What Is Jaundice In Newborns

Is Newborn Jaundice Harmful

If jaundice is left untreated and bilirubin levels reach limits exceeding 25mg, there is the possibility of cerebral palsy, deafness, or certain forms of brain damage to occur. Jaundice in itself may not become harmful to a baby, but it may be the symptom of an underlying medical condition that can cause other issues.A less serious side effect that may occur from jaundice is sleepiness in the newborn. This can cause the baby to not eat well, which can make jaundice worse.

Reasons Why Babies Get Jaundice And Might Require Immediate Treatment

Neonatal jaundice, or the appearance of yellow skin and eyes in an infant, is one of the most common newborn health conditions. About 60% of babies develop jaundice within 2-3 days after delivery.

Jaundice is caused by an accumulation of bilirubin in the body. When red blood cells break down naturally, this yellow substance is formed. Our livers usually process and remove bilirubin, but newborn livers are not functioning at full capacity right away and they cant break down excess bilirubin as easily. The mothers liver performed this process before the baby was born.

Instead of exiting through a newborns stool, excess bilirubin is reabsorbed into the body, building up in the blood and causing the skin and eyes to appear yellow. This is called physiologic jaundice the type we see most often.

For many babies, it takes less than a week for the liver to excrete the excess bilirubin on its own without treatment. In rare cases,excess bilirubin can deposit in organs beyond the skin including the brain, which can cause permanent brain damage.

Babies are at increased risk of developing jaundice if they are:

• Born prematurely
• Of East Asian descent
• A sibling of a child who had neonatal jaundice

We check every baby for jaundice before they leave the hospital and usually can tell just by the skin color. If we suspect high levels of bilirubin, well confirm with a blood test and recommend follow-up appointments if symptoms dont go away on their own.

Should A Mother Continue Breastfeeding If Her Child Has Jaundice

Supplementation can include mothers expressed breast milk, pasteurized donor human milk, or infant formula.

Usually. Most newborns with jaundice can continue breastfeeding. More frequent breastfeeding can improve the mothers milk supply and, in turn, improve caloric intake and hydration of the infant, thus reducing the elevated bilirubin. In rare cases, some infants may benefit from a time-limited, temporary interruption of breastfeeding with replacement feeding to help aid in the diagnosis of breast milk jaundice. Ongoing clinical assessment, including repeat bilirubin levels, will help determine when breastfeeding can resume. Further guidance is outlined in the Academy of Breastfeeding Medicines clinical protocols on supplementationexternal icon and jaundiceexternal icon. If temporary breastfeeding interruption is required, it is critical to help mothers maintain their milk production during this time.

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What Causes Jaundice In A Newborn

Jaundice occurs when the rate of formation of bilirubin exceeds the rate of removal from the body via stool and urine. Most babies develop jaundice as a normal occurrence, also known as physiological jaundice. This happens because the bilirubin produced by the baby in the womb is removed by the placenta. After birth, the babys liver may need some time to mature enough to complete this task on its own.

Newborn jaundice may also be caused by certain conditions:

• Preterm birth. Premature babies do not have sufficiently developed liver functions and are more vulnerable to developing jaundice.
• Breast milk jaundice. Breast milk jaundice occurs due to certain substances in breast milk that can hamper the bodys ability to get rid of bilirubin. Breast milk jaundice generally develops within the first week after birth, around day 4 or 5, peaks within the first 2 weeks, then takes many weeks to go away. Breast milk jaundice does not mean the mother should stop breastfeeding the baby if the baby is feeding and growing well and gaining weight.
• Not enough breast milk. Babies who do not receive enough breast milk due to issues such as poor latching or reduced breast milk production may lose a lot of weight, which can cause a rise in bilirubin levels.
• Certain ethnicities. Babies of East Asian or Mediterranean descent have a higher likelihood of getting jaundice.

Other conditions that may cause newborn jaundice include the following:

How Can I Prevent Jaundice In My Newborn

Jaundice in newborns is normal and usually cant be prevented. You can reduce the risk that your baby will develop severe jaundice by feeding them often. Frequent feedings stimulate regular bowel movements which will help your baby get rid of the bilirubin.

• Breastfed babies: You should breastfeed your baby eight to 12 times a day during their first week of life.
• Formula-fed babies: You should give your baby one to two ounces of formula every two to three hours during their first week of life. Ensure at least eight feeds in a 24-hour period.

Also, make sure your babys healthcare provider checks your babys bilirubin level before you leave the hospital. Schedule a follow-up visit during your babys first week of life to have the bilirubin level checked again.

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What Are The Symptoms Of Newborn Jaundice

The first sign of jaundice is a yellowing of a babys skin and eyes. The yellowing may begin within 2 to 4 days after birth and may start in the face before spreading down across the body.

Bilirubin levels typically peak between 3 to 7 days after birth.

If a finger lightly pressed on a babys skin causes that area of skin to become yellow, its likely a sign of jaundice.

What Are The Symptoms Of Jaundice In Newborns

Jaundice often appears in newborns on the second or third day after birth. Newborn jaundice progresses in the following pattern of severity. Stage 1 is the least severe.

• Stage 1: jaundice in babys face, especially the eyes
• Stage 2: jaundice in babys arms and chest
• Stage 3: jaundice in babys thighs
• Stage 4: jaundice in babys legs and palms of hands

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How Can Newborn Jaundice Be Prevented

There’s no way to prevent the most common type of newborn jaundice. Most cases occur because a babys liver is not mature enough to get rid of bilirubin in the bloodstream.

You can reduce your baby’s risk of jaundice by:

• Getting a RHo-GAM shot if your blood type is identified as Rh-negative during pregnancy and again 72 hours after delivery if your baby is Rh-positive
• Feeding your baby at least eight to 12 times a day, which helps her have regular bowel movements and removes bilirubin from her body.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

• What to Expect the First Year, 3rd edition, Heidi Murkoff.
• What to Expect When Youre Expecting, 5th edition, Heidi Murkoff.

When To Contact A Medical Professional

All babies should be seen by a provider in the first 5 days of life to check for jaundice:

• Infants who spend less than 24 hours in a hospital should be seen by age 72 hours.
• Infants who are sent home between 24 and 48 hours should be seen again by age 96 hours.
• Infants who are sent home between 48 and 72 hours should be seen again by age 120 hours.

Jaundice is an emergency if the baby has a fever, has become listless, or is not feeding well. Jaundice may be dangerous in high-risk newborns.

Jaundice is generally not dangerous in babies who were born full term and who do not have other medical problems. Call the infant’s provider if:

• Jaundice is severe
• Jaundice continues to increase after the newborn visit, lasts longer than 2 weeks, or other symptoms develop
• The feet, especially the soles, are yellow

Talk with your baby’s provider if you have questions.

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What Are The Symptoms Of Jaundice In Newborns How To Treat Jaundice In Newborns

Around 20% of newborns are seen to experience the ill effects of jaundice. While most of them are normal, some of them are serious and will require extra attention. It happens when a child’s blood has an excess of bilirubin which as a rule clears up after a week or two and should in this case is the normal jaundice in newborns, and not the serious type. Bilirubin is a compound your body makes when it breaks down old red blood cells. Your liver ordinarily channels bilirubin from your blood which your body disposes of through excretion. However, if your baby’s liver is under-developed and h

Signs That Jaundice May Be Getting Worse

In most cases, jaundice will go away on its own after a few weeks, but if you notice any of the following symptoms, your baby needs medical attention right away:

• Your babyâs skin becomes more yellow

• Your baby is abnormally drowsy or sluggish

• Itâs difficult to wake your baby from sleep

• Your baby has a high-pitched cry

• Your baby is sucking or feeding poorly

• Your baby has fever

• Your baby is arching his neck and body backwards.

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Measuring How Much Jaundice The Baby Has

A blood test checks the bilirubin level. Some hospitals also use an instrument placed on your baby’s skin as a screening test to help decide if a blood test is needed. A blood test is required to determine if the jaundice is due to liver disease. This requires measurement of liver function tests, plus both the total and the conjugated fraction of bilirubin.Note: Many labs may measure just the total bilirubin unless the conjugated fraction is specifically requested by the doctor.

Who Can Get Jaundice

All newborns are susceptible to jaundice. Breastfed babies who aren’t getting enough milk are more likely to have high bilirubin levels than babies who get enough breast milk or formula.

If you are breastfeeding and concerned about your baby’s jaundice, you can nurse on demand and then supplement with formula until your baby’s jaundice is managed.

Similarly, premature babies are more likely to have jaundice since their bodies have not developed enough to filter blood through the liver.

Babies with darker skin are at risk for their jaundice going undetected for longer since yellowing of the skin is more difficult to see. In this case, check your baby’s eyes and gums for signs of yellowing and ask for additional testing if you have concerns.

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How Can I Prevent Jaundice

Feeding your baby frequently in the first hours and days after his birth helps reduce the risk of jaundice. Feeding often will make your baby pass more stool. The milk also gives your babys liver the energy it needs to process the bilirubin. Your babys stool should turn from dark green to yellow.

If you are having trouble breastfeeding, it is important to get help. It might be necessary to offer your baby supplementary feeds of formula to avoid dehydration and to keep the jaundice from getting worse.

What Are The Different Types Of Newborn Jaundice

There are a few different types of jaundice in newborns.

Physiological jaundice

The most common type of jaundice in newborns is physiological jaundice. This type of jaundice is normal. Physiological jaundice develops in most newborns by their second or third day of life. After your babys liver develops, it will start to get rid of excess bilirubin. Physiological jaundice usually isnt serious and goes away on its own within two weeks.

Breastfeeding jaundice

Jaundice is more common in breastfed babies than formula-fed babies. Breastfeeding jaundice frequently occurs during your babys first week of life. It happens when your baby doesnt get enough breast milk. It can occur due to nursing difficulties or because your milk hasnt come in yet. Breastfeeding jaundice may take longer to go away.

Breast milk jaundice

Breast milk jaundice is different than breastfeeding jaundice. Substances in your breast milk can affect how your babys liver breaks down bilirubin. This can cause a bilirubin buildup. Breast milk jaundice may appear after your babys first week of life and may take a month or more to disappear.

Other types of jaundice can occur if your baby has an unrelated medication condition.

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How Is Newborn Jaundice Treated

Mild jaundice will usually resolve on its own as a babys liver begins to mature. Frequent feedings will help babies pass bilirubin through their bodies.

More severe jaundice may require other treatments. Phototherapy is a common and highly effective method of treatment that uses light to break down bilirubin in your babys body.

In phototherapy, your baby will be placed on a special bed under a blue spectrum light while wearing only a diaper and special protective goggles. A fiber-optic blanket may also be placed underneath your baby.

In very severe cases, an exchange transfusion may be necessary in which a baby receives small amounts of blood from a donor or a blood bank.

This replaces the babys damaged blood with healthy red blood cells. This also increases the babys red blood cell count and reduces bilirubin levels.

How Is Newborn Jaundice Diagnosed

The hospital discharges most mothers and newborns within 72 hours of delivery. Its very important for parents to bring their babies in for a checkup a few days after birth because bilirubin levels peak between 3 to 7 days after birth.

A distinct yellow coloring confirms that a baby has jaundice, but additional tests may be needed to determine the severity of the jaundice.

Babies who develop jaundice in the first 24 hours of life should have bilirubin levels measured immediately, either through a skin test or blood test.

Additional tests may be needed to see if a babys jaundice is due to an underlying condition. This may include testing your baby for their complete blood count , blood type, and Rhesus factor incompatibility.

Additionally, a Coombs test may be done to check for increased red blood cell breakdown.

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What Is Newborn Jaundice

Newborn jaundice refers to the yellowish discoloration of the skin and eyes. Jaundice is also called hyperbilirubinemia because it occurs when a yellow substance called bilirubin is elevated in the blood. Bilirubin is formed when red blood cells are broken down in the body, which normally occurs when old RBCs are replaced by new ones.

You can check the development of jaundice in your baby by gently pressing on their forehead to lightly blanch the skin. If the skin that was pressed appears yellow, it may indicate jaundice. Since it may be difficult to detect jaundice in babies with a darker complexion, always examine your baby in natural light. You can also look for jaundice under the babys tongue or on the white of their eyes.

What Treatments Are Available For Jaundice

Your baby will not need any special treatment if they have normal jaundice. You can treat mild jaundice in the first week by simply making sure that your baby has enough fluid and you can do this by breastfeeding. Breastfeeding gives your baby essential food and the right amount of water. Babies do not normally need extra water. Regular feeding to boost the supply of breastmilk is important.

If the bilirubin level is high, the most commonly used treatment is phototherapy . It does not contain rays that would harm your baby. Phototherapy is very safe and effective and can only happen in hospital. See .

A small number of babies with severe jaundice may have liver disease. Your baby may need blood tests or to go to hospital for tests, especially if the jaundice does not go away by 2 weeks of age or your baby has pale poo or dark wee.

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Treatment For Jaundice In Babies

Treatment for jaundice in babies depends on the cause, but may include:

• mild jaundice if the baby is otherwise healthy and well, no treatment is necessary. The baby’s liver will take only a few days to process bilirubin properly
• moderate jaundice phototherapy is the most common treatment. Phototherapy transforms the bilirubin in the babys skin into a less harmful chemical. Your baby may be undressed and placed in a warm incubator under blue lights. To maximise exposure to the lights, your baby will wear only a nappy and eye protection. Alternatively, a biliblanket may be used. A biliblanket is a pad placed directly against the baby that bathes the baby in light. Again, baby wears only a nappy and is wrapped in a flexible blue light mat. Treatment usually lasts one or two days and may occur at home, or in the hospital ward with the mother. To prevent dehydration and increase the bilirubin excretion, your baby will require regular feeding every three to four hours
• severe jaundice sometimes babies need treatment with more than one blue light at a time . When this happens, babies are usually admitted to a newborn nursery. Rarely, and only in very severe cases where an underlying condition is causing the jaundice, a blood transfusion may be needed.

Treatment for common conditions that cause jaundice may include:

Treatments for rare conditions that cause jaundice may include:

Newborn Jaundice: What Parents Need To Know

• By Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing

Most newborn babies turn at least a little bit yellow. Known as jaundice, this condition is a very common and usually normal part of the newborn period. But in some very rare cases it can lead to a more serious problem. Thats why parents need to know about it.

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