If your new baby's skin and eyes look yellow, it's possible he may have jaundice. It may seem alarming to you, but it's a common problem in newborns, and it's usually harmless. Sometimes it goes away on its own, or your doctor may suggest light therapy or other treatments to knock it out.
Jaundice happens when too much bilirubin -- a chemical that red blood cells release during their normal breakdown process -- builds up in the blood. About 60% of babies get it.
Some of the body's red blood cells break down every day and create bilirubin in the blood. It's the liver's job to filter it out of the bloodstream. When your baby is still in your womb, your liver clears out his bilirubin for him. After birth, your baby's liver takes over.
Sometimes, your newborn's liver can't break down bilirubin as quickly as his body makes it, and it starts to build up. Because bilirubin is a yellow compound, it turns your baby's skin and eyes yellow.
Too much bilirubin in the blood is the most common cause of jaundice. At very high levels, bilirubin can cause brain damage, but this is rare.
Your newborn might be getting jaundice because he:
- Has a liver that's still maturing
- Was born prematurely
- Isn't getting enough breast milk, or something in the breast milk is causing jaundice
Jaundice typically shows up 2 or 3 days after your baby is born. Some types may show up sooner or much later. These kinds are caused by a disease or condition, such as:
- Hemorrhage (bleeding) somewhere inside your baby's body
- Infection of the blood (sepsis)
- Bacterial or viral infections
- Liver problems
- Lack of certain enzymes
- Problem with red blood cells that makes them break too easily
Jaundice may also happen if a mom has a different blood type from her baby. If that's your situation, your body may make antibodies that attack your baby's red blood cells. In some cases, you can help prevent this by getting special shots when you're pregnant.
Your baby may have a greater chance of getting jaundice if he's:
- Born before 37 weeks
- Of East Asian or Mediterranean descent
- Has trouble breast or bottle feeding
- A younger sibling of a child who had jaundice
- Born to a mother with O-type or Rh negative blood
The telltale sign of jaundice is a yellow color to your baby's skin and yellow in the whites of his eyes. It typically starts on the face. Once bilirubin levels in the blood get higher, the yellow color moves to the chest and stomach, and then, finally, the legs and arms.
Usually, a doctor can tell your baby has jaundice by looking at him. But she will also want to know how much bilirubin is in your baby's blood to help decide on a treatment plan. She may:
- Draw blood from your baby and send it to a lab.
- Test your baby's skin with an instrument that measures bilirubin levels by shining a special light on him.
If your doctor suspects that a condition is causing your baby's jaundice, she may do other tests, like a urine sample.
In many cases, jaundice goes away on its own in 1 to 2 weeks. Your doctor will decide whether your baby should wait it out or start treatments like:
Extra feedings. Taking in more breast milk or formula will help your baby poop more often, which can help clear out bilirubin from the body. Or, if your baby is having trouble breastfeeding, your doctor may recommend you feed him breast milk from a bottle or also feed him formula.
Phototherapy. In this treatment, the doctor puts your baby under blue-green lights. It can help bilirubin leave his body in his urine. He'll wear a diaper only so that most of his skin can soak up the light. He'll wear patches to protect his eyes. The light may come from a special pad or mattress that puts out blue-green light.
Intravenous immunoglobulin (IVIg). If your baby's jaundice happens because he has a different type from his mom, your doctor may need to give him a blood protein through an IV that helps stop the breakdown of red blood cells.
Exchange transfusion. If your baby has severe jaundice that isn't getting better with other methods, he may need a blood transfusion called an exchange transfusion. In this process, your doctor draws small amounts of your baby's blood and replaces it with blood from a donor.
Your baby will need to stay in the neonatal intensive care unit (NICU) for the procedure. It's rare for babies to need this level of treatment for jaundice.
There isn't much you can do to prevent the typical jaundice in newborns. But you can help move it along by being sure your baby is well fed. If you're breastfeeding, aim for 8-12 feedings a day in the first days of your baby's life. If you're formula feeding, offer 1-2 ounces every 2-3 hours.