Jaundice, also known as yellow jaundice or neonatal hyperbilirubinemia, is a liver condition commonly seen in newborns. Here’s everything you need to know about jaundice, its causes, and how it is treated in babies.
What Causes Jaundice?
Jaundice is caused by high levels of a yellow pigment called bilirubin that can build up in a newborn’s blood. Bilirubin is present in all human blood, and is a natural byproduct of the breakdown of red blood cells. The liver processes and breaks down bilirubin, making it easier for the body to get rid of it via urine and stool.
Here’s the catch—during pregnancy, the pregnant person’s liver is responsible for processing bilirubin for their baby. After birth it can take a few days for your little one’s liver to become efficient at removing bilirubin from their own body, which can cause this buildup to occur. The most common sign of jaundice is a yellowish tint in a newborn’s skin and the whites of their eyes.
Women & Babies Hospital tests all babies’ bilirubin levels within 36 hours of birth to ensure proper care.
How Serious is Jaundice in Newborns?
Jaundice is pretty common—in fact, about three in five newborns have jaundice. Often the jaundice is mild and will resolve itself without any treatment as your little one’s liver begins to mature. However, if bilirubin levels are rapidly rising and baby doesn’t receive the necessary treatment, it can potentially be harmful to the brain.
Some babies with certain health conditions may need treatment to help lower their bilirubin levels, including those with:
- Blood type mismatches (such as Rh disease)
- Internal bleeding or bruising at birth
- Problems with the liver (including infection or other diseases that affect the liver)
- Red blood cell issues (common in twins and babies that are small for their gestational age)
- Genetic conditions
- Blood infections
How is Jaundice Treated in Newborns?
The great news is that many times no treatment is necessary, and mild jaundice will disappear on its own within 2-3 weeks. For mild cases, baby’s provider might recommend sitting with your little one near a sunny window when possible, as sunlight can naturally break down the body’s bilirubin levels. Be sure to strip baby down to their diaper to allow sunlight to hit their body—and stay inside. Direct sunlight and UV exposure is dangerous for baby’s skin.
Other treatments for moderate to severe cases of jaundice include:
- Increased nutrition: More frequent feedings (and possibly supplementing with formula for breastfed babies) helps to make sure your little one is having plenty of dirty diapers, therefore naturally lowering their bilirubin levels.
- Light therapy (phototherapy): Baby is placed under a special lamp that emits blue-green spectrum light, while wearing only a diaper and eye protection. This light changes the structures of the bilirubin molecule so they can be more easily eliminated through urine and stool. Phototherapy can also be done through the use of a special light-emitting pad or mattress that baby lays on top of.
- Exchange transfusion: If severe jaundice doesn’t respond to other treatments, baby might need an exchange transfusion of blood. This is done by withdrawing small amounts of baby’s blood and replacing it with donor blood in order to dilute the bilirubin. This procedure is done in the NICU and is extremely rare.
Are Some Babies More Likely Than Others to Have Jaundice?
Yes. Increased risk factors for jaundice include:
- Premature babies: A baby born before 37 weeks’ gestation is more likely to have jaundice since the liver may not be fully developed or functioning properly.
- Breastfed babies, particularly those who aren’t latching or breastfeeding well: Feeding often can help keep baby’s bilirubin levels down, but if you and baby are still working on getting breastfeeding established, a backup of bilirubin can occur. Be sure to work with your nurses and lactation consultants to make sure baby gets frequent feedings of breastmilk or formula.
- Ethnicity: While not well understood, newborns with East Asian or Mediterranean ethnicities are more likely to have higher bilirubin levels.
Your baby’s provider will examine signs of jaundice and potentially recheck bilirubin levels at their first checkup after birth. If additional treatment or testing is needed, your provider will inform you.
Of course it’s also important to keep an eye on your little one once you’re home. A good way to check baby for yellowing (especially in darker-skinned babies) is to press down for a moment on their skin near a bone (on their forehead, chest, shin, etc.) and look at the skin beneath the fingerprint. If the skin looks yellow instead of pale, this may be a sign of jaundice. You should call your doctor if baby:
- Appears more yellow, particularly below the knees
- Isn’t eating well
- Isn’t wetting 6 diapers in 24 hours or having regular stools
- Is sleepier than normal
- Is fussy or hard to console
- Has a fever or is vomiting frequently
Remember, mama—jaundice is incredibly common, and typically easy to treat. If your little one is diagnosed with jaundice after birth, you’re in great hands with a wonderful care team.