Feeding FAQ: 4-6 months – Other

Question – Unusual skin colour due to diet

I have a question that came up at my daughter’s doctor’s appointment today. He asked me what I was feeding her because her nose is a little yellow and her palms are pinker than they should be. He immediately asked if I was feeding her a lot of carrot, sweet potato, pumpkin, and the like. I said yes. He said it looks as though she is getting too much vitamin A. Anyone heard of this before? My daughter is exceptionally fair skinned and I can see now that her nose is a little yellowish. Any advice would be greatly appreciated.

Answer:

It is perfectly possible that your daughter’s skin could be a little yellow or orange due to her diet. To set your mind at rest, it is not due to too much vitamin A, which can be toxic. It is caused by related substances called carotenes, some of which are converted to vitamin A as they enter our body through our small intestine. For this reason, the orange or yellow skin colouring is called carotenemia. As you’ll have guessed from the doctor’s questions, high amounts of carotenes are found in red, yellow and orange vegetables, notably carrots. This is where the name carotene comes from, as the substance was first discovered in carrots and this vegetable does provide about 30% of the carotene in our diets. Other sources of carotenes are:

• Orange, red and yellow vegetables, including sweet potato, pumpkin, squash, red and yellow peppers and sweet corn
• Some green vegetables, particularly leafy ones such as spinach, but also broccoli and asparagus – the yellow or orange colour of the carotenes is hidden behind the green colour of the chlorophyll in these vegetables
• Yellow and orange fruits such as peaches, apricots and mangoes
• Egg yolk
• Milk, especially breast milk. In fact, the yellow colour of the early colostrum breast milk is due to carotenes. Research has shown that breast fed babies have higher levels of carotene in their blood.
• Butter and margarine – carotene may be added to give them a more appealing yellow colour.

As you can see, your daughter could be getting carotenes from quite a few different foods, and not just the obvious yellow and orange vegetables such as corn and pumpkin. It can take two weeks for the maximum amount of carotenes to be excreted through the skin, so a change in skin colour now could also be related to different foods eaten several weeks ago.

Babies and young children are much more likely than adults to have carotenemia; one reason is that they do tend to eat quite a lot of vegetables such as carrots, corn and sweet potatoes – these are great weaning foods for children, partially because of the appeal of their natural sweetness. Probably for this reason, many jars of commercial baby foods also contain carrots. In addition, cooking, pureeing and mashing food increases the amount of carotene that can be absorbed from it – while fruit and vegetables are rarely pureed and sometimes not even cooked for adults, they always are for infants. By the way, it’s not an old wives tale that carrots help us see in the dark – the beta-carotene found in carrots is an essential component of the structures our eyes use for black and white vision when light levels are low.

Under normal circumstances, most carotene is converted to vitamin A as it passes into the body. However, when we take in larger amounts, our body converts less to vitamin A (a good thing, as too much vitamin A is toxic). Instead it passes out of our body through our large intestine and our skin. Your daughter’s doctor pointed out the colour of the skin on her nose and the palms of her hands – these are two areas of the body that show the carotene colour most prominently; others are the soles of feet and the skinfolds that run from the nose to the mouth. While the change in skin colouring from the carotenes can be alarming, it causes no harm to your daughter. However it’s important to be aware that a change of colour in your child’s skin can be a sign of something more serious, so always seek medical advice. Carotenes do not show up in eyes, and yellowing of the eyes as well of the skin may be a sign of jaundice and should be investigated immediately. For your own peace of mind you may wish to limit the fruit and vegetables that are higher in carotenes for the next few weeks. At this point you will probably find that your daughter’s nose and palm colour has returned to normal.