Hey, I hope you've had a really good week working towards being, or working as a midwife!

This post is another in the 'Midwife Motivation Mondays' category. These posts are a bit like  Radio 4's 'thought for the day', except not religious, and specifically for midwifery, because we need encouragement and inspiration like nobody else.

I've had an eventful week. I had one lovely standing birth, which came as a surprise after a long OP labour.  I also had some longer more complicated issues which left me pretty drained...but that's what running, chocolate and red wine are all for. Exercise can be so hard to get back into when you've had a few days off - but I'm always so glad I've gone when I just do it.

This blog also really helps me. I love that someone out there is reading it, it helps me to write about things, so thanks for that.

Now I'm in a happy and calm frame of mind again I can tell you, well done for whatever you've been up to midwifery wise, keep going! It's not an easy job, but it's so worthwhile. And sometimes - like with my upright birth - it's exciting and a privilege to be working as a midwife.

So onto today's topic.

Blueberry Muffin Baby Syndrome sounds cute, but it's a sign something is very wrong. It refers to baby who has numerous bruises presenting without trauma.

These bruises are called purpura. They are either caused by small areas of bleeding, or else extramedullary erythropoiesis, meaning new red blood cells being made just under the skin when really they should just be made in the bone marrow, liver and spleen. They do not 'blanch' (discolour) when pressed and are usually all over the skin.

The condition can be caused from infection, or from some cancers, I'll go into the details below. It's a very sad fact that some babies with Blueberry Muffin Baby Syndrome die.

If you come across a baby with multiple bruises be very cautious and get a paediatric review from someone senior.

Blueberry Muffin Baby Syndrome can be associated with the 'TORCH' infections.

TORCH stands for Toxoplasmosis, Other infections (lots of different ones), Rubella, Cytomegalovirus, and Herpes Simplex.

These infections are usually transmitted 'vertically' - which doesn't mean mum has been standing up! - it means through the placenta.

The treatments for these infections differ. Some like Syphilis and Toxoplasmosis can be treated with antibiotics. Some have poor prognoses, with issues like blindness, deafness, autism and so on. Some babies do just fine.

Blueberry Muffin Baby Syndrome can also be as a result of a blood problem.

Sometimes mums and babies have incompatible blood types, or have had an intra uterine blood problem, and may need treatment for jaundice or transfusions.

And the third prognosis is cancer.

Some of these babies do very well, depending on the type of cancer. Some don't respond well to treatment.

A midwife friend of mine told me all about Blueberry Muffin Baby Syndrome.  One of the things I love about midwives is how we storytell. Storytelling is often underestimated. But stories carry information with them. Information you might forget at once if you read it in a textbook.

She told me how a baby was born at home, covered in what looked like bruises. How she phoned the most experienced midwife in the area. And got a paediatrician to review.

And no-one knew what the bruises meant. The baby wasn't seen by a senior paediatrician for several days. As with many complex and unusual conditions, a diagnosis took days.

Now, the end of this story is very sad. The baby in question had leukemia and died shortly before their third birthday.

It's really hard to read about things like this. But as midwives we help families cope with new life but also death and unexpected outcomes. Knowledge is power. That's why I think storytelling is so crucial, something we should indulge in often.

Because I won't forget that baby. And the midwife in question will have told many more midwives.

So if I have a baby born into my care with Blueberry Muffin Syndrome, I will know to say:

'I don't know what's caused the bruises. It might be an infection. It might be a blood disorder or something more complicated. I will get a paediatrician to review ASAP. This condition might resolve quickly and easily with treatment. It also might be more serious. Whatever happens, we will get through it together. '

 

If you found this post interesting or useful, as always, please like and share it, and I'd love to hear any comments below!