What
is jaundice?
Jaundice is a common condition in newborn infants that
usually shows up shortly after birth. In most cases, it goes
away on its own. If not, it can be treated easily.
A baby has jaundice when bilirubin, which is produced
naturally by the body, builds up faster than a newborn's liver
can break it down and get rid of it in the baby's stool. This
happens because of one or more of the following reasons:
- The baby's developing liver is not yet able to remove the
bilirubin from the blood
- More bilirubin is being made than the liver can handle
- Too much of the bilirubin is reabsorbed from the
intestines before the baby gets rid of it in the stool
Too much bilirubin makes a jaundiced baby's skin look yellow.
This yellow color will appear first on the face, then on the
chest and stomach, and, finally, on the legs.
What is bilirubin?
Everyone's blood contains hemoglobin found in red blood
cells. Red blood cells live only a short time and, as they die,
the oxygen-carrying substance (hemoglobin) is changed to yellow
bilirubin. Normal newborns have more bilirubin because their
liver is not efficient at removing it. Older babies, children,
and adults get rid of this yellow blood product quickly, usually
through bowel movements.
Jaundice can be dangerous if the bilirubin reaches too high a
level in the blood. The level at which it becomes dangerous will
vary based on a child's age and if there are other medical
conditions. A small sample of your baby's blood can be tested to
measure the bilirubin level. Other tests may be needed to see if
your baby has a special reason to make extra bilirubin that is
causing the jaundice.
Parents should be aware of any changes in their newborn's
skin color or the coloring in the whites of their child's eyes.
Look at the baby under natural daylight or in a room that has
fluorescent lights. A quick and easy way to test for jaundice is
to press gently with your fingertip on the tip of your child's
nose or forehead. If the skin looks white (this is true for
babies of all races), there is no jaundice. If you see a
yellowish color, contact your pediatrician to check your baby to
see if significant jaundice is present.
Treating Jaundice in Healthy Newborns
Mild to moderate levels of jaundice do not require any
treatment. If high levels of jaundice do not clear up on their
own, your baby may be treated with special lights or other
treatments. These special lights help get rid of the bilirubin
by altering it to make it easier for your baby's liver to get
rid of it. This treatment may require that your baby stay in the
hospital for a few days. Some pediatricians treat babies with
these lights at home. If your baby needs light therapy, talk to
your pediatrician about how long the treatment lasts and where
it will be done.
Another treatment is more frequent feedings of breastmilk or
formula to help pass the bilirubin out in the stools. Increasing
the amount of water given to a child is not sufficient to pass
the bilirubin because it must be passed in the stools. Rarely,
babies may require treatment of their blood to remove bilirubin.
For example, in a few cases of very high bilirubin levels, a
blood exchange is done to give a baby fresh blood and remove the
bilirubin. Your pediatrician will give you more details if other
treatments are necessary. Once your child's bilirubin level goes
down, it is unlikely that it will increase again. However, if
your child continues to look yellow after 3 weeks of life, talk
to your pediatrician as other tests may need to be done.
Most breastfed babies do not have a problem with jaundice
that requires interruption of breastfeeding. However, if your
baby develops jaundice that lasts a week or more, your
pediatrician may ask you to temporarily stop breastfeeding for a
day or two. If you must temporarily stop breastfeeding, talk to
your pediatrician about pumping your breasts so you can keep
producing breast milk and can restart nursing easily.
If your baby has jaundice, do not be alarmed. Remember that
jaundice in a healthy newborn is not serious and usually clears
up easily. If your baby has a very serious case of jaundice and
other medical problems, your pediatrician will talk to you about
other treatments.
