Mongolian spot: causes, symptoms, diagnosis and treatment

Gray-blue pigmentation on the skin of children in the first years of life in our region is very common. For those who have never encountered such a phenomenon, it can cause the most contradictory thoughts - including that the child is bruised. In fact, doctors consider bluish marks in Asian children to be quite harmless, with rare exceptions.

Doctors explain the phenomenon of such spots or their accumulation by the concentration of melanocytes - cells that produce pigment in certain areas of the skin. The spot can be either congenital or appear in the baby in the first weeks or months of his life. The sizes vary from a few millimeters to more than 10 centimeters, and it can be either a single spot of irregular shape or a whole galaxy of such formations. The area of the spot is smooth, does not rise above the skin and looks very much like... a huge bruise. This is a kind of birthmark - from light gray to dark blue and almost black in color, which has the amazing property of disappearing naturally.

The spot becomes lighter as the child grows and at some point disappears completely. The area in its place becomes identical to the color of the baby's skin. It is believed that not a single case has been recorded of blue spots degenerating into malignant formations. Therefore, parents can exhale, in addition, the stain may have an aesthetically unsightly appearance, especially if it is rich in color and located on visible areas of the skin - legs, arms. In itself, it does not pose a risk to the child’s health. Neither in the present nor in the future, except in rare exceptional cases.

Scientists have determined that the presence of a spot is nothing more than a sign of belonging to characteristic ethnic groups. Not only Kazakh children are born with such spots, but also Korean, Chinese, Japanese, Mongolian, Yakut, Buryat, Southeast Asian, East African, Latin American, etc. Unscientific theories of the origin of the “Mongolian spot,” which is also called “Turkic”, “sacral”, coccygeal, as well as “Genghis Khan’s spot” (supposedly the conqueror himself passed this mark on to his descendants) or “Tengri’s slap” - this is how the heavenly deity blesses newborns. Among eastern peoples, its presence is considered a very favorable sign; 5 years ago in Japan there was even a meeting between geneticists and anthropologists on the topic of the “Mongolian spot” phenomenon.

Causes of the Mongolian spot

As for scientists, they believe that the reason for the appearance of the Mongolian spot in infants lies in deviations of embryonic development caused by a special gene present in the Mongoloid race. In fair-skinned children, melanin is released only when exposed to ultraviolet radiation, but in a child of the Mongoloid race, melanin is constantly produced, and for this reason Mongolian spots may occur. As you know, the skin consists of a superficial layer - the epidermis and a deeper layer - the dermis. The cells that produce melanin during normal pigmentation are located in the epidermis. When the embryo develops in the womb, the process of migration of pigment cells from the ectoderm to the epidermis remains incomplete. Because of this, pigmentation remains in the deep layers of the skin, which leads to the formation of Mongolian spots.

Who has it?

It is no coincidence that this mark is called the “Mongolian spot.” Most often it occurs in infants of the Mongols, Buryats, Yakuts, Koreans, Chinese, Japanese, Khakassians and other representatives of the Mongoloid race. The appearance of such a congenital spot has been noted among North American Indians, Ainu and Eskimos. It is extremely rare that the “Genghis Khan spot” can be seen in infants of other races, and, as a rule, its appearance means that there were Mongoloids in the family. In this case, the spot occurs in both newborn boys and girls.

Manifestations of the Mongolian spot

Pigmented formations are most often localized in the sacrum, back, lumbar area, buttocks, and on the upper and lower extremities. Occasionally, the location of the Mongolian spot may change, this is called nevus migration. Mongolian spots are sometimes localized in atypical areas: on the legs, forearms and other parts of the body.

The size of the spots can vary greatly: from very small formations (the size of a small coin) to large areas of pigmentation reaching the size of a plate. In some infants, the congenital spot may completely cover the entire area of the back or buttocks.

Mostly the color of a Mongolian spot is bluish or gray, but sometimes it can be bluish-brown if the melanin is, for one reason or another, located in the shallow layers of the skin. A characteristic feature of the Mongolian spot is that its color is evenly distributed over the entire surface of the nevus. As the child gets older, the color of the Mongolian spot becomes less saturated, and in most cases the pigmentation completely disappears by the age of five. According to statistics, Mongolian spots disappear in 19 out of 20 children. There are rare cases where blue Mongolian spots remain in a child until adolescence, and sometimes until the end of life. The Mongolian spot is a melanoma-neutral nevus, and in dermatology there has not been a single case of a Mongolian spot developing into melanoma. Blue Mongolian spots are often confused with bruises and hematomas, but they have nothing to do with these injuries and are skin pigmentations that are harmless to humans. Such stains can only cause aesthetic inconvenience.

What does a mother need to know about her newborn baby?
The questions are answered by the chief freelance neonatologist of the Ministry of Health of the Amur Region, assistant of the Department of Childhood Diseases of the Faculty of Pedagogical Training and Pedagogical Training of the AGMA, Ph.D. Kharchenko Maria Vitalievna.

Any question you have, you can ask through our {rokbox text=|form|}index2.php?option=com_contact&view=contact&id=2{/rokbox} feedback.

My baby was born weighing 3 kg 600 grams, and in the maternity hospital he lost 250 grams. Is this normal or not? After all, I breastfed him at the “child’s request,” as recommended by the pediatrician. Maybe I should have supplemented him with formula. ?

Don't worry, everything is fine! During the first 5 days of life, a newborn may lose up to 10% of its birth weight.

Your baby has lost 7% of his original weight. This weight loss is normal and is called physiological weight loss . It can be caused by several reasons: the passage of meconium, quite significant losses of fluid through the skin and lungs (during the baby’s breathing) and insufficient nutrition in the very first days of life. Colostrum, which a child receives in the first days of life, cannot fully compensate for the child’s energy costs. However, if mother and baby are in the same room, then she will be able to put him to the breast every time he demands it (free feeding mode). In this case, the mother’s milk comes in much faster and the newborn’s weight loss is unlikely to exceed 5-7%. Most babies, with this type of feeding, regain their original weight by the time they are discharged from the maternity hospital or during the first days (week) of being at home.

What is colostrum and why is everyone so in favor of early breastfeeding?

Colostrum is a secretion of the mammary gland, which is a yellowish thick liquid with a salty taste and a specific odor. Colostrum production begins a few days before birth (with the exception of premature birth) and continues for 3-4 days after birth. Colostrum differs from milk in its increased acidity, higher content of proteins (mainly albumins and globulins), fats, minerals and vitamins and less sugar.

In terms of the set and combination of nutrients, colostrum is an indispensable food for newborns. It contains a large number of immune bodies and antioxidants that protect the baby from various infections that his immune system does not yet produce. Colostrum also stimulates normal intestinal activity, helps cleanse the newborn’s digestive system of meconium and fills it with bifid flora, thereby facilitating the baby’s adaptation to extrauterine existence.

Early latching is the latching of the baby to the mother's breast in the delivery room 20-30 minutes after birth. The first contact between mother and child is extremely important. It is believed that the sooner a mother can touch her baby, hold him close, the better for establishing emotional connections between her and the child, the sooner the mother’s maternal instinct awakens, and the child’s love for his mother. It is at this moment that the child begins to recognize you by your voice, absorbing the warmth of your body with his whole being, learns that you are a source of food for him, his protection, and begins to love you. The first, so early application of a child to the breast can be considered the first vaccination, because Colostrum contains a large amount of antibodies (immunoglobulins) that protect the baby from various infectious agents of the surrounding world. Breastfeeding a baby in the delivery room is also very beneficial for the mother, because... When a baby sucks at the breast, the mother's body actively produces a hormone - oxytocin, which causes contractions of the uterus and helps prevent postpartum uterine bleeding.

Please tell us about birthmarks, and which ones should we be “afraid of”?

Quite often, birthmarks of various colors and types can be observed on the skin of a newborn baby. Some birthmarks remain with a person for life, while others disappear after a while.

Congenital age spots can vary in color: from barely noticeable light brown to dark brown and even black. The shape, size and number of pigment spots are different. It happens that pigmented birthmarks have the same shape and are located in the same places on the body as those of the child’s parents. Pigmented moles (nevi) rise above the surface of the skin.

In addition to pigmented birthmarks, there are vascular birthmarks - hemangiomas . They can be of different color saturation: from pale pink to dark crimson, sometimes with a purple tint. Hemangiomas are quite common, but at birth they can be very pale and flat, and therefore almost invisible. Some time after birth, the spots may increase in size and rise above the surface of the skin. With age, some hemangiomas disappear on their own, but more often “port-wine stains” remain for life.

Most newborns with yellow and dark skin (having Asian and/or Negroid blood) have rather large gray-blue spots that never rise above the surface of the skin between the shoulder blades, along the spine or in the sacrum, buttocks. These are “Mongolian blue spots”. Most of these spots disappear by 5-6 years, but some “Mongolian” spots remain.

In addition to birthmarks, which remain on a person’s skin for life, newborns may also experience spots or stripes that will disappear after a short time. Thus, between 2-8 weeks of life, some children may develop a thin pigment strip along the midline of the abdomen, which will disappear after 2-3 months.

On the head (on the back of the head, forehead, bridge of the nose, eyelids or lips), some babies can observe reddish vascular spots (telangiectasia ). Old obstetricians call them “Stork Slivers.” These are the remains of embryonic vessels that disappear by 12-15 months.

You should pay close attention to birthmarks on your baby’s body. Usually they do not require any care or treatment, but you must remember that the doctor will monitor children who have more than 5 age spots on their body or have port-wine stains on the face, or protruding moles. And be sure to tell your doctor if you notice that a birthmark on your child’s body is increasing in size or changing color!

Please tell us what is newborn jaundice?

1-2 days after birth, most newborns experience yellowing of the skin and mucous membranes. Yellowing begins on the face and then spreads to the entire body. This is physiological jaundice of the newborn. The cause of this condition is enzymatic immaturity of the liver. A newborn baby's blood contains a large number of erythrocytes (red blood cells), which are highly unstable and easily destroyed. When red blood cells break down in a person's blood, hemoglobin (a substance that binds and transports oxygen) is released, which in turn is destroyed, turning into the yellow pigment bilirubin. Having entered the liver, bilirubin, under the influence of liver enzymes, is converted into a component of bile and excreted into the intestine. The newborn's liver cannot cope with large amounts of bilirubin, and it is released into the blood. In an adult, bacteria live in the intestines that continue the process of breaking down bilirubin. Newborn babies do not have such bacteria, but they do have an enzyme that allows bilirubin to be reabsorbed into the blood. As a result, the baby’s skin, mucous membranes and whites of the eyes acquire a yellowish tint. Such jaundice is observed in almost all children in the first days of life. It does not require treatment because the blood clears itself within a few days. If jaundice persists for more than a week, a blood test is taken from the child to determine the amount of bilirubin, after which treatment (phototherapy) is prescribed.

What should a newborn baby be able to do?

A healthy full-term baby should be able to:

briefly raise his head when lying on his stomach (but the child still cannot hold his head while in an upright position!);
reflexively move legs and arms (almost all the time when not sleeping);
move your head from side to side;
respond to sudden stimuli with active movements of the whole body;
demonstrate the normal development of unconditioned reflexes: “searching for the breast”, sucking, grasping, crawling (lying on the stomach, if you place your palms on the baby’s piles), etc.;
close your eyes to bright light and focus your vision at a distance of 20-30 cm from the eyes. The eyes may “squint” slightly at this time;
respond to sounds: to loud ones - by shuddering or freezing, to a quiet voice - by “listening”;
ask to eat every 2-2.5 hours;
frequently empty the intestines (at every feeding and sometimes up to 12 times a day) and the bladder (from 6 to 20 times a day);
maintain normal body temperature (from 36.50 to 37.30).

Please tell us what free swaddling is?

Swaddling still remains the most popular way of dressing children in our country, at least during the newborn period. Conventionally, swaddling is divided into tight and loose.

Tight swaddling is when the baby is wrapped in a swaddle up to the neck, covering both arms and legs, after which he resembles an ancient Egyptian mummy. It is believed that this option is optimal for the first week of a child’s life - the baby does not disturb himself with restless and unconscious movements of his hands and sleeps better. Whether this is true, you can check in practice.

Free swaddling is when the child is dressed in a vest on top, and you wrap the lower part of the body with a diaper, while the arms remain free, and the legs are not swaddled tightly (the diaper is fixed under the baby’s chest, and the legs move freely in the resulting bag). At the same time, you need to remember that if you use loose swaddling for a newborn baby at night, you need to use baby undershirts with sleeves sewn at the ends (because the baby may get scratched or be afraid of his sharp nails). In the second month of life, such precautions are usually not required.

When can you dress your baby in real clothes?

Whenever you want, even upon discharge from the maternity hospital! The manner of dressing newborns in blouses and pants is more typical for Europeans, because The textile industry abroad has been producing clothes marked “from 0 to 6 months” for many years. Our compatriots, rather, are committed to tradition, in the sense that they prefer to swaddle the baby at home, albeit in a free way, and leave beautiful things that resemble adult clothes for ceremonial occasions at the clinic, for guests, or for walks. And yet, if you are categorically against turning a little person into a cocoon, today there are ample opportunities to dress him “for real” from the first days of life (and even premature babies). The most important thing is that children's clothing is comfortable for the baby, easy and quick to put on, take off and wash.

Benefits of diapers:

easy to wash and iron;
more affordable.

Flaws:

almost inaccessible to dads (in the sense of mastering the swaddling technique!);
Tight swaddling restricts the baby's movements.

Advantages of “real” dressing:

available for dads;
amuses mother and others.

Flaws:

more difficult for “sanitization”
double-sided ironing of eight pairs of sliders “at speed” can affect mother’s nervous system.

Remember that a newborn baby, regardless of gender, does not like to dress, resists this in every possible way, and you will have to carry out this procedure in record time with the least amount of effort!

Attention! Hats, caps and scarves on the head of a child in the house are not needed. They are used after bathing to protect the baby’s wet head from hypothermia (for a short time, until the head dries out) or during walks.

Please tell us how to tell if your baby is warm or cold?

When dressing your baby, always remember the basic principle - dress like yourself! If you walk around the house wearing a hat, go ahead! But this is rare. With all responsibility, we can say that a baby wrapped up to the brim, crowned with a flannel cap, will instantly catch a cold and get sick if you unwrap him. Give your baby's body a chance to fight the environment and activate its natural powers.

How to determine if your baby is warm? A fairly accurate criterion is the condition of the skin: normally the skin is light pink and pleasantly warm to the touch. If the baby is red, the skin is hot, and even damp, and diaper rash and heat rash appear - there is no doubt that you are dressing him too zealously. Reduce the amount of clothing you wear and don't stress! If the baby begins to freeze, his nose will first turn red and become cold, then his arms and legs will become cold. They may even acquire a bluish tint, but you should not allow this to happen. There must be a limit to everything, even testing your child’s safety margin. Warm him up as soon as possible and dress him a little warmer, and remember, not a single healthy child will stoically endure the cold. If the baby is really cold and frozen, you will be the first to know about it - by angry crying, active movements and restlessness.

Please tell me what temperature should be in the room where a newborn baby is?

The temperature in the room where the newborn is located should be 22-240. In modern apartments, during the heating season, the air not only has a higher temperature, but also is dry. This leads to drying out of the nasal mucosa in the newborn and the formation of crusts. That's why babies sneeze often. It is necessary to regularly ventilate the room and humidify the air using modern climate systems or wet diapers that can be hung near the radiators.

How to correctly measure body temperature in a newborn baby?

First, you should know that a healthy newborn has fluctuating body temperatures, especially in the first week of life. Only by one and a half to three months the temperature becomes fairly constant. The amplitude of temperature fluctuations during the day depends on age, air temperature, physical activity, emotional state (screaming, prolonged crying lead to an increase in t0), the quality and quantity of food taken (overfeeding, underfeeding can lead to an increase in t0), the state of the endocrine system and others factors.

Secondly, temperature measurement must be carried out while the child is calmly awake. Temperature measured during sleep or during feeding may be 0.3-0.5 degrees higher.

Thirdly, the normal temperature in newborns is considered to be a temperature in the range of 36.5-37.30 (rectal temperature is 0.3-0.50 higher).

The temperature can be measured in the usual way (as in adults) in the armpit or in the anus.
When measuring the temperature in the armpit, make sure it is dry, press the handle tightly against your body and hold the thermometer for 5-10 minutes. You can place a thermometer rectally. In this case, the temperature measurement time is reduced to 3-4 minutes. Nowadays, modern digital infrared thermometers have appeared in pharmacies, allowing you to measure body temperature in just 1-2 seconds. This thermometer allows you to measure the temperature by only briefly touching the baby’s forehead or inserting it into the ear. In standby mode, such a thermometer shows the air temperature in the room. Infrared thermometers “pacifiers” are also sold in pharmacies, with the help of which it is convenient to measure the baby’s temperature in the mouth. By the way, this method is quite widely used by mothers in many foreign countries. All this is quite convenient, although such pleasure is quite expensive. {rokbox text=|interactive form|}index2.php?option=com_contact&view=contact&id=2{/rokbox}

Diagnosis of the Mongolian spot

Despite the fact that Mongolian spots on the skin do not pose any threat to the life and health of the child, if they are detected, consultation with a dermatologist is necessary. The doctor determines the origin of the spot and makes an accurate diagnosis, because Mongolian spots may resemble melanoma-dangerous nevi: blue nevi, nevi of Ota and pigmented pilar nevi, which require special treatment. A specialist may prescribe a dermatoscopy, siascopy, and even a biopsy for a child with a Mongolian spot to detect melanin in the deep layers of the dermis. If, after diagnosis, doctors determine the absence of malignant nevi, then no treatment is required. Mongolian spots of any shape and size go away on their own, so there is no need to register with a dermatologist.

Pigment spots on the skin do not itch, are not injured and do not cause any inconvenience to the owner, other than cosmetic ones. Mongolian spot is not a disease and therefore does not require prevention. The prognosis for this type of pigmented nevus is favorable.

Clinical picture

The Mongolian spot usually has certain characteristics that help distinguish it from other marks on the skin:

Present on the skin from birth.
It is distinguished by a gray-blue or cyanotic color. Sometimes there are bluish-brown markings.
Has an uneven color over its surface.
Most often it has an irregular shape, but there are round and oval spots.
It can have different sizes - from a small coin to 10 cm or even more.
Most often it is localized on the lower back, sacrum or butt. However, sometimes spots appear on the back, legs (their back side), etc. Some sources contain data on the possible migration of the spot when it moves over time.
Most often it is present on the skin in a single copy, but sometimes several spots are observed on the body at once.

After the baby is born, the spot usually has a rich color. Over time, the trail gradually becomes smaller and loses brightness. By the age of 5, Mongolian spots usually disappear, although in some cases they can be present on the child’s body until adolescence and even adulthood. Such a prolonged presence on the skin is most often recorded if the spots are multiple in nature and are located in rather atypical places.

Fortunately, dermatologists have never encountered a Mongolian spot malingering, which leads to the development of skin cancer. Therefore, such a tumor on the body is considered safe.

Localization Features

Mongoloid spots are also called coccygeal spots. The second name is associated with their frequent location. Often the pigment island in a newborn is located on the butt, in the tailbone area and on the buttocks, as well as on the lower back and hips. With extensive damage, pigmentation can occupy the entire back, including the neck and head of the child. Often the site of localization is the perineum and lower extremities, especially the back of the legs. Less commonly, islands are found on the arms, abdomen, and face.

Pediatricians:

Avzalova Daria Evgenevna

Pediatrician, neonatologist
Experience: 18 years Reviews: 7

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Barzenok Tatyana Arsenyevna

Head of the pediatric department, pediatrician of the first category
Experience: 28 years Reviews: 17