Fussy baby? Is it a hair tourniquet?
Fussy baby?
One thing pediatricians always think about when faced with an inexplicably fussy baby is Hair Tourniquet Syndrome.
Thankfully, it is rare. But it is also painful, time-sensitive, and potentially dangerous.
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Every parent should know about hair tourniquet syndrome. This article provides some helpful educational material, but always remember this is not medical advice - and reach out to your doctor if you have questions about your child, especially if they are unusually fussy.
Make sure you head over to the guide section of this website for your free fussy baby cheat sheet! I also have a separate post with tips for gassy babies here.
What is a hair tourniquet?
As any postpartum mama knows, we lose a lot of hair over that first postpartum year.
In young infants, a fallen hair (or a thread) can get tangled around a finger, a toe, or genitals and constrict the flow of blood. We see this most often in infants under 6 months, but it can be seen in toddlers and older children (in this case, it is usually the result of them intentionally winding something around the area or, unfortunately, because of child abuse).
When this happens, inflammation and swelling set in - which then leads to the tourniquet squeezing the tissue even more tightly. Eventually, if it is not removed, it can lead to permanent necrosis/death of the tissue.
How can I tell?
The hair or thread winds around a finger, a toe, a penis, or even labia but is sometimes hard to see.
Instead, you will typically see swelling (and sometimes discoloration) of the area beyond the constriction, and a circumferential indentation where the hair is constricting blood flow.
Note that in uncircumcised males this can happen underneath the foreskin.
Here is a dramatic example, but they can be more subtle, too.
Is it serious?
If addressed promptly, these often have no long term consequences.
The issue is that sometimes young babies are in footed pajamas, or in socks, and it may be awhile before tourniquets are noticed.
If they are present for a long time, they can cause cause serious problems including nerve or blood vessel injury, ischemia (or lack of oxygen) to the affected area, and potentially death of the tissue - requiring amputation.
What can be done?
For a superficial tourniquet, with limited swelling, if the hair is visible it can be removed at home.
If the end is visible, it can be unwound with fingers or a tweezer.
If the hair is knotted, the knot can be broken or cut (carefully) and then unwrapped from the affected body part.
Depilatory creams (such as Nair or Feet) can also be used for hair tourniquets on fingers or toes, but should be avoided if the skin is broken or on genitalia (especially in females due to proximity to mucus membranes). Apply to the hair per instructions and remove after a few minutes (usually works within about 10 minutes). This won’t work for tourniquets made from thread, obviously, and keep in mind it can cause skin irritation or burning.
Sometimes the hair will break, or be difficult to visualize and remove. For tourniquets that have been present for a long time, are deeper, or associated with significant swelling or discoloration (or pain), sometimes children will need to have them removed under sedation.
If you suspect or have removed a hair tourniquet from your infant, especially if it was associated with any discoloration or swelling, always talk to your pediatrician. They may want to assess your little one to make sure that there has been no permanent damage.
How do I prevent hair tourniquets?
Keep hair tied back when attending to your baby.
Check fingers, toes and genitalia with each diaper change (especially if your baby is usually in footed pajamas or socks).
If your baby is unusually fussy, make sure you look for a tourniquet.
Check out my medical cabinet recommendations under “faves” to see what else I recommend you have in your cabinet!
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