Newborn Jaundice

Taking your newborn home from the hospital is always a special time. But when your newborn baby begins to look a little, well, yellow within a few days of being born, it can be a bit scary. The good news is that jaundice in newborns is extremely common and often doesn’t even require any treatment.

What is Jaundice?
Jaundice refers to a condition whereby your skin and the whites of your eyes begin to look yellow. Yellowing occurs when the bilirubin levels, a byproduct of red blood cells that is produced when red blood cells are broken down, in your body increase. Although jaundice can be related to a more serious illness or disease, in newborn babies, jaundice is most typically the result of an immature liver.

Types of Jaundice
Generally, there are three common types of jaundice that can affect babies.

Physiologic Jaundice: This is the most common form of jaundice and affects about 50% of all full-term newborns. Physiologic jaundice tends to develop between 2 and 4 days after birth and clears up within a week or two. This form of jaundice is the result of a baby having an immature liver.

Jaundice of Prematurity: In this instance, it is premature babies that are affected by jaundice. In addition to possibly having an immature liver, preemies may not be developed enough to properly excrete bilirubin from their bodies, causing a build up of it in their system.

Breast Milk Jaundice: About 1% to 2% of breastfeeding newborns will develop jaundice as a result of a substance present in their mother’s breast milk. This substance hinders the proper expulsion of bilirubin through the intestines leading to an increased level of bilirubin in your baby’s system. This type of jaundice usually presents 4 to 7 days after birth and can last as long as 3 to 10 weeks. In some cases, it may be necessary to temporarily switch to formula feeding until the jaundice resolves.

In rarer instances, newborn jaundice may occur as a result of Rh incombatiblity. In these cases, the Rh incompatibility causes a mother’s antibodies to kill off her baby’s red blood cells. This quickly leads to a build up of bilirubin in the child. Signs of jaundice due to Rh factor usually appear the day your baby is born. Giving a mother a shot of Rh immunoglobulin can prevent problems in future pregnancies.

Other rare but possible causes of newborn jaundice include:

• Infection
• Cystic fibrosis
• Congenital toxoplasmosis
• Congenital syphilis
• Congenital herpes
• Hepatitis
• Congenital rubella

Symptoms of Jaundice
The most obvious symptom of jaundice is yellowing of the skin and whites of the eyes. Newborns affected by jaundice usually appear yellow first in the face and then in the arms, body, and legs. Other symptoms associated with jaundice include lethargy and poor appetite.

To check to see if your baby has developed jaundice, gently press on your baby’s forehead. This will force the blood out of the area. Normally, when this happens, the skin turns white. In babies with jaundice, though, the skin will remain yellow in appearance. Because babies are typically released from the hospital within a day of being born, it is up to parents to be on the watch for signs of jaundice. If you notice that your baby has developed jaundice, call her doctor.

Diagnosing and Treating Jaundice
Diagnosing jaundice can be done through a physical examination and/or through a blood test to measure the level of bilirubin in your baby’s system. Because jaundice rarely poses any threat to your baby’s healthy, there is generally no need to treat mild cases, as the jaundice will resolve itself on its own.

Premature babies with jaundice or those with excessively high bilirubin levels may receive phototherapy. This treatment uses a special type of light to breakdown the bilirubin in your baby’s skin, making it easier to pass through into the intestines and leave the body through bowel movements. In very severe cases, an exchange transfusion may be required, whereby your baby’s blood is exchanged with fresh, donated blood.

Doctor or Emergency?
For the most part, newborn jaundice goes away on its own without any treatment or complications. However, if since being diagnosed with newborn jaundice, your baby’s jaundice hasn’t disappeared after two weeks, his palms or soles have become yellow, his skin appears bright yellow, or some other symptoms have developed, call your child’s doctor.

Head to the emergency room if your baby:

• Isn’t feeding well
• Develops a fever
• Becomes listless

Although rare, jaundice can cause kernicterus with complications including brain damage, deafness and cerebral palsy.