A hemoglobin of 26 g/dL in the neonate indicates polycythemia. This condition places the neonate at risk for circumoral cyanosis and acrocyanosis (bluish discoloration of the hands and feet) because the thickness of the blood prevents it from becoming fully oxygenated in the lungs as well as causes difficulty in the blood reaching the tissues. For this reason, it also causes respiratory distress syndrome. The thickened blood becomes sluggish, leading to clot formation that could cause swelling of the right lower extremity if a clot formed in one of the veins in the leg. Polycythemia causes hypoglycemia, rather than hyperglycemia, due to the metabolic demand of the excess erythrocytes.