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Hidden hairs can strangle baby's tiny toes, doc warns

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Sweet baby toes can be the source of a rare but painful condition called toe tourniquet syndrome, in which hair wraps around the tiny digit, cutting off circulation.

When it comes to babies, it seems that danger lurks in the most unusual of places.  Certainly one would never see a wisp of human hair as a menace.

But, as it turns out, if a single strand of hair wraps around a baby’s toe, it can cut off circulation and ultimately doom the appendage. Though rare, this happens often enough for doctors to have given it a name: toe tourniquet syndrome.

Michelle Whelan’s baby was one of the lucky ones. One day as Whelan was changing her infant she noticed that several of her baby’s toes were beginning to turn purple. Whelan was sure if she couldn’t find out what was wrong that her baby might lose one or more of her toes.

Fortunately for Whelan, the surgeon at her local hospital on Massachusetts' Nantucket Island, Dr. Timothy Lepore, recognized right away what had happened. He pulled out his magnifying glasses, spotted the culprit strand and cut it away.

Whelan’s story, along with many other intriguing cases handled by Lepore, are described in the new book “Island Practice,” written by Pam Belluck, a New York Times health writer.

“I didn’t know anything about toe tourniquet syndrome when I had my two kids,” says Belluck. “It’s not in any pregnancy books or first-year books. You’d think the hair would break, but it’s apparently very strong and can get 100 revolutions around a tiny toe if you have long hair.”

The actual incidence of toe tourniquet syndrome is unknown, but doctors have documented dozens of reports of rare cases. The problem doesn’t always involve the toes. A 1988 Pediatrics study reviewed 60 cases of what was dubbed “hair-thread tourniquet syndrome.” Of those, 24 incidents involved toes, 14 involved fingers and 22 painful incidents reported hair wrapped around babies’ genitals, including tiny penises.

As recently as this year, the Hong Kong Journal of Paediatrics reported the case of a 2 1/2-month-old girl whose right fourth toe was inexplicably blue and swollen -- until doctors detected an errant hair and removed it. 

Lepore says he’s seen only three cases in his 30 years of practice. But he’s still on alert for the syndrome any time he sees a baby with a discolored toe or other digit.

 “You’ve got to have a persistent paranoid suspicion whenever you see something that doesn’t look right -- like a blue or a red toe,” he says. “And you can’t let people blow you off. If your kid’s toe is blue there’s got to be a reason.”

The danger, if your doctor doesn’t recognize toe tourniquet syndrome, is that your baby could lose a toe, Lepore says. Don’t be afraid to mention toe tourniquet syndrome to the doctor if that diagnosis doesn’t get consideration, he adds. 

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