Infant Jaundice

Overview

What is jaundice?

Infant jaundice is when a baby’s skin, eyes, and mouth turn a yellow color. Jaundice is common in the first few days of a baby’s life. The yellow color is caused by bilirubin.

Bilirubin is a yellow substance made when the body breaks down old red blood cells. The liver filters it from the bloodstream, and it leaves the body through the stool (poop). Sometimes bilirubin builds up in your baby’s body. This could be because your baby’s liver can’t break it down. It could also happen if your baby has extra red blood cells to break down. This build-up can give your baby jaundice.

Jaundice is common in babies and is usually not serious.

Symptoms of jaundice

The main symptom of jaundice is a yellowing of your baby’s skin. Look for color changes in the skin, the whites of your baby’s eyes, and the pink skin inside your baby’s mouth. If these areas turn yellowish, call your baby’s doctor.

If your baby has pale skin, it should look white when you gently press it with your fingertips. If the skin looks yellow when you press on it, your baby may have jaundice. If your baby has darker skin, it may be harder to see yellowing. But you should still be able to tell by your baby’s eyes and inside of your baby’s mouth.

Artificial light, especially fluorescent lights, can sometimes fool your eyes into seeing a yellow color that is not really there. Try to check your baby in natural daylight in a sunny room.

Infant jaundice usually appears between 2 and 7 days after birth. As the amount of bilirubin in the blood builds up, your baby’s body will get more yellow. As the bilirubin level rises, the yellow color can move from your baby’s head down to the chest and even down to the toes. These are signs that your baby may have more severe jaundice. If this happens, you should call your baby’s doctor right away.

 Causes

What causes jaundice?

Jaundice is caused when too much bilirubin builds up in your baby’s body. Bilirubin is made when the body breaks down old red blood cells. This is a normal process that happens all through life. Usually, the liver breaks down bilirubin so it can leave the body through the stool. But an infant’s liver might not yet be developed enough to filter out the bilirubin. Or your baby may have a condition that increases the number of red blood cells that need to be replaced. These can cause the bilirubin to build up in your baby’s body, causing jaundice.

There are several common types of jaundice:

Physiological (normal) jaundice: Many newborns have this jaundice. Most of the time it isn’t severe. It doesn’t cause any problems and goes away on its own within 2 weeks.

Prematurity jaundice: Premature babies’ livers often aren’t developed enough to break down bilirubin effectively. They are often treated, even if their bilirubin levels aren’t as high.

Breastfeeding jaundice: Babies can get this when they don’t get enough breast milk. This can happen because of difficulties with breastfeeding or because the mother’s milk hasn’t come in yet.

Breast milk jaundice: Sometimes substances in breast milk cause bilirubin levels to rise. They can also make it harder for the baby’s body to get rid of bilirubin through the stool. This type starts after 3 to 5 days and slowly gets better over a number of weeks.

In some cases, jaundice is caused by an underlying problem. This could include bleeding, infection, or a liver condition.

What are the risk factors for jaundice?

Your baby is more likely to have jaundice if he or she is:

  • Premature (born before 38 weeks): A premature baby is more likely to have an immature liver. He or she may have fewer bowel movements than a full-term baby. This means that a premature baby might not be able to remove bilirubin as quickly as a full-term baby.
  • Bruised during birth:Bruises create more red blood cells that need to be turned into bilirubin. This can raise bilirubin levels in the bloodstream.
  • Having trouble breastfeeding:Babies who have trouble breastfeeding may be dehydrated or have a low calorie intake. This can increase the risk of jaundice. Ask your doctor for help if you or your baby are having trouble breastfeeding.

Diagnosis

How is jaundice diagnosed?

Your baby’s doctor will watch for signs of jaundice before you leave the hospital after having your baby. Many hospitals check bilirubin levels when a baby is 24 hours old. They can use a probe that estimates the bilirubin level just by touching the skin. If the level is high, it will be confirmed by a blood test.

If you are at home and your baby’s skin is yellow, see your baby’s doctor right away. The doctor will take a small amount of your baby’s blood and measure the bilirubin in it. Your doctor will probably measure your baby’s bilirubin level a number of times. If necessary, your baby will be treated. This usually keeps the bilirubin level from getting high enough to hurt your baby.

Prevention

Can jaundice be prevented or avoided?

In most cases, jaundice in an infant is normal and you can’t prevent it. You can reduce the risk that your baby will develop jaundice by feeding them at least 8 to 12 times a day for the first several days. This helps them have regular bowel movements, which removes bilirubin from their body.

Treatment

Most of the time, treatment for jaundice is not needed. Mild jaundice usually goes away on its own in 1-2 weeks.

For more serious cases of jaundice, your baby might need treatment at the hospital. Most babies who need treatment for jaundice get light therapy (also called phototherapy).

During phototherapy, your baby is placed under special lights or on a special light-producing blanket. He or she will wear only a diaper and a mask to protect their eyes. The light helps your baby’s body get rid of the excess bilirubin. Phototherapy usually lasts for 1 or 2 days. Sometimes, if the bilirubin levels aren’t too high, you may be able to use phototherapy at home.

It is also important that your baby drink plenty of breastmilk or formula when he or she has jaundice. This will help them have bowel movements and remove the bilirubin from their body. Try to feed your baby 8 to 12 times per day. Talk to your baby’s doctor if you have any questions about feeding your baby.

If phototherapy doesn’t work and your baby’s bilirubin level continues to rise, your baby might need an exchange transfusion. In this treatment, some of your baby’s blood is taken out and replaced with fresh blood.

If an underlying condition is causing the jaundice, your doctor will treat the underlying condition.

Living with jaundice

How long will my baby have jaundice?

Jaundice lasts for a different time in different babies. Often, a baby’s bilirubin level goes up for the first 3 to 4 days and then slowly goes back down. A baby who is breastfed may have mild jaundice for a longer time than a baby who is formula-fed.

Can jaundice hurt my baby?

Jaundice is not a serious problem in most healthy babies. However, very high bilirubin levels can be dangerous, even causing brain damage. The risk of serious injury to your baby from high bilirubin levels is increased if your baby is premature. But jaundice is almost always diagnosed before the bilirubin level gets high enough to cause this kind of damage.

 Questions

  • Does my baby need treatment?
  • What treatment is best for my baby?
  • Will my baby have any problems from jaundice?
  • Will my baby need light therapy?
  • Does my baby have a severe case of jaundice?
  • Will I need to bring my baby in for follow-up appointments?
  • Will my baby need to go into the hospital?