Back to Previous Page

Newborn Jaundice

(Hyperbilirubinemia)

Definition

Jaundice is a yellow coloring in your baby’s skin, and sometimes, the whites of the eyes. Newborn jaundice happens during the first weeks of life. There are many types of jaundice, including:
Baby with Jaundice
Jaundice Baby
Copyright © Nucleus Medical Media, Inc.

Causes

The yellow coloring is caused by bilirubin. Bilirubin is a waste product. It is created when red blood cells are broken down. Bilirubin normally passes out of the body through feces or urine. Jaundice occurs when there is an abnormal buildup of bilirubin. Different types of jaundice have different reasons for the abnormal buildup of bilirubin:

Risk Factors

Factors that may increase your baby’s chance newborn jaundice include:

Symptoms

The main symptom of jaundice is yellow skin color. The color usually starts in the face. The yellow color may then spread down to the stomach and legs. Certain environments may make your baby appear yellow. To look for yellow skin, place your baby near a window or in a room with fluorescent light. If you are still unsure, press gently on the baby’s forehead or chest. Watch as the color reappears.

When to Call the Doctor

Call your baby's doctor if you suspect your baby has jaundice.
If your baby has been diagnosed with jaundice, call your doctor if:
  • Yellow color gets deeper
  • Yellow color spreads to other parts of the body or the eyes
  • Jaundice lasts for more than three weeks
Very high levels of bilirubin in your baby’s blood can be dangerous. It can lead to a very rare form of brain damage called kernicterus. It is important to see a doctor if your baby has signs of this condition. Call the doctor immediately if your baby:
  • Is tired all the time or difficult to wake
  • Sucks or nurses poorly
  • Looks weak or floppy
  • Arches his or her back or neck backwards
  • Develops a high-pitched cry or fever
  • Has convulsions or spasms

Diagnosis

The American Academy of Pediatrics recommends that all babies are assessed for jaundice before they leave the hospital. Your baby will be checked again at 3-5 days of age. If your doctor suspects jaundice, he will ask about your baby’s symptoms and medical history. A physical exam will be done.
Tests may include:

Treatment

Most babies with jaundice will not need treatment. Jaundice in formula-fed infants will usually clear up in two weeks. In breastfed babies, jaundice usually clears up in 2-3 weeks.
If your child does need treatment, talk with the doctor about the best treatment plan. Treatment options include:

Change in Feedings

Increased breastfeeding can help clear bilirubin from your baby's body. Your doctor may ask you to aim for 8-12 feeding per 24-hour period. Do not let your baby sleep for more than four hours without feeding during this time period. If you are having any problems breastfeeding, ask your doctor or lactation specialist for help.
Babies that are formula-fed will need to get extra formula. Ask the doctor for guidelines as to how much formula you should provide. You may need to give your baby 1-2 ounces (30-60 milliliters) of formula every 2-3 hours.
For most jaundice, extra breastfeeding is helpful. However, breast milk jaundice is caused by the breast milk. Your doctor may recommend stopping breastfeeding for a couple days. This will let the bilirubin decrease. Once the jaundice has cleared it is safe to resume breastfeeding.

Phototherapy

Phototherapy is the use of special lights. The lights helps alter the bilirubin in the blood. The bilirubin can then easily pass in the urine or through the gastrointestinal tract.
Your baby will be placed naked, or wearing only a small diaper, under special blue or white lights. A shield will help to protect your baby's eyes. Phototherapy may be done at home or in the hospital.
These light are specially designed to treat the bilirubin without harming your baby's skin. Putting your baby in the direct sunlight is NOT recommended. Direct sunlight on a naked baby can cause a dangerous sunburn.

Exchange Transfusion

In the most severe cases of jaundice, your doctor may recommend a blood transfusion. A transfusion will replace your baby’s blood with new blood. The excess bilirubin will be removed with the blood.

Prevention

There are no current guidelines to prevent newborn jaundice.

RESOURCES

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

The March of Dimes http://www.marchofdimes.com

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Infant jaundice.American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/jaundice.html. Updated April 2014. Accessed August 21, 2014.

Jaundice in healthy newborns. Nemour's Kid's Health website. Available at: http://kidshealth.org/parent/pregnancy%5Fcenter/newborn%5Fcare/jaundice.html. Updated November 2011. Accessed August 21, 2014.

Muchowski KE. Evaluation and treatment of neonatal hyperbilirubinemia. Am Fam Physician. 2014;89(11):873-878.

Neonatal hyperbilirubinemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 15, 2013. Accessed August 21, 2014.

Neonatal hyperbilirubinemia. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pediatrics/metabolic%5Felectrolyte%5Fand%5Ftoxic%5Fdisorders%5Fin%5Fneonates/neonatal%5Fhyperbilirubinemia.html. Updated October 2013. Accessed August 21, 2014.

Neonatal obstructive jaundice. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 2, 2014. Accessed August 21, 2014.

Revision Information