JAUNDICE AND YOUR NEWBORN

To make sure your baby’s first weeks are safe and healthy, it is important that:

  • Your baby is checked for jaundice in the hospital
  • If you are breastfeeding, you get the help you need to make sure it is going well
  • Your baby is seen again by a health care professional at 2-3 days after discharge

 

Q: What is jaundice?
A: Jaundice is the yellow color seen in the skin of many newborns. It happens when a chemical called bilirubin builds up in the baby’s blood. Jaundice can occur in babies of any race or color.

Q: Why is jaundice common in newborns?
A: Everyone’s blood contains bilirubin, which is removed by the liver. Before birth, the mother’s liver does this for the baby. Most babies develop jaundice in the first few days after birth because it takes a few days for the baby’s liver to get better at removing bilirubin.

Q: How can I tell if my baby is jaundiced?
A: The skin of a baby with jaundice usually appears yellow. The best way to see jaundice is in good light, such as daylight or under fluorescent lights (not a regular light bulb). Jaundice usually appears in the face and then moves to the chest, abdomen, arms, and legs as the bilirubin level increases. The whites of the eyes will usually be yellow. Jaundice may be harder to see in babies with darker skin color.

Q: Can jaundice hurt my baby?
A: Most infants have mild jaundice that is harmless, but in unusual situations, the bilirubin level can get very high and might cause brain damage. This is why newborns should be checked carefully for jaundice and treated to prevent a high bilirubin level.

Q: How is my baby checked for jaundice?
A: If your baby looks jaundiced in the first few days after birth, your baby’s doctor or nurse practitioner may use a skin test or blood test to check your baby’s bilirubin level. A bilirubin level is always needed if jaundice develops before the baby is 24 hours old. Whether a test is needed after that depends on the baby’s age, the amount of jaundice, and whether the baby has other factors that make jaundice more likely or harder to see.

Q: Does breastfeeding affect jaundice?
A: Jaundice is more common in babies who are breastfed than babies who are formula fed, but this occurs mainly in infants who are not nursing well. If you are breastfeeding, you should nurse your baby at least 8 to 12 times a day for the first few weeks. This will help you produce enough milk and will help to keep the baby’s bilirubin level down. If you are having trouble breastfeeding, ask your baby’s doctor, nurse practitioner, or lactation specialist for help. Breast milk is the ideal food for your baby.

Q: When should my newborn get checked after leaving the hospital?
A: It is important for your baby to be seen in our office when the baby is between 3 and 5 days old because this is usually when a baby’s bilirubin is highest. The timing of this may vary depending on your baby’s age, when the baby was released from the hospital, and other factors.

Q: Which babies require more attention for jaundice?
A: Some babies have a greater risk for high levels of bilirubin and may need to be seen sooner after discharge from the hospital. Ask your doctor about any early follow-up visits if your baby has any of the following:

  • A high bilirubin level before leaving the hospital
  • Early birth (more than 2 weeks before the due date)
  • Jaundice in the first 24 hours after birth
  • Breastfeeding is not going well
  • A lot of bruising or bleeding under the scalp related to labor and delivery
  • A parent or sibling who had high bilirubin and received light therapy.

 

Q: When should I call my baby’s doctor or nurse practitioner?
A: Call you baby’s doctor or nurse practitioner if:

  • Your baby’s skin turns yellow
  • Your baby’s abdomen, arms, or legs are yellow
  • Your baby is jaundiced and is hard to wake, fussy, or not nursing or taking formula well.

 

Q: How is jaundice prevented?
A: Most jaundice requires no treatment. When treatment is necessary, formula supplementation to increase digestion and bowel movements, or placing your baby under special lights (prescribed by our office) while he or she is undressed will lower the bilirubin level. Depending on your baby’s bilirubin level, this can be done in the hospital or at home. Jaundice is treated at levels that are much lower than those at which brain damage is a concern. Treatment can prevent the harmful effects of jaundice.

Q: When does jaundice go away?
A: In breast fed infants, jaundice often lasts for more than 2 to 3 weeks. In formula fed infants, most jaundice goes away by 2 weeks. If your baby is jaundiced for more than 3 weeks or is getting worse, see your baby’s doctor or nurse practitioner.