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This case series highlights the significance of promptly identifying and addressing the issue. The presence of metabolic acidosis and methaemoglobinaemia was detected and promptly treated by administering methylene blue and normal fluid therapy. Following that, the newborns have been discharged on exclusive breastfeeds. Despite being infrequent, the initial manifestation of these instances exhibited characteristics that deviated from the norm for a differential diagnosis in an infant experiencing hypoxia, metabolic acidosis and diarrhoea. It is crucial to promptly identify and administer methylene blue treatment to potentially rescue the life of the neonate.<\/jats:p>","DOI":"10.1136\/bcr-2024-262479","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T10:01:39Z","timestamp":1734516099000},"page":"e262479","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Methaemoglobinaemia in neonates with acute gastroenteritis: lethal, but curable"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1771-8806","authenticated-orcid":false,"given":"Arjun","family":"Morishetty","sequence":"first","affiliation":[{"name":"Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8132-9574","authenticated-orcid":false,"given":"Umamaheswari","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1487-836X","authenticated-orcid":false,"given":"Prakash","family":"Amboiram","sequence":"additional","affiliation":[{"name":"Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7052-8826","authenticated-orcid":false,"given":"Saishree","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"2025082804343860000_17.12.e262479.1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1097\/SMJ.0b013e318232139f","article-title":"Methemoglobinemia: pathogenesis, diagnosis","volume":"104","author":"Skold","year":"2011","journal-title":"S Med J"},{"key":"2025082804343860000_17.12.e262479.2","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s12098-007-0192-x","article-title":"Transient methemoglobinemia in an infant","volume":"74","author":"Venkateswari","year":"2007","journal-title":"Indian J Pediatr"},{"key":"2025082804343860000_17.12.e262479.3","first-page":"57","article-title":"Methemoglobinemia: Infants at risk","volume":"49","author":"Fossen Johnson","year":"2019","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"key":"2025082804343860000_17.12.e262479.4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/00494755231205632","article-title":"Acquired methaemoglobinaemia in infancy associated with acute diarrhoea: A case series","volume":"54","author":"Jajoo","year":"2024","journal-title":"Trop Doct"},{"key":"2025082804343860000_17.12.e262479.5","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/S0196-0644(94)70275-6","article-title":"Incidence of subclinical methemoglobinemia in infants with diarrhea","volume":"24","author":"Pollack","year":"1994","journal-title":"Ann Emerg Med"},{"key":"2025082804343860000_17.12.e262479.6","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1002\/ajh.26340","article-title":"Recommendations for diagnosis and treatment of methemoglobinemia","volume":"96","author":"Iolascon","year":"2021","journal-title":"Am J Hematol"},{"key":"2025082804343860000_17.12.e262479.7","unstructured":"Price D . 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