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A few years ago, a young Japanese couple traveled with their infant to the United States. Then during their stay, they were unexpectedly approached by social services and detained as their child was taken away from them. As they did not speak much English, they got their embassy involved. As it turned out, some people had seen the infant’s blue spot and assumed the child was a victim of child abuse. While the nightmare of this particular couple was easily resolved and parents soon reunited with their child.

The issue of the blue spot remains a phenomenon largely unknown outside of Eurasia and East Asia. It is called “Mongolian spot-MS” given by Edwin Baelz in 1901 referred to what he termed the “Mongoloid race”, in other words Asians.

It has bluish-gray, flat skin markings that appear at birth or shortly thereafter during the infantile age in different sizes, located on the lower back and buttocks and at the base of the spine. They can also appear on the shoulders, upper back, arms, wrists, legs, ankles, lateral abdomen and elsewhere. Palms, soles, face and head are usually spared.

Contrary to what is widely believed in Mongolia, it appears to be also quite common in other countries. The prevalence of Mongolian spots varies among different ethnic groups according to the overall depth of pigmentation. It has been reported for example Asian: 95-100%, East African: 90-95%, Native American: 85-90%, Hispanic: 50-70%, Caucasian: 1-10%.

Scientifically, the MS are caused by entrapment of melanocytes in the dermis during their migration from the neural crest into the epidermis in fetal development. Microscopically dermal melanocytoses are seen in all newborn babies irrespective of race. Differences in the number of dermal melanocytes may cause the racial variation. It fades away after a few years and almost disappear between age 7 to 13 years. Therefore, no treatment is required.

In terms of symbolism, blue color is important color in Mongolia. Mongolians believe that the Mongols has worshiped the eternal blue sky from ancient times and considered this birthmark as a heavenly seal for Mongolians only. Its main referent is to the sky and it has therefore important connotations to both nature and shamanism.

To this day, blue remains the favorite color of Mongols, used for clothing and for all types of support of national sentiments as are witness expressions such as ancient historical books named “hoh dewter-blue book”, “hoh sudar-blue history-hoh tuuh”. Tied up in this color symbolism, the question of blue spot can be seen as highly metaphoric.

Interestingly, rather than being understood as a sign of a common origin of both Mongols and others harking back to ancient history, the incidence of the blue spot in other populations tends to be attributed by Mongols to Chinggis khaan and to his conquering army. The significance of the blue spot as an allegorical device has been harnessed by both artists and nationalists, for whom it is a fertile symbolic terrain. Numerous writers have appealed to the phenomenon in their discussions of Mongolian identity. The famous rock band “ALTAN URAG”, also took on this symbolism with their song “Blue spot”.

It occurs in many other ethnic groups worldwide and is equally rich in symbolism for them.

Koreans think it is a shaman spirit to whom people pray around childbirth, slapped the baby's behind to hasten the baby to quickly get out from his or her mother's womb. In China, among common folk it is said to be caused by the Buddhist goddess of childbirth Songzi Guanyin (The Goddess of Baby Sending) when she is slapping the babies backside telling it to be born. Others say it is because the baby does not want to leave the mother's womb so Songzi Guanyin will kick it out, leaving the bruise. While a small portion of people, wrongfully, believe it happens when the doctor is slapping the baby's backside to make it cry.

The mark is also common among Maya people of the where is referred to as Wa in Maya, which means "circle". In Ecuador, the native Indians of Colta are insultingly referred to in Spanish by a number of terms which allude to the slate grey nevus.

In Spanish it is called mancha mongólica and mancha de Baelz.

In western countries, if a child is born with a “Mongolian Blue Spot” must be noted on the certificate proving that it is not harmful. Because the spots on the bodies of these children are mistaken for the result of violence. Such measures have been taken as a result of inspections by law enforcement agencies.

It is important to recognize that Mongolian spots are birthmarks, not bruises.

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