Why are my baby's hands swollen?

I observed my baby passing dark stool after birth, but now, at eight months, the baby has swollen, painful hands. Could the baby have syphilis? Abner

Dear Abner,

In the first 24 to 48 hours after birth, a newborn will pass its first stool, known as meconium, which is dark, thick, and sticky. This stool is made up of cells, proteins, fats, and bile, and it sounds like this is what your baby passed. Instead of worrying that this is a sign of a disease, it is important to recognise that it is a normal occurrence, indicating that your baby’s intestines are functioning well.

 At around eight months of age, if a baby develops painful swelling in the hands, it may indicate sickle cell anaemia. This condition can be inherited from parents who are carriers of the sickle cell gene without showing any symptoms themselves.

While joint pain can occur during the secondary stage of syphilis, it is unlikely that your baby has syphilis. During antenatal care, mothers are screened for syphilis, and if found positive, they are treated with antibiotics to prevent transmitting the disease to the baby.

In the womb, babies initially produce embryonic haemoglobin and later, until about six months after birth, fetal haemoglobin (HbF). Both of these types of haemoglobin do not cause sickling or symptoms associated with sickle cell anaemia. However, babies with sickle cell anaemia may begin to experience pain, such as what you describe, around six months of age. This pain occurs when sickled cells block blood flow in small blood vessels, particularly in the hands and feet.

You should take your baby should to a paediatrician. In addition to assessing the baby’s overall health, the doctor can investigate the cause of the painful swelling in the hands.