What does polycythemia at birth indicate?

If you’ve spent any time in the hospital, you may have heard people talking about polycythemia. If not, well…you’re really missing out on some exciting conversations about blood! But fear not, we’re here to help you understand what all that chatter is about.

What Is Polycythemia?

Polycythemia is a fancy word for having too many red blood cells. This can happen for a variety of reasons, but when it happens at birth it’s known as neonatal polycythemia (neonatal meaning ‘newborn’, not ‘glowy’).

So let’s back up a bit. Why do we care so much about red blood cells anyway? Well, those little guys are responsible for carrying oxygen around our bodies. And as anyone who’s ever tried holding their breath knows, oxygen is pretty important stuff.

Red blood cells also contain something called hemoglobin which gives them their lovely red color (and makes them very popular with vampire bats). Hemoglobin sticks to oxygen like velcro and helps transport it from the lungs to the rest of the body.

Now imagine if your body had too many red blood cells. You might think “Wow great! More hemoglobin means more oxygen! I’m going to be super strong and healthy!” (Wrong)

The problem with having too many red blood cells is that they start getting in each other’s way (like trying to walk through Times Square during rush hour) which makes it harder for them all to get where they need to go (the opposite direction than everyone else…wait no that was me trying to escape NYC last summer).

Symptoms of Polycythemia

So what does this mean for babies born with polycythemia? The short answer: Not much most of the time.

In fact, sometimes babies can have high levels of red blood cells and never show any symptoms (which is not something you can say about most people with high levels of anything).

However, in some cases babies may experience:
Cyanosis: a blueish tint to the skin caused by lack of oxygen
Hypoglycemia: low blood sugar
Jaundice: yellowing of the skin due to bilirubin buildup
Respiratory distress: difficulty breathing

Causes of Polycythemia

So why do some babies have too many red blood cells? There are several possible reasons:

Maternal Factors:

Sometimes this condition can be triggered by the mother. For example, if she has diabetes, her baby may produce more red blood cells than normal (this is NOT an excuse for all those ice cream binges though) .

When labor and delivery are prolonged or stressful for either mom or baby, it could also potentially raise risk factors for developing polycythemia.

Other maternal factors include smoking during pregnancy – which changes your fetus’ oxygen environment – or having other medical conditions such as rheumatoid arthritis being passed onto your child.

Baby Factors:

In other cases(polycytheamia vera), there’s no obvious cause(root cause analysis will definitely come in handy here). The baby just seems to have decided that more red blood cells were needed(well intentioned but disastrous decisions like these usually echo among office water coolers.). These types occur rarely and account for only 1% (or less)of all newborns.

But sometimes polycythemia is related with infant diseases like Hypoxia(Ischemic damage from low birth weight) intrauterine growth restriction(IUGR)-where placenta becomes weak-, twin-twin transfusion syndrome(TTTS)–affecting specifically identical twins–, fetal-maternal hemorrhage(bleeding between fetus & mother), congenital heart or lung disease, and other metabolic disorders.

Treatments for Polycythemia

Most of the time, no treatment is needed if no symptoms are present. Sometimes, doctors will recommend performingblood tests on a regular basis to monitor the baby’s red blood cell level(which essentially means bringing in your toddler several times a week to get poked with needles).

If the baby does have symptoms of polycythemia or has high levels of red blood cells, there are several possible treatments including::
Partial exchange transfusion: Replacing some or all of the baby’s blood with donor blood. This can be done using an umbilical venous catheter (UVC) by placing it under ultrasound guidance pointing towards liver surface.
Hydration: Giving extra fluids via IV line or oral feeding(to drown those RBCs).
– Medications: Like diuretics which help removing fluid from body rapidly could work in managing neonatal polycthemias particularly during postnatal period when just treatment strategy is demanded


Polycythemia may sound like some sort of weird condition you’d catch while vacationing in Chernobyl—but don’t worry! In most cases it’s not cause for concern (except maybe if your child wants to grow up as vampire) . Chances are that if your doctor suspects that your little one might have polycythemia they will order follow-up testing ,albeit getting lab results can really slow down fun activities(#labratproblems amirite?).

As always,(and this applies more generally not only in medical contexts), prevention remains better than cure so make sure you discuss at length any conditions that predispose risk factors for expecting mothers ahead of delivery date(tip,stress-free pregnancies make saintly babies)!