If blood circulating to the body is a mix of oxygen-poor and oxygen-rich blood, the body may not receive enough oxygen. When this happens, the child can develop a bluish tint (cyanosis) to the skin. If your child has "blue spells":

• Attempt to calm the child. This is the most important thing you can do.
• Try placing the child with the knees to his or her chest—either on the back with the knees drawn up to the chest or in a sitting position with the chest to the knees.
• You may need to give your child oxygen if the spells are severe and do not improve with a change in position. Oxygen is given by placing a small tube at the entrance to the nostrils. Your doctor will determine the proper amount of oxygen needed.
• Note when the spells occur and plan activities to try to decrease the spells.
• Try to prevent the cyanosis by keeping your child warm, decreasing activity, and feeding small, frequent meals.
• Notify your child's doctor when a blue spell occurs.