What Is Newborn Jaundice and How Is it Treated?

After all the time and planning, your newborn is finally here! It’s such an exciting time, and there’s so much going on. One thing you might notice a day or two after birth is that your newborn baby’s face is starting to turn a little yellow. If you do see this, he may have jaundice. Read on to learn more about what jaundice is, what the causes and symptoms are, how jaundice is diagnosed and treated, and what the complications of severe jaundice might be.

What Is Jaundice in Newborns?

Many otherwise healthy newborn babies get jaundice. Here’s how it happens: The normal breakdown of red blood cells in the bloodstream produces a yellow substance called bilirubin. If your baby’s liver isn’t yet able to fully remove bilirubin from the bloodstream, a buildup of this substance occurs. This buildup, called hyperbilirubinemia, is what causes jaundice, which is when your baby’s skin and maybe the white parts of his eyes turn a yellowish colour.

Signs and Symptoms of Jaundice

With jaundice, a yellowish colour will typically appear on your baby’s face first. This yellowish colour may also spread to the chest and tummy, and begin to appear on the arms and legs, and in the whites of your baby’s eyes. Let your baby’s healthcare provider know if you notice any of these signs.

Signs That Jaundice May Be Getting Worse

In most cases, jaundice will go away on its own after a few weeks, but if you notice any of the following symptoms, your baby needs medical attention right away:

• Your baby’s skin becomes more yellow

• Your baby is abnormally drowsy or sluggish

• It’s difficult to wake your baby from sleep

• Your baby has a high-pitched cry

• Your baby is sucking or feeding poorly

• Your baby has fever

• Your baby is arching his neck and body backwards.

What Causes Jaundice in Newborns and Babies?

1. If you’re breastfeeding your baby and he isn’t nursing about 8 to 12 times per day. (Learn how you might increase your breast milk supply.)

2. If your baby was born prematurely. Preemies are more likely to get jaundice than full-term babies because they may be less able to efficiently remove bilirubin from the bloodstream.

3. If you and your baby have what is called ABO incompatibility. ABO incompatibility is when your blood type and your baby’s blood type are different and noncompatible.

4. If your baby was delivered via vacuum extraction. The bruising that may happen on your baby’s head during the procedure could lead to a higher concentration of bilirubin, which leads to jaundice. Your healthcare provider may opt for a vacuum extraction during a vaginal delivery if she decides you need assistance delivering your baby. Injuries that may happen during a vacuum extraction generally have no lasting effects on your baby.

5. If your baby has certain genetic issues that make red blood cells fragile, which means they break down more easily and, therefore, increase bilirubin levels. Your healthcare provider can determine if your baby is at risk of having these particular kinds of genetic issues.

6. If your baby contracts a blood infection called sepsis.

7. If your baby has internal bleeding of any kind.

8. If you, as the mom, have cytomegalovirus (CMV), which is a common virus occurring in 50 to 80 percent of women in North America. by the time they turn 40. CMV doesn’t usually cause symptoms, but if it does, they’re usually fatigue, a sore throat, and fever. If you’re a healthcare worker or work with children, you’re more likely to get CMV, so let your healthcare provider know if you do. In any case, talk to your provider if you’d like to be tested.

9. If your Rh factor, which is a protein found on the surface of red blood cells, is negative and your baby’s is positive.

10. If you had gestational diabetes during your pregnancy. Your provider will offer screening tests for this form of diabetes during your pregnancy.

When Does Jaundice Usually Occur in Babies?

A majority of healthy newborns have physiological jaundice, which is also called “normal” jaundice. This “normal” jaundice usually appears about two to four days after birth. It typically doesn’t require special treatment and goes away on its own within two or three weeks.

If jaundice occurs before or after the second to fourth day of birth, it may be caused by something more serious than physiological or “normal” jaundice such as a genetic disorder, an infection, or one of the other causes of jaundice listed above.

Diagnosis

Your baby should be checked for jaundice by her healthcare provider between three and five days after birth, as this is when bilirubin levels are usually highest. Your baby’s healthcare provider will do an initial evaluation based upon the amount of yellow in the skin as well as your baby’s age and other factors. If she determines that jaundice may be present, to more accurately diagnose the condition, your baby’s healthcare provider might test for jaundice with

• a blood test

• a skin test (A transcutaneous bilirubinometer device is used, which measures the reflection of a special light that it shines through your baby’s skin.)

• a physical exam. There are some cases when your baby may need to be checked sooner than three to five days after birth. These include:

• If your baby had jaundice within the first 24 hours after she was born

• If your baby had high bilirubin levels before she left the hospital (It’s the policy of most hospitals to examine your baby for signs of jaundice before she’s released to go home.)

• If your baby was born more than two weeks before her due date

• If your baby isn’t breastfeeding about 8 to 12 times per day

• If your baby has a lot of bruises or bleeding under her scalp—usually the result of a difficult delivery

• If you, your partner, or your baby’s sibling has had high bilirubin levels and had to be treated for it.

Jaundice Treatment

• Light therapy. Also called phototherapy, this treatment reduces bilirubin levels by putting your baby under special lights. This phototherapy treatment is done either at the hospital or at your home if you have the special kind of lighting needed. Your baby will need to be undressed under the lights and she’ll need to wear special eye covering to protect her eyes.

• Intravenous immunoglobulin (IVIg). If your baby’s jaundice is related to blood type differences between you and your baby, for example in the case of ABO Incompatibility, then an intravenous transfusion of a blood protein that helps slow the breakdown of red blood cells in your baby may help end the jaundice.

• Exchange transfusion. In rare instances when other treatments aren't effective, an exchange transfusion treatment is done to reduce jaundice. In this treatment, small amounts of blood are taken from your baby and replaced with donor blood so the bilirubin levels in your baby’s blood are diluted. This procedure is done in a newborn intensive care unit (NICU) at the hospital. If your baby needs to be cared for in the NICU, you can expect specialized and expert care.

How Long Does Jaundice Typically Last?

It’s best to ask your healthcare provider when things are likely to return to normal, as the length of time your baby has jaundice can be affected by what caused the jaundice in the first place and what treatment your baby’s getting. In cases of physiological (“normal”) newborn jaundice, if you’re breastfeeding your baby, it will usually go away within two or three weeks without special treatment. If you’re formula feeding, “normal” newborn jaundice will likely only last until your baby is about 2 weeks old, since formula—unlike breast milk—doesn’t slow the liver’s capability of removing bilirubin from the bloodstream. Talk to your baby’s healthcare provider if she has been diagnosed with “normal” jaundice, but it seems to last for more than three weeks.

Potential Complications Associated With Jaundice

In some cases, if left untreated, high levels of bilirubin can affect the brain and result in serious complications. Prompt treatment is the best way to protect against complications like kernicterus, which is a form of brain damage. Kernicterus can result in vision problems, learning problems, dental problems, or movement disorders. Don’t worry—kernicterus is rare. Babies are usually treated well before jaundice becomes this severe. Keep your baby’s healthcare provider informed about any symptoms your baby might have and she will be able to take steps to help ensure severe complications are avoided.

The Bottom Line

Jaundice is very common in newborn babies, and most often it’s the kind that will clear on its own within a few weeks. Keep an eye on your baby and let your baby’s healthcare provider know if you see any signs of jaundice getting worse or persisting beyond a couple of weeks. Remember that quick diagnosis and treatment can help ensure that any jaundice is well managed, and doesn’t cause any problems for your baby. Soon things will settle down and you can enjoy this newborn phase. Turn your Pampers diapers and wipes into amazing rewards. Download the Pampers Club App today!