About half of all newborns develop jaundice, a yellowing of a babys skin and eyes. Newborn jaundice can occur when babies have a high level of bilirubin, a yellow pigment produced during normal breakdown of red blood cells. In older babies and adults, bilirubin is usually processed by the liver, and then passed through the intestinal tract. However, a newborns still-developing liver may not be mature enough to remove bilirubin.
The good news is that in most cases, newborn jaundice goes away on its own as a babys liver develops and as the baby begins to feed, which helps bilirubin pass through the body.
In most cases, jaundice will disappear within two to three weeks. Jaundice that persists longer than three weeks may be a symptom of an underlying condition. Additionally, high levels of bilirubin can put a baby at risk for deafness, cerebral palsy, or other forms of brain damage. Thats why the American Academy of Pediatrics (AAP) recommends that all babies be examined for jaundice every time vital signs are measured, or at least every 8 to 12 hours; before discharge from the hospital; and again a few days after discharge. (AAP, 2004)
Babies at highest risk for developing newborn jaundice are:
Other causes of newborn jaundice include bruising at birth or other internal bleeding, infection, liver malfunction, enzyme deficiency, or an abnormality in a babys red blood cells.
The first sign of jaundice is a yellowing of a babys skin and eyes. The yellowing may begin within two and four days of birth and start in the face before spreading down across the body. Bilirubin levels typically peak between three to seven 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.
While most jaundice is normal, in some cases it may indicate an underlying medical condition. Severe jaundice also increases the risk of bilirubin passing into the brain, which can cause permanent brain damage. Contact your doctor if you notice the following symptoms:
Most mothers and newborns are discharged from the hosptial within 72 hours of delivery. Its very important for parents to bring their babies in for a check-up a few days after birth, since bilirubin levels peak between three and seven days after birth.
A distinct yellow coloring confirms that a baby has jaundice, but additional tests are needed to determine how severe the jaundice is.
Babies who develop jaundice in the first 24 hours of life should have bilirubin levels measured immediately, either through a skin or blood test.
Additional tests may be needed to see if a babys jaundice is caused by an underlying condition. This may include testing for red blood cell counts, or testing for blood type and Rh incompatibility.
Mild jaundice will usually resolve on its own as a babys liver begins to mature. Frequent feedings—between 8 to 12 times a day—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 a babys body. Babies are placed in a special bed under a blue spectrum light, wearing only a diaper and special protective goggles. A fiber optic blanket may also be placed under the baby.
In very severe cases, an exchange transfusion may be necessary. In an exchange transfusion, small amounts of blood are taken from a donor (or from a blood bank) and given to the baby, in essence replacing a babys damaged blood with healthy red blood cells. This increases the babys red blood cell count and reduces bilirubin levels.
There is no real way to prevent newborn jaundice, but parents can keep jaundice from becoming more severe by taking the following precautions: