Jaundice in Newborns

Newborn jaundice is a common occurrence in babies. Physiological jaundice—the yellowing of skin and eyes—is usually harmless.

Jaundice occurs because a substance called bilirubin builds up in the blood. Bilirubin is a waste product that forms when the body breaks down old red blood cells. This substance is then excreted from the body in the baby’s stool.

While the baby is in the womb, the placenta breaks down and removes bilirubin. After birth, the baby’s own liver will begin to break down and remove the bilirubin. However, because a newborn’s liver is just figuring out how to work, it may need a few days to get good at this process.

As a result, the level of bilirubin tends to increase after birth, usually peaking around 2-4 days. The yellow pigment in the skin and eyes decreases gradually and usually disappears within two weeks after birth. For most babies, the temporary elevated bilirubin level doesn’t cause any problems. Some babies who have a blood type that is different from their mother’s blood type are at an increased risk of high bilirubin levels and must be monitored more closely.

Two other forms of jaundice can occur if a baby is exclusively breastfeeding:

Breastfeeding jaundice occurs when a baby is not getting adequate amounts of breast milk and becomes dehydrated (because of problems nursing or the mother’s milk is not in yet). Putting the baby to the breast as often as possible will encourage mom’s milk production. The more the baby eats, the more bilirubin will be eliminated when the baby stools.

Breast milk jaundice, which appears in about 1-2 percent of babies, is often caused by substances in the breast milk itself that prevent proteins in the liver from breaking down the bilirubin. This form of jaundice typically takes a little longer to disappear. Interestingly, this type of jaundice usually runs in families.

There are usually no health problems associated with jaundice, as long as the bilirubin level does not reach a critically high point. Risk factors for developing levels that are too high include being premature, having a blood type that is not compatible with mom’s blood type, or even exclusive breastfeeding. Your doctor will monitor your baby closely for risk factors and look for signs that the bilirubin level may need to be checked.

Your doctor may recommend placing your baby under special lights to help the body process the bilirubin if the level becomes too high. This process, called phototherapy, may be done in the hospital or even at home, if the bilirubin levels are not dangerously high.

More serious jaundice may occur when the newborn’s body must rapidly replace blood cells due to abnormal blood cell shapes, incompatible blood type between the mother and baby, infections, or a lack of certain enzymes.

Jaundice that develops within the first 24 hours of birth may need to be investigated more closely to rule out any serious potential causes. Once you bring your baby home from the hospital, be sure to call your doctor if the jaundice appears to spread or deepen, if the baby has a fever of over 100 degrees Fahrenheit, or begins to look or act sick.

Sources:

• National Institutes of Health
• Newborn jaundice.
  National Institutes of Health
• Breast Milk Jaundice.
  KidsHealth
• Jaundice.

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