Concerns About Petechiae on My 3-Month-Old
This evening, I discovered that my 3-month-old son, who was born prematurely at 34 weeks and experienced intrauterine growth restriction (IUGR), had petechiae visible under his chin and along one side of his jaw while he was feeding. I reached out to his pediatrician immediately, but it was already past 9 PM. I have been monitoring his temperature diligently, and he hasn't developed a fever. Earlier today, he had been fussier than usual. To provide some context, I had undergone surgery a week ago, which meant he was on formula alone for approximately 36 hours. His usual feeding routine consists of half 24 calorie Neosure and half breast milk. During the formula-only period, he was especially cranky in the evenings and consumed only 2 to 2.5 ounces instead of his normal intake of 3.5 ounces. Once I reintroduced breast milk, his fussiness improved, but around day five following my surgery, he became gassy and returned to consuming only 2.5 ounces. I attributed this to a recent switch in his nipple size from preemie to level 1, so I changed it back to a transitional nipple. Since then, he has consistently consumed between 2.75 and the full 3.5 ounces over the last 24 hours. However, during his 6 PM feed, he showed significant fussiness and only drank 2.5 ounces, prompting me to administer Mylicon drops. Just before his 9 PM feed, he seemed extremely hungry and became quite agitated while awaiting his bottle to warm. He was making a high-pitched scream, turning purple, and seemed to be losing his voice while thrashing in my arms. Once fed, he eagerly finished his usual 3.5-ounce bottle and promptly fell asleep. Later, he completed his nighttime feeding of 3.5 ounces with minimal intermittent fussing due to gas. In my research about petechiae, I learned that it can be associated with meningitis; however, he displays no fever, stiffness in the neck, or bulging fontanel. He has been fussy intermittently and has not consistently completed his bottles. It’s now 2 AM, and upon checking again with a flashlight, I observed a few singular dots near his eyes, on his nose, and around his chest and neck area. It is unclear whether I simply missed these earlier or if this condition is worsening. I also wonder if the petechiae could have resulted from him straining during his distressing episodes of crying. I am uncertain whether I should wait until morning for further guidance or take action now, especially since the last two feeds he completed fully, despite previous eating inconsistencies.
Answers (1)
7/23/2025, 8:20:59 AM
OpenHealth AI
It's understandable to be concerned about petechiae on your 3-month-old son, especially given his medical history and recent changes in his feeding patterns. Here's a breakdown of the situation and recommended steps you can take.
Main Points
Petechiae can arise from various causes, and in infants, they warrant careful observation. Given your son's recent feeding difficulties, fussiness, and history, it's crucial to monitor him closely. While it may be tempting to wait until morning, your son’s current symptoms suggest that further action may be needed.
Explanation
Petechiae are small, pinpoint red or purple spots caused by bleeding under the skin. They can appear for many reasons, including normal crying due to straining or potentially more serious issues, such as infections or coagulation disorders.
Given your description:
- Lack of Fever: This is reassuring, as systemic infections often present with fever.
- Recent Fussiness and Feeding Changes: Your son has had feeding inconsistencies, which may contribute to distress but are also important to consider.
- High-Pitched Crying and Distress: This can indicate discomfort or pain, particularly if associated with feeding difficulties.
Next Steps
-
Immediate Assessment:
- Reassess Symptoms: Monitor your son closely for any changes. Look for additional petechiae, signs of fever (even low-grade), persistent fussiness, or changes in responsiveness.
-
Document Findings:
- Keep a Record: Note how many petechiae you see, their size, and any new symptoms (like increased fussiness or feeding inconsistencies) throughout the night. This information can be helpful for the pediatrician.
-
Feeding Considerations:
- Continue to Feed as Normal: Ensure that he is fed according to his typical routine and watch for any difficulties during feeding.
- Continue to Use Comfort Measures: If he appears gassy, keep using Mylicon or similar remedies, ensuring baby is comfortable during feedings.
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Seek Immediate Care:
- If you notice any new concerning symptoms, such as:
- Increased petechiae or a new rash
- Sudden behavior changes (more lethargic, not responding as usual)
- Significant fussiness that seems unmanageable
- Signs of severe distress (persistent crying, difficulty breathing)
- Contact your pediatrician or go to the nearest emergency room for further assessment. While it's essential not to panic, ensuring your son is safe and any serious issues are quickly identified is crucial.
- If you notice any new concerning symptoms, such as:
Conclusion
While many cases of petechiae may be benign, given your son's age and recent health changes, it’s advisable to remain vigilant and reach out for professional guidance as needed. Your prompt attention to his symptoms is commendable, and keeping an eye on him will be beneficial. If you have any ongoing concerns overnight, don’t hesitate to seek help.
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