Q: My 9-month-old baby's hands and feet turn purple and she shivers before getting a fever. What should I do?
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My 9-month-old baby was hospitalized for a urinary tract infection (UTI). Right before her fever spikes, she starts shivering intensely, and her hands, feet, and legs turn a purplish, mottled color. Her breathing also sounds a bit unusual during these moments. I gave her fever-reducing medication, covered her with a warm blanket, and gently rubbed her hands. Are these the right steps, and is there anything else I should be doing when this happens?
Answer:
Seeing your baby shiver and turn purple can be very alarming, but this is a physiological response known as chills or rigors. When the body's internal thermostat resets higher to fight an infection, blood vessels in the extremities constrict to redirect heat to the core organs. This temporary constriction can cause the hands, feet, and legs to feel cold and look pale or purplish, while the shivering is the muscles working to rapidly generate body heat.
Here is a review of what you did and additional steps you can take:
Fever-reducing medication: Administering antipyretics as prescribed or guided by the medical team is appropriate to relieve discomfort.
Warm blanket during shivering: Providing light warmth while she is actively shivering and feeling cold is correct. However, once the shivering stops and her skin feels hot, remove extra layers and dress her in a single, loose layer of clothing so her body can release heat.
Gentle hand massage: Massaging her extremities gently can help promote comfort and local circulation.
Additional supportive measures:
Hydration: Offer small, frequent amounts of breast milk, formula, or fluids to prevent dehydration.
Room temperature: Keep the room comfortably temperate (around 22–24°C / 72–75°F) rather than overly hot or stuffy.
Monitor temperature: Check her temperature regularly to track the fever's progression and report readings to the care team.
When to alert the medical staff immediately:
Because your baby is currently hospitalized, notify the nursing staff or doctor right away if you observe:
Persistent rapid, labored, or grunting breathing
Discoloration spreading to the lips, tongue, or face (which may indicate low oxygen levels rather than just cold extremities)
Extreme lethargy, limpness, or difficulty waking up
Rhythmic twitching, stiffening of the limbs, or signs of a seizure
Since your baby is in an inpatient setting, inform the on-duty nurse or attending pediatrician as soon as these shivering episodes begin so they can evaluate her vital signs and breathing in person.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
