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Jaundice and the Newborn Baby

Monday, February 15, 2021

What is Newborn Jaundice?

Jaundice is a common newborn condition that causes baby’s skin and the white part of the eyes to appear yellow. Most babies will have at least some jaundice in the first few days following birth.

What Causes Jaundice?

Once babies are born, they do not need as many red blood cells as they needed for life in the womb. They therefore break down these extra red blood cells after birth. Bilirubin is the waste that remains.

Baby’s body gets rid of the extra bilirubin through the liver. A newborn’s liver, however, can be a bit immature. Jaundice occurs when bilirubin builds up faster than the newborn’s liver can break it down and pass it from the body. The amount of yellow varies due to the level of bilirubin in the baby’s bloodstream.

Sometimes babies are jaundiced due to an underlying issue such as a blood incompatibility (mom and baby have different blood types and the mother’s antibodies attack the baby’s red blood cells) or an infection. If baby’s jaundice shows up within the first 24 hours after birth or lasts longer than normal, additional tests may be required.

How Do I Know If My Baby Has Jaundice?

Newborn jaundice will first appear on the baby’s face and eyes, typically around 2 days of age. As baby’s level of bilirubin increases, the yellow color moves down the body. Jaundice usually peaks on the third or fourth day of life and then starts to go away. As the bilirubin level in baby’s bloodstream falls, the yellow color will fade, first in the lower parts of baby’s body and lastly in baby’s face. When the baby’s face and whites of the eyes are back to normal color, you know that the jaundice has resolved. This usually happens by 1-2 weeks of age.

The Canadian Pediatric Society and the American Academy of Pediatrics recommend early screening for jaundice. This screening often involves testing a small sample of your baby’s blood. A newer technology uses a light meter pressed against baby’s skin for an initial measurement of jaundice. In this case, blood tests are only done if the light meter reading is high.

A simple way to look for jaundice is to take your baby near a window during daylight hours.  Press your baby’s skin with your finger and quickly release. You may be able to see the yellow tinge of the jaundice on baby’s skin. (Please note: It is difficult to assess jaundice in artificial lighting or if your baby is wearing yellow.) If you see jaundice past your baby’s hips and baby is not feeding well or has been born prematurely, notify your healthcare provider.

What Should I Do If My Baby is Jaundiced?

If your baby is jaundiced, the best thing that you can do is to make sure baby is getting enough milk.  Feed frequently, at least 8-12 times per day. If you are having breastfeeding difficulties, seek help from a trained professional.  Bilirubin is excreted in the baby’s stools. Infrequent bowel movements allow the bilirubin to be reabsorbed from the gut rather than being eliminated in the stool.

Jaundice can make babies sleepy. You may need to wake the baby to feed or use wake up techniques to keep baby actively nursing at the breast.

What Are the Treatment Options for Jaundice?

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In most cases, jaundice will resolve on it’s own without the need for treatment. If treatment is required, phototherapy is used. Phototherapy is a light treatment that will help your baby clear the bilirubin from his system. Most commonly, phototherapy is done in the hospital although a few communities offer phototherapy in the home. In the most severe cases, a blood transfusion may be required for baby.

When Should I Be Worried?

You should notify your healthcare provider if your baby:

Has jaundice during the first 24 hours of life.

Is too sleepy to feed, despite the use of wake up techniques.

–  Is not having an adequate number of wet and dirty diapers.

In most cases, jaundice is normal and will resolve on it’s own, especially if your baby is feeding well. If you are feeling uncertain or have any questions, please notify your healthcare provider.

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References and More Information:

  1. De Carvalho, M., Klaus, M.H. and Merkatz, R.B., 1982. “Frequency of breast‐feeding and serum bilirubin concentration“. American journal of diseases of children, 136(8), pp.737‐738.
  2. Jaundice in Newborns: Parent FAQs.” HealthyChildren.org. Healthy Children.org. June 2017.  Web.
  3. Jaundice in newborns.caringforkids.cps.ca. Caring for Kids, Canadian Paediatric Society, Feb. 2012. Web.
  4. Jaundice in Newborns (Hyperbilirubinemia).healthlinkbc.ca. Health Link BC.12 Apr. 2016. Web.

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