Understanding and Managing Jaundice in Newborns

Highlights

• Jaundice is a yellow discolouration of the skin or the white areas of the eyes.
• Jaundice is usually harmless, but a nurse or doctor should check and monitor jaundice in every newborn baby.
• Tests such as blood, urine tests, and ultrasound can help diagnose the cause of your baby’s jaundice.
• If your baby has high bilirubin levels, they might need treatment including phototherapy (light therapy), or in severe cases, an exchange blood transfusion.

In This Article

• What is jaundice?
• Symptoms of jaundice
• Causes of jaundice
• When to seek medical attention
• Diagnosing jaundice
• Treatment options for jaundice
• Preventing jaundice
• Possible complications of jaundice
• Tools and assistance

What is jaundice?

Jaundice is the yellow discoloration of the skin or the whites of the eyes due to high bilirubin levels in the blood.

It is common in newborns, with mild jaundice occurring in about 1 in every 2 full-term newborns, and being more common in premature babies.

Jaundice usually appears from the third day after birth and typically resolves within 1 to 2 weeks.

It is usually harmless, but every case should be checked by a doctor or nurse.

Symptoms of jaundice

Yellowing of the skin and whites of the eyes, typically starting on the face and head.

As bilirubin levels increase, the yellowing can spread down the body.

Some babies may also be drowsy and have difficulty feeding.

Causes of jaundice

• Physiological jaundice: Newborns’ livers may not process bilirubin well, causing skin yellowing. This resolves by 2 weeks.
• Premature babies are more likely to develop jaundice than full-term babies.
• Breast milk jaundice: This jaundice occurs in breastfeeding babies and resolves after several weeks.
• Dehydration: Poor feeding may cause jaundice, which resolves with proper feeding.
• Hypothyroidism: Low thyroid levels in newborns may cause jaundice.
• Blood group incompatibility: If the mother’s and baby’s blood types don’t match, jaundice can occur.
• Infection: Infections, like a urinary tract infection, may cause jaundice.
• Biliary atresia: A rare condition where bile tubes are scarred, leading to liver disease if untreated.
• Progressive Familial Intrahepatic Cholestasis (PFIC): A genetic condition causing persistent jaundice due to bile production issues.

When to seek medical attention

Take your baby to the doctor if:

• The baby is unwell, feeding poorly, and not gaining weight.
• The baby’s poo becomes pale or their urine becomes dark.
• Jaundice appears within the first 48 hours after birth.
• The jaundice becomes more noticeable after a week or doesn’t go away after 2 weeks.

Diagnosing jaundice

Jaundice is typically diagnosed through a clinical examination by a doctor.

Additional tests may include:

• Blood tests
• Urine tests
• Ultrasound of the liver

Treatment options for jaundice

For mild jaundice, treatment typically involves ensuring the baby stays well-hydrated with frequent breast or formula feeds.

If jaundice develops several days after birth, the baby’s bilirubin levels may be monitored with heel prick blood tests.

If bilirubin levels are high, phototherapy (blue light treatment) may be required. This helps the liver process the bilirubin more effectively.

For babies with breast milk jaundice, breastfeeding can continue as normal since this type of jaundice usually resolves on its own.

Severe jaundice treatment

Severe jaundice may require an exchange blood transfusion, where the baby’s blood is replaced with compatible fresh blood. This treatment is rare.

Preventing jaundice

Jaundice cannot be prevented but can usually be treated effectively when it occurs.

Possible complications of jaundice

Very high bilirubin levels can rarely cause brain damage and hearing loss.

The risk of complications is minimized through careful monitoring of bilirubin levels while the baby is in the hospital.

Tools and Assistance

For families seeking support with jaundice management, here are some useful tools:

1. Newborn Care Guides: Many hospitals and pediatric clinics offer brochures on jaundice and its treatment.
2. Monitoring Devices: Bilirubin meters can help healthcare providers monitor bilirubin levels in the baby.
3. Breastfeeding Support: Lactation consultants can provide guidance for breastfeeding-related jaundice, including breast milk jaundice.
4. Healthcare Professionals: Pediatricians and neonatologists are key resources for diagnosis and treatment.
5. Health Apps: Some apps help track feeding, sleeping, and diaper changes, including jaundice symptoms.
6. Home Care Tips: Many organizations offer guidelines on caring for a baby with jaundice, including at-home phototherapy.
7. Support Groups: Emotional support from parenting groups or counselors can be helpful during this time.
8. Follow-Up Care: Regular follow-up visits with your healthcare provider are crucial for monitoring bilirubin levels.