Newborn Jaundice

This condition can be treated. Contact your doctor if you think your baby may have jaundice.

Causes

The yellow coloring is caused by bilirubin. Bilirubin is a waste product. It is created when red blood cells are broken down. Bilirubin normally passes out of the body through feces or urine. Jaundice occurs when there is an abnormal buildup of bilirubin. Different types of jaundice have different reasons for the abnormal buildup of bilirubin:

• Physiologic jaundice
  • May be caused by the breakdown of fetal red blood cells.
  • The baby’s body does not get rid of bilirubin very efficiently in the first days of life.
• Breastfeeding jaundice
  • Occurs in about 13% of breastfed babies.
  • This type of jaundice is caused by dehydration and poor calorie intake. It may happen in babies that are not taking in enough breast milk.
• Breast milk jaundice
  • Occurs in only 2% of babies.
  • It may be caused by a substance in breast milk that blocks the elimination of bilirubin.
• Hemolysis
  • Caused by massive breakdown of red blood cells.
  • May be caused by mismatched blood types in mom and baby such as Rh disease.
  • This type of jaundice will occur within the first 24 hours of life. It occurs before the baby leaves the hospital and can be harmful.
• Inadequate liver function
  • The liver may be impaired by an infection or liver disease.
  • This type of jaundice usually happens before the baby leaves the hospital.

Risk Factors

The following factors increase your baby’s chances of developing newborn jaundice:

• Prematurity—babies born before 36 weeks of pregnancy
• Brother or sister treated for jaundice
• Baby has a different blood type than mother, resulting in hemolysis
• East Asian, Mediterranean, or Native American descent
• Poor feeding with breast or bottle
• Large bruises or a condition called cephalhematoma (bleeding under the scalp related to labor and delivery)
• High bilirubin levels or signs of jaundice in the first 24 hours of life (before leaving the hospital)
• Certain liver enzyme deficiencies
• Infection

Symptoms

The main symptom of jaundice is yellow skin color. The color usually starts in the face. The yellow color may then spread down to the stomach and legs. Certain environments may make your baby appear yellow. To look for yellow skin, place your baby near a window or in a room with fluorescent light. If you are still unsure, press gently on the baby’s forehead or chest. Watch as the color reappears.

If your baby has yellow skin do not assume it is due to newborn jaundice. These symptoms may be caused by other health conditions.

Diagnosis

The American Association of Pediatricians recommends that all babies are assessed for jaundice before they leave the hospital. Your baby will be checked again at 3-5 days of age. If your doctor suspects jaundice, he will ask about your baby’s symptoms and medical history. A physical exam will be done.

Tests may include the following:

• Examination of baby’s skin
• Transcutaneous bilirubin (TcB)—a light is passed through the baby’s skin to screen for high bilirubin levels
• Blood test—to check level of bilirubin in blood, may be done if TcB shows a risk for high bilirubin levels

Treatment

Most babies with jaundice will not need treatment. Jaundice in formula-fed infants will usually clear up in two weeks. In breastfed babies, jaundice usually clears up in 2-3 weeks.

If your child does need treatment, talk with the doctor about the best treatment plan. Treatment options include:

Prevention

There is no known way to prevent newborn jaundice.