Jaundice of the Newborn

What is jaundice?

Jaundice is a yellowish discoloration of the newborn skin caused by bilirubin.  It first appears in their face and moves toward their chest and abdomen as the bilirubin level rises.  It may also make the white part of their eye yellow.  In most cases this is a normal physiologic process.  The rise in the infant’s bilirubin level occurs over the first few days of life.   While many infants become jaundiced only a few will require treatment. 

How do I know if my baby will be at risk?

Jaundice is common during the newborn period.  The newborn produces 2-3 times more bilirubin during this time as compared to adulthood and due to the immaturity of the liver and intestines the bilirubin is cleared more slowly.  Bilirubin is also a byproduct of red blood cell destruction.  Destruction of red blood cells in the newborn may be caused by bruising, a blood type incompatibility, an infection or the natural process of red blood cell destruction.  The natural process of red blood cell destruction may also be exaggerated in the newborn if they are born with a high hematocrit (red blood cell volume) or have a sequestration of red blood cells such as in a cephalohematoma (the cephalohematoma usually appears as a soft ‘bump’ on the infant’s head that has resulted from delivery and contains blood that needs to be reabsorbed by the infant’s body).   Additional risk factors include poor feeding, dehydration or decreased voiding and stooling patterns.

When will I know my baby’s bilirubin level?

Every baby at Overlake Hospital will have a bilirubin level drawn prior to discharging home.   While this level is helpful in determining the infant’s risk of needing treatment many infants will still need to be followed closely by their pediatrician after discharge. 

What is the treatment?             

The most common treatment for hyperbilirubinemia is phototherapy.  The infant is placed under a special blue light which breaks down the bilirubin into parts that are easier to eliminate in the stool and urine.  While many infants will need this treatment in the hospital some infants may be able to receive treatment in their home.  This treatment is safe and has few side effects (side effects include skin rash and/or loose stools).  It is also important to maintain good feeding, thus resulting in good hydration while the bilirubin levels are elevated.

What if my infant is born premature?

Premature infants are at even higher risk for jaundice or hyperbilirubinemia that requires treatment.  If your baby is in the NICU the bilirubin level will be monitored regularly.  If you have a late preterm infant born at 35-37 weeks that discharges home from the hospital with you, your pediatrician will monitor your baby’s bilirubin levels and decide on what treatment is best for your baby.

What makes breastfeeding or breast milk jaundice different?

Breast feeding jaundice generally occurs after the first 3-5 days of life and may last into the third week of life or beyond.

Additional Resources

To ensure the health of mom and baby in the early days, we encourage you to take advantage of our Postpartum Follow-up Program. A mother-baby nurse who specializes in postpartum care will assess baby’s health and mom’s recovery, and address any questions about feeding or baby care. You can find more information here: http://www.overlakehospital.org/services/medical-clinics/specialty/womens-clinic/postpartum-care-support/

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