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OVERVIEW

What is jaundice?

Infant jaundice (say: “john-diss”) is when a baby’s skin, eyes, and mouth turn a yellow color. Jaundice is common in the first few days of a baby’s life. The yellow color is caused by bilirubin.

Bilirubin is made when the body breaks down old red blood cells. This is a normal process that happens all through life. Usually, the liver filters bilirubin from the bloodstream, but an infant’s liver might not yet be developed enough to filter out the bilirubin. If bilirubin builds up in your baby’s body, it can give your baby jaundice.

Jaundice is common in babies and is usually not serious.

SYMPTOMS

How can I tell if my baby has jaundice?

The only way to tell if your baby has jaundice is to look for color changes in your baby’s skin, the whites of your baby’s eyes, and the pink skin inside your baby’s mouth. If these areas turn yellowish, you may want to contact your baby’s healthcare provider.

If your baby has pale skin, it should look white when you gently press it with your fingertips. If the skin looks yellow when you press on it, your baby may have jaundice. If your baby has darker skin, it may be harder to check the skin, but you should still be able to tell by your baby’s eyes and inside of your baby’s mouth. If you see signs of jaundice in your baby, contact your healthcare provider right away.

Artificial light, especially fluorescent lights, can sometimes fool your eyes into seeing a yellow color that is not really there. So try to check your baby in natural daylight in a sunny room.

Infant jaundice usually appears between 3 and 7 days after birth. As the amount of bilirubin in the blood builds up, your baby’s body will get more yellow. As the bilirubin level rises, the yellow color can move from your baby’s head down to the chest and even down to the toes. These are signs that your baby has more severe jaundice, and you should contact your healthcare provider right away.

CAUSES & RISK FACTORS

What causes jaundice?

Jaundice is caused when too much bilirubin builds up in your baby’s body. Bilirubin is made when the body breaks down old red blood cells. This is a normal process that happens all through life. Usually, the liver filters bilirubin from the bloodstream, but an infant’s liver might not yet be developed enough to filter out the bilirubin. If bilirubin builds up in your baby’s body, it can give your baby jaundice.

In some cases, jaundice is caused by an underlying problem, such as bleeding, infection, or a liver condition.

What are the risk factors for jaundice?

Babies are more likely to have jaundice if they are:

• Premature (born before 38 weeks): A premature baby is more likely to have an immature liver and have fewer bowel movements than a full-term baby. This means that a premature baby might not be able to remove bilirubin as quickly as a full‑term baby.
• Bruised during birth: Bruises create more red blood cells that need to be turned into bilirubin, which can raise bilirubin levels in the bloodstream.
• Having trouble breast-feeding: Babies who have trouble breast-feeding may be dehydrated or have a low calorie intake. This can increase the risk of jaundice. Ask your healthcare provider for help if you or your baby are having trouble breastfeeding.

DIAGNOSIS & TESTS

How will my healthcare provider diagnose jaundice?

If your baby’s skin is yellow, contact your baby’s healthcare provider right away. The healthcare provider will take a small amount of your baby’s blood and measure the bilirubin in it. Your healthcare provider will probably measure your baby’s bilirubin level a number of times. If necessary, your baby will be treated. This usually keeps the bilirubin level from getting high enough to hurt your baby.

TREATMENT

How is jaundice treated?

Mild jaundice usually goes away on its own in 2-3 weeks.

For more serious cases of jaundice, your baby might need treatment at the hospital. If an underlying condition is causing the jaundice, your healthcare provider will treat the underlying condition.

Most babies who need treatment for jaundice get light therapy (also called phototherapy). During phototherapy, your baby is placed under special lights. The light helps your baby’s body get rid of the excess bilirubin. Phototherapy usually lasts for 1 or 2 days.

If phototherapy doesn’t work and your baby’s bilirubin level continues to rise, your baby might need an exchange transfusion. In this treatment, some of your baby’s blood is taken out, diluted, and then transferred back into your baby.

How long will my baby have jaundice?

Jaundice lasts for a different time in different babies. Often, a baby’s bilirubin level goes up for the first 3 to 4 days and then slowly goes back down. A baby who is breastfed may have mild jaundice for a longer time than a baby who is formula-fed.

COMPLICATIONS

Can jaundice hurt my baby?

Jaundice is not a serious problem in most healthy babies. However, very high bilirubin levels can be dangerous, even causing brain damage. The risk of serious injury to your baby from high bilirubin levels is increased if your baby is premature.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• What treatment is best for my baby?
• Does my baby need treatment?
• When should I contact my baby’s healthcare provider?
• Will my baby have any problems from jaundice?
• Will my baby need light therapy?
• Does my baby have a severe case of jaundice?
• Will I need to bring my baby in for follow-up appointments?
• Will my baby need to go into the hospital?

FOR MORE INFORMATION

Canadian Paediatric Society website:
https://www.cps.ca/

Sources

Hyperbilirubinemia in the Term Newborn by ML Porter, CPT, MC, USA, and BL Dennis, MAJ, MC, USA (02/15/02, http://www.aafp.org/afp/20020215/599.html)