Jaundice in Babies

After all the waiting 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 your baby is born is that your little one’s face, or the whites of his or her eyes, seem to have a slightly yellow tinge. If you do see this, your newborn 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 also what the complications of severe jaundice might be.

What Is Jaundice?

Many otherwise healthy newborn babies get jaundice. The name is derived from the French word ‘jaune’, meaning yellow.

Jaundice in a newborn baby is not usually anything to worry about, but in some rare cases it may be a sign of a more serious underlying condition. This is why it’s important to let your doctor or midwife know straight away if you notice yellow skin or any of the other symptoms of jaundice in your little one.

The symptoms of newborn jaundice usually appear within two or three days of your baby’s birth. In most cases the condition will clear up by the time your child is around 2 weeks old.

Jaundice Symptoms

Symptoms of jaundice in your newborn might include:

• Yellowing of your baby’s skin or the whites of his or her eyes

• Yellowing of the soles of your baby’s feet, or the palms of his or her hands

• Dark yellow urine (normal newborn pee is colourless)

• Pale-coloured poo

• Drowsiness

• Not wanting to feed or feeding less than usual.

Let your doctor or midwife 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 your baby shows any of the following symptoms – regardless of whether the jaundice is already being treated or monitored – your baby needs medical attention right away:

• Skin becoming noticeably more yellow

• Becoming more sleepy, lethargic or hard to wake

• A high-pitched cry

• Brief pauses in breathing (apnoea)

• Difficulty feeding

• Arching the neck and body backwards.

What Causes Jaundice in Newborn Babies?

The yellow skin seen in newborns who have jaundice is caused by a yellow substance called bilirubin. This is produced during the normal breakdown of red blood cells in the bloodstream.

In the first week or two, your newborn baby’s liver is still developing, and it may not yet be capable of removing the bilirubin from the bloodstream quickly enough.

In this case, the bilirubin can build up in your little one’s system. This build-up is called hyperbilirubinemia, and it’s what causes the characteristic yellow skin that can be a sign of jaundice.

When Does Jaundice Usually Occur in Babies?

Most healthy newborns that show symptoms of yellowing skin have what’s referred to as normal ‘neonatal’ jaundice.

This ‘normal’ jaundice usually appears about two to three days after your baby’s birth. It typically doesn’t require special treatment and goes away on its own within two or three weeks.

Your baby will usually be examined for jaundice within 72 hours of being born, as part of his or her routine medical check-ups.

If you notice signs of jaundice any time before or after this examination, it’s important to let your midwife, doctor or health visitor know.

If jaundice develops within the first 24 hours after birth it could require immediate treatment. Tell your doctor or midwife straight away if you notice any signs of jaundice in the first day.

Diagnosis

If your newborn shows signs of jaundice, your baby’s doctor will examine his or her skin, the whites of the eyes and possibly the gums. Your doctor may also check your baby’s urine and poo.

If jaundice is suspected, a medical device known as a bilirubinometer may be used to test the level of bilirubin in your baby’s blood. This works by shining a light onto your newborn’s skin and analysing the light that is reflected back.

A sample of your baby’s blood can also be tested for bilirubin, but this is usually only done if the jaundice has developed within the first 24 hours of birth, or if the bilirubinometer reading is very high.

The decision on whether any treatment is needed depends on the level of bilirubin.

More blood tests may be recommended if the jaundice lasts for more than two weeks, or if your baby needs treatment.

Jaundice Treatment

In most cases, the jaundice will clear up by itself without treatment within a week or two. It’s important to keep breastfeeding or formula feeding regularly during this time, because bilirubin leaves the body via your baby’s urine.

If the jaundice is making your little one sleepy and you think he or she may be feeding less as a result, ask your midwife or doctor for advice.

If your doctor determines that your baby needs treatment for jaundice, one of the following treatments may be recommended:

• Light therapy. Also knows as phototherapy, this kind of jaundice treatment uses fluorescent light, shone through your newborn’s skin, to break down the bilirubin. This may be done using a special light-emitting blanket known as a ‘biliblanket’, or sometimes with overhead lights. Phototherapy is usually administered in the postnatal ward of your local hospital, although in some cases it may be possible for the treatment to be given in your home.

• Exchange transfusion. If the level of bilirubin is very high, a blood transfusion can be performed with donor blood that doesn’t contain bilirubin.

• Intravenous immunoglobulin (IVIg). If your baby’s jaundice is related to a blood type incompatibility between you and your baby, such as rhesus disease, then your newborn may be given an injection of antibodies called immunoglobulin (IVIg).

• Other treatments. Sometimes, jaundice may be caused by another underlying condition such as an infection. In these cases, your doctor will recommend the appropriate treatment for that underlying condition.

How Long Does Jaundice Typically Last?

It’s best to ask your healthcare provider when things are likely to return to normal, because 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.

‘Normal’ newborn jaundice usually goes away within a few weeks without special treatment, but for reasons that are not fully understood it may last a bit longer in breastfed babies.

If your baby’s jaundice needs treatment and/or it’s caused by another underlying condition, your doctor will be able to tell you how long it’s likely to last.

Possible Complications Associated With Jaundice

In some cases, if left untreated, extremely high levels of bilirubin can affect the brain and result in a serious condition known as kernicterus. Prompt treatment is the best way to protect against complications like this.

Don’t worry — kernicterus is rare. In fact, it affects fewer than 1 in every 100,000 babies in the UK.

Jaundice is very common in newborn babies, and most often it’s the kind that will clear up on its own within a couple of weeks.

Remember that quick diagnosis and treatment can help ensure that the jaundice is well managed and doesn’t cause any problems for your baby. Soon things will settle down and you can get on with enjoying the newborn phase.