By nature, toddler pale skin is quite normal. They haven’t seen much sunlight, and their melanin is still developing. Most parents don’t even notice their toddler's skin tone, but a red flag might go off if you do notice they look pale. While your toddler may be lighter than most kids if it is your natural skin tone, if the change comes on suddenly it could signal a problem. Things like anemia, or low oxygen levels can cause them to become pale. This article will let you know some of the causes of why this happens, and when to get in touch with your pediatrician.

Is It Normal?

If you are fair skinned, it is most likely that your toddler is too. It is also very normal for toddler skin to lighten in the months that have less sunlight like, winter. If your toddler seems healthy and does not have any other symptoms, pale skin may be his or her normal skin color.

If you think there may be a change in skin color from darker to lighter, check the following areas for a nice pink color:

• Inner mouth membranes
• Inner eyelid
• The tongue
• Palms of the hands
• Pink fingernail beds

What Causes It?

If you notice toddler pale skin come on suddenly, it may be due to one of these conditions:

1.    Anemia

Anemia happens when there are not enough red blood cells in the body. Toddlers with anemia usually have other symptoms like unusual fatigue, off balance when walking, shortness of breath, trouble sleeping, and they may complain of leg cramps or pain.

Anemia should be checked by your doctor and supplements may be given to help bring iron levels up. Children should never be given iron without your doctor’s advice, as it can be toxic to small children. It is also helpful to feed them foods rich in iron like enriched breads, enriched cereals, spinach, and blackstrap molasses.

2.    Frostbite

If your child seems unusually pale after exposure to cold, it could possibly be frostbite. This happens when the blood cells rush to the vital organs to keep the core temperature stable. Going outside to play in snow without proper body covering can cause frostbite quickly in below freezing temperatures, and sometimes even above freezing in small children. Other symptoms of frostbite include blistering of the skin, complaints of tingling, burning sensations, numbness, and a waxy feel to the skin.

Frostbite can be a medical emergency. Never run the skin under hot water. Doctors may suggest gentle rewarming of the tissues, which is most often done in the emergency room.

3.    Low Oxygen

Low oxygen levels due to respiratory illness or disease can cause the skin to pale. This is commonly seen in children with heart conditions or asthma. You may notice other symptoms like shortness of breath, complaining of a “heavy chest,” excessive coughing or wheezing, fatigue, and low activity levels.

Pale skin due to low oxygen should be checked right away. If your child has a heart condition or respiratory issue like, asthma, call the doctor or go to the nearest emergency room. If you notice any of the other symptoms listed above, call 9-1-1.

4.    Shock

Shock is a medical emergency caused by low blood pressure. This can occur with injuries, or even after a routine immunization. When blood pressure drops, the body pulls blood and fluids into the innermost blood vessels to maintain inner blood pressure. This results in less blood flow to the outer areas of the body, causing toddler pale skin. Other symptoms of shock include cool skin, fast breathing, fast pulse, fainting, weakness, vomiting, and feeling cold.

This is a medical emergency, call 9-1-1 right away. Your child most likely needs fluids and warming to help stabilize the blood pressure. Do not give any fluids by mouth at home. Your child may faint and vomit, which may cause them to aspirate fluids into their lungs.

5.    Blocked Blood Vessel

If your child injures an arm or leg resulting in fracture, this may cause blockage to a major blood vessel, cutting off the blood supply to the skin and making it look pale. Likewise, if an injury ruptures a blood vessel, bleeding in other areas can draw blood away from the skin.

Any injuries that make the skin look pale should be checked right away. This could be the sign of a fracture, which needs an x-ray to diagnose. Get your child to the nearest emergency room or urgent care clinic with an x-ray machine for evaluation.

6.    Anxiety

Believe it or not, anxiety can cause the skin to temporarily become pale. This is because the release of adrenaline causes the blood vessels to constrict, and not allow blood flow to the skin. This can happen for a number of reasons with toddlers. Things like loud noises, stranger anxiety, parents yelling, scary movies, and animal exposure, can all cause anxiety in toddlers. If this happens, it usually helps to remove them to a quiet area until they calm down. You will most likely know it is anxiety due to sudden crying, shaking, and clutching onto a parent for comfort.

When to See a Doctor

In most cases, pale skin is nothing to worry about in toddlers. However, if this comes on suddenly and your toddler has other symptoms, you should call your pediatrician or go to the nearest emergency room. If there is an issue with breathing or fainting, call 9-1-1.

Call your pediatrician as soon as possible if your child is pale with:

• Fever or fatigue
• Unusually cranky
• Coughing or stuffy nose
• Nausea and vomiting
• Crying spells

Call 9-1-1 if your child is pale with:

• Difficulty breathing or wheezing
• Not responding to your voice
• Complaining of chest pain or dizziness
• Having trouble walking or standing up
• Had a recent fall or severe injury