Newborn Jaundice

What is newborn jaundice?

Newborn jaundice is excess bilirubin in your newborn’s blood. Bilirubin is a yellow substance found in your newborn’s red blood cells. Excess bilirubin will cause your newborn’s skin and the whites of his or her eyes to turn yellow. Jaundice is also called hyperbilirubinemia.

What causes newborn jaundice?

Increased bilirubin occurs when your newborn’s body breaks down old red blood cells as it should, but cannot remove the bilirubin. Jaundice is common in newborns.

What increases the risk for newborn jaundice?

• Bruised during birth: A narrow birth canal may cause bruising on his or her head. Large bruises release bilirubin in the blood.
• Lack of breast milk: The mother’s body may not produce enough milk or the newborn may not be able to latch onto the breast the right way. This may prevent the newborn from getting enough nutrition or fluids and may raise bilirubin levels in his or her body.
• Premature birth: Your newborn may be at risk for jaundice if he or she was born too early because the liver may not have fully developed yet. The liver is needed to help flush out bilirubin from the body. He or she may also be at risk if he or she weighs less than an average newborn.
• Infection or a blood disorder: Sepsis (blood infection) or a blood disorder, such as hemolysis, may increase the risk for newborn jaundice. Hemolysis causes breakdown of more red blood cells, which can lead to excess bilirubin. This can also occur if the mother and newborn have different blood types.

What are the risks of newborn jaundice?

Too much bilirubin in your newborn’s blood may lead to brain damage. The damage may cause disorders such as hearing loss and cerebral palsy. Rarely, severe jaundice may lead to breathing problems, seizures that cannot be controlled and coma. Severe jaundice may be life-threatening.

How can I help decrease my newborn’s risk for jaundice?

Breastfeed your baby as early and as often as possible. You may use formula along with breast milk if you do not produce enough breast milk alone. Look for signs of thirst in your baby, such as lip smacking and restlessness. Try to breastfeed eight to 12 times daily for the first few days to boost your milk supply. Ask your healthcare provider for help if you have trouble breastfeeding.

How is newborn jaundice diagnosed?

Your newborn’s healthcare provider will check your newborn’s skin and eyes. Tell your healthcare provider how long your newborn has had signs of jaundice and if you or your newborn has a blood disease, different blood types or if any siblings also had jaundice. Tell your healthcare provider if your newborn was bruised during birth or has trouble breastfeeding. Your newborn may also need blood tests to check for bilirubin and to measure red blood cell levels. These tests will show if he or she has or is at risk of developing jaundice.

How is newborn jaundice treated?

Your newborn will likely be treated in the hospital. You will be able to stay with your newborn so you can continue to breastfeed. Treatment for jaundice includes:

• Phototherapy: This treatment uses light to turn bilirubin into a form that your newborn’s body can remove. One or more lights will be placed above your baby and he or she will be placed on his or her back to absorb the most light. Your baby may also lie on a flexible light pad or be wrapped in the light pad. Eye covers may be used to protect his or her eyes from the light.
• Exchange transfusion: Your newborn’s healthcare provider may replace a portion of your newborn’s blood with blood from a donor. This will be done if your newborn has severe jaundice.

When should I follow up with my newborn’s provider?

You may need to follow-up with a pediatrician two to three days after you leave the hospital, following your baby’s birth. Ask for a specific follow-up time. Your newborn may need more blood tests to check bilirubin levels. Write down your questions so you remember to ask them during your visit.

Create a follow-up plan before leaving the birth hospital. All babies 3 to 5 days old should be checked by a nurse or doctor, because this is usually when a baby’s bilirubin level is highest. The time of the follow-up visit will depend on how old your baby is when you leave the hospital and any other risk factors. Babies with jaundice in the first 24 hours of life or with high bilirubin levels before discharge should have an early follow-up plan.

When should I contact my baby’s provider if I have concerns?

If your baby is experiencing any of the following symptoms, ask to be seen by your baby’s provider the day you call:

• has very yellow or orange skin (skin color changes start from the head and spread to the toes).
• Is hard to wake up or will not sleep at all.
• Is not breastfeeding or sucking from a bottle well.
• Is very fussy.
• Does not have enough wet or dirty diapers.

When should I seek immediate care or call 911?

Get emergency medical help if your baby is experiencing any of the following:

• Crying inconsolably or with a high pitch.
• Arched like a bow (the head or neck and heels are bent backward and the body forward).
• Has a stiff, limp, or floppy body.
• Has strange eye movement.