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The Dangers of String or Hair on Baby Toes-Truth!

The Dangers of String or Hair on Baby Toes-Truth!

Summary of eRumor:
Toe tourniquet syndrome happens when a piece of hair or string becomes wrapped so tightly around a baby’s toes that it cuts off circulation and sometimes leads to amputation.
The Truth:
Toe tourniquet syndrome is a real threat to babies, but it doesn’t happen very often.
Warnings about the dangers of string or hair becoming tightly wrapped around a baby’s toe and cutting off circulation gained widespread attention in 2012. That’s the year author Pam Belluck’s book “Island Practice: Cobblestone Rash, Underground Tom and Other Adventures of a Nantuket Doctor” was released. In the book, Belluck recounts how Dr. Timothy Lepore’s encountered toe tourniquet syndrome:

He even saved the toes of a two-month-old by spotting the rare “toe-tourniquet syndrome,” which is caused by hair wrapping around infants’ toes and cutting off circulation.

Because 90% of mothers experience postpartum hair loss, babies are most at risk when they’re between four days and 19 months old. Dr. Muhammad Ali Hussain, the senior plastic surgery registrar at Canberra Hospital in England, told the Daily Mail he’s seen three or four cases of toe tourniquet syndrome:

‘They get entangled and the mother doesn’t notice what has happened until the time they start crying and they don’t know exactly what is happening, why they are crying.

‘By the time they present it’s already a couple of days and it has been cutting through the toe.

‘In a fair-coloured child and with blonde-coloured hair you can’t identify there is a hair.

‘Even under a microscope it’s difficult.’

And it turns out that baby toes aren’t the only appendages in danger. An article published by Pediatrics medical journal in 1988 reported that fingers, toes and external genitalia could all be in danger. Doctors discussed six cases — all infants between 12 days and 5 months old — in which hair or fiber was removed from toes before any long-term damage was done. After reviewing literature, they found 60 documented cases — 24 involving toes, 14 involving fingers and 22 involving genitals:

The majority of the toe and external genitalia cases were caused by hair, whereas the majority of finger strangulations were caused by thread from mittens. At greatest risk for strangulation are the middle finger and third toe, followed by the index finger and second toe. Patients with finger or penile involvement were more likely to suffer significant complications from the injuries than those patients with toe involvement. Based on our own experience and that described in the literature, we recommend prompt removal of the offending fiber, followed by prolonged conservative management of the damaged distal tissue, in the hope of maximal tissue salvage. Increased physician awareness of this syndrome is mandatory for prevention, diagnosis, and early treatment.

There’s no current data on how common string-hair tourniquet syndrome is, but plenty of credible first-person accounts are relatively easy to find online. The most common symptoms are fingers or toes appearing purple or swollen, or a baby being in distress for no apparent reason.