What Is Newborn Jaundice?
Jaundice happens when too much bilirubin, a chemical that red blood cells release during their normal breakdown process, builds up in the blood. Sometimes it goes away on its own, or your doctor may suggest light therapy or other treatments to knock it out.
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 their bilirubin for them. After birth, your baby's liver takes over.
Sometimes, your newborn's liver can't break down bilirubin as quickly as their body makes it, and it starts to build up. Because bilirubin is a yellow compound, it turns your baby's skin and eyes yellow. It can also happen if the bile ducts are blocked or scarred, a condition called biliary atresia.
Babies have a greater chance of getting jaundice if they’re:
- Born before 37 weeks
- Of East Asian or Mediterranean descent
- Are exclusively breastfed or are having trouble breastfeeding or bottle feeding
- A younger sibling of a child who had jaundice
- Born to a mother with type O or Rh-negative blood
Jaundice typically shows up 2 or 3 days after your baby is born and goes away within the first couple of weeks. Some types may show up sooner or much later.
Breastfeeding jaundice happens because your baby isn’t eating enough. Your milk may not have come in yet or your baby is having trouble latching on. The more your baby eats, the more quickly their body clears waste, including bilirubin, from their system.
Breast milk jaundice appears after the first week. Doctors don’t know exactly why it happens, but they think something in breast milk keeps your baby’s liver from processing bilirubin effectively. This kind of jaundice can last for several months.
More serious kinds of jaundice 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 their baby. If that's your situation, your body may make antibodies that attack and break down your baby's red blood cells. In some cases, you can help prevent this by getting special shots when you're pregnant.
The telltale sign of jaundice is a yellow color to your baby's skin and yellow in the whites of their 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. Jaundice may be harder to notice on dark skin, so check the whites of your baby's eyes and under your baby's tongue to see if those areas look yellowish.
Severe jaundice can be an emergency situation, so call your doctor right away if:
Usually, a doctor can tell your baby has jaundice by looking. But they’ll also want to know how much bilirubin is in your baby's blood to help decide on a treatment plan. They may:
- Take blood from your baby and send it to a lab to measure the level and kinds of bilirubin.
- Test your baby's skin with an instrument that measures bilirubin by shining a special light on them.
If your doctor suspects that a condition is causing your baby's jaundice, they may do other tests, like:
- A urine sample to check for infection
- A complete blood count to measure the number of red blood cells
- A reticulocyte count to see if the number of newly formed red blood cells is normal
- A blood type test to see if the mother’s blood is incompatible with the baby’s
- A Coomb’s test to see if the immune system is destroying the baby’s red blood cells
- A liver function test
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 them breast milk from a bottle or also feed them formula.
Phototherapy. The doctor puts your baby under blue-green lights. It can help bilirubin leave their body in their urine. They'll wear a diaper only so that most of their skin can soak up the light. They’ll wear patches to protect their 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 they have a different blood type from their mom, your doctor may need to give them 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, they may need a blood transfusion called an exchange transfusion. In this process, your doctor repeatedly 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.
Newborn Jaundice Complications
Don’t hesitate to get your baby checked if you notice signs of jaundice. It’s rare, but if severe jaundice is left untreated, bilirubin can enter the brain and cause permanent damage. This condition is called kernicterus, a complication that includes:
Newborn Jaundice Prevention
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. Exposing your baby to sunlight also helps break down indirect bilirubin. Sit by the window indoors with your baby or take your baby for a stroll in the stroller if it is a nice day with sunshine.