Hyperbilirubinemia, often known as newborn jaundice, gives a yellow tint to your baby’s skin and eyes and is often just their little body adjusting to life outside the womb. Jaundice is very common and usually temporary, occurring in up to 60% of full-term babies and up to 80% of pre-term babies during the first week of life. With a bit of monitoring and simple care, most babies recover quickly and fully. Here’s what you need to know to understand jaundice and help your baby regain their rosy, healthy glow.
What is jaundice?
Jaundice is characterized by a yellow discoloration of the body tissues, including the skin and eyes. Discoloration is caused by an excess accumulation of bilirubin, a yellow chemical found in the hemoglobin, the part of the blood responsible for carrying oxygen. Jaundice is typically caused by increased production of bilirubin, impaired excretion of bilirubin, or some combination of both factors.
Normal bilirubin blood serum levels are less than 1 milligram per deciliter, though the normal ranges can be higher for newborns. Jaundice patients often have serum levels three times higher or more. As bilirubin builds up in the body, skin color changes from yellow to green.
Yellowing of the skin and eyes typically occurs between two and five days after birth, but may be difficult to see in babies with darker skin. To check for jaundice, gently press on your baby’s nose or forehead under natural lighting. Normally, pressed skin should look pale. If it looks yellow when pressed, that’s a sign of mild jaundice.
Most hospitals will examine your baby for signs of jaundice multiple times before sending them home. The American Academy of Pediatrics (AAP) recommends checking for jaundice every 8 to 12 hours between birth and discharge. If your baby is discharged before they are 72 hours old, make a follow-up appointment to check for jaundice within 2 days.
What causes jaundice in newborns?
Every day, some of the red blood cells in your body die and get replaced by new ones. The old blood cells get filtered out by the liver, creating bilirubin in the process. That bilirubin is then sent to the digestive system, where it gets excreted in your poop. In newborns, however, the liver isn’t yet mature enough to effectively get rid of bilirubin, and it starts to build up, resulting in jaundice.
Newborns produce more bilirubin than adults because their red blood cells break down more quickly in the first few days of life. During pregnancy, the parent’s liver removes bilirubin for the fetus; after birth, the baby’s body has to clear bilirubin on its own, and it often isn’t quite up to the task.
Jaundice is common in infants, especially in pre-term babies born before 28 weeks. Some breastfed babies may also be at increased risk. Babies who have difficulty nursing may lack proper nutrition or be dehydrated, contributing to excessive bilirubin buildup. In most cases, jaundice is totally normal and nothing to worry about, but it may be a symptom of more serious health conditions, including liver, pancreas, and gallbladder disorders. Additional causes include:
- Certain drugs
- Cancers of the liver, bile ducts, or pancreas
- Gallstones
- Blood disorders
- Genetic syndromes
- Internal bleeding
- Enzyme deficiency
- Bruising during birth – a difficult birth can cause bruising, which may result in an increased breakdown of red blood cells, leading to a temporary buildup of bilirubin.
- Incompatible blood type – rarely, the birthing parent and newborn have incompatible blood types. When this happens, antibodies from the parent can cause excessive breakdown of blood cells.
How do you prevent jaundice in newborns?
Many parents may wonder how to avoid jaundice in a newborn, but there’s no surefire way to stop jaundice from happening. Instead, parents should focus on looking for the signs, observing the progression, and engaging medical help if necessary.
How is jaundice treated in newborns?
Jaundice treatments in newborns target the underlying cause and range from simple observation to light-based therapies. Phototherapy is a treatment that utilizes blue light to aid the liver in removing bilirubin from the body.
Fortunately, one of the most reliable preventative measures and treatments for jaundice is feeding your baby, something you are already doing. Breastfed babies should eat eight to twelve times per day during the first week of life. Formula-fed babies should drink one to two ounces of formula every few hours, with at least eight feedings every 24 hours during the first week. Feeding encourages bowel movements, which helps the body eliminate excess bilirubin.
How long does jaundice last in newborns?
While jaundice can be a little frightening for new parents, it almost always requires no treatment (aside from observation and cuddles) and goes away on its own within a couple of weeks. However, it’s essential to monitor your baby’s symptoms and seek medical attention if they don’t improve. Severe jaundice can lead to brain damage and other serious complications if left untreated.
What are the signs a newborn is recovering from jaundice?
Symptoms of jaundice in a newborn may develop gradually or appear suddenly. The most notable signs are a yellowing of the skin and sclera (the white part of the eyes). Additional symptoms include:
- Yellowing inside the mouth
- Dark or brown urine
- Pale or clay-colored poops
- Itching
- Difficulty waking or listlessness
Over the course of a couple of weeks, these symptoms should decrease and resolve. The signs of recovery from jaundice in newborns are the same as the symptoms, only in reverse.
- Yellow color fades from the skin and eyes. Fading typically begins with the lower body and works its way toward the face and eyes
- Lower bilirubi serum levels
- An easier time waking and increased alertness
- Increased appetite, improved feeding, and weight gain
- Normal stool color
- Good urine output (six to eight wet diapers) with pale or light-yellow color
The good news is that jaundice usually looks scarier than it actually is, and it almost always resolves on its own. But that doesn’t mean you have to go it alone. The healthcare team at Wee Care Pediatrics is ready and waiting to help and answer any questions you might have. With our Layton office open after hours, we are here when you need us.
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