Misunderstanding Mongolian Spots

It's a good idea to ask your pediatrician to make a note of your child's Mongolian spots, which can commonly be mistaken for child abuse.

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Peter and Alice Foster had spent three glorious months getting to know their daughter, Sarah, whom they’d adopted from India at eight months. Now, at 11 months, Sarah was starting daycare. The transition seemed to be going smoothly–Sarah loved the activities at the center–until two weeks into the program. That’s when the Fosters were visited by a state social worker who informed them they were being investigated for child abuse! Sarah had several large, dark circles on her buttocks that a daycare worker had taken to be bruises. The Fosters, though shocked, quickly explained that Sarah’s “bruises” were actually Mongolian spots.

What Are Mongolian Spots?

Mongolian spots are flat, irregular-shaped birthmarks commonly seen among people of Asian, East Indian, African, or Latino descent. According to the American Journal of Dermatology, at least 90 percent of people of African heritage have these marks, as do over 80 percent of Asians. Despite the name, Mongolian spots have no known anthropologic significance, except for being more common in darker-skinned infants. (Although 10 percent of Caucasians also have Mongolian spots.)

These bluish to deep brown-black skin markings often appear on the base of the spine, on the buttocks and back, and sometimes on the ankles or wrists. Spots are caused by skin cells called melanocytes and have normal texture. They commonly appear at birth, or shortly after birth, and can look very much like bruises.

Are They Dangerous?

Mongolian spots are benign and are not associated with any illnesses or risk factors. They generally fade in a few years and disappear by puberty. Though they sometimes persist into adulthood, there is no need for treatment.

Keep Records

Since Mongolian spots can easily be mistaken for bruises, they have triggered accusations of child abuse. The Fosters should have spoken to their daughter’s caregiver about the spots when they registered for daycare.

Fortunately, the couple had a good relationship with their pediatrician, who quickly straightened out the misunderstanding with the child welfare agency. In fact, the doctor had kept a diagram of the number and position of Sarah’s Mongolian spots in her file. The Fosters not only talked to the daycare center about the spots, they also educated their neighbors and family.


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