemoglobin normally functions and what occurs with it is abnormal or there is insufficient oxygen delivery.

Diagnosis: This section will be expanded to include the traditional workup that is used when an infant presents with cyanosis including history and physical exam findings. Additionally, it will include potential growth curve findings which can be specific to the infant population. This section will also include the laboratory studies and imaging studies that are needed to diagnose the common causes of blue baby syndrome such as TOF and methemoglobinemia.

Prevention or Screening: This new section will focus on current recommendations to prevent blue baby syndrome such as having a nitrate level below 10miligrams per liter in the water and limiting nitrate-rich foods in the case of methemoglobinemia. It will also include the congenital heart defects screening that is done to newborns at bedside with a pulse oximeter.

Treatment or Management: This section will be expanded to further describe the kind of surgery that is done for TOF and to explain how methylene blue addresses methemoglobinemia. This section will also cover the use of supplemental oxygen.

Outcomes: This will be a new section to provide information on the outcomes of infants with blue baby syndrome, it will likely be specific to the direct causes of the cyanosis.

Epidemiology: This section will provide prevalence data on the common causes of blue baby syndrome. Risk factors will also be added to this section, as well as the age range patients typically present with blue baby syndrome.

History: This section does a nice job of describing how the surgery for TOF, a cause of blue baby syndrome, was developed. If additional historical context for blue baby syndrome is found it will be added to this section.

Some of the current sources I plan on using to edit this article include the Nelson Textbook of Pediatrics and the Textbook of Neonatal Resuscitation. I look forward to working on this article and welcome all input, suggestions, and comments to improve the article. Thanks!

Wikimedstudent (talk) 15:05, 13 January 2022 (UTC)