What is jaundice?
Most people have heard about jaundice, when the baby's skin is yellow, but may not understand why it happens or what to do for it.
When babies are born, they have a lot of red blood cells. These extra red blood cells break down into bilirubin (pronounced billy-ru-ben). A newborn baby's liver is not mature enough to get rid of this bilirubin so it builds up in the baby's body and causes the skin and the whites of the eyes to turn yellow. If the bilirubin level gets too high, it can hurt your baby's nervous system.
Finding out that your baby has jaundice can be scary but it is very common, and most times does not cause any problems. Ask your doctor or nurse if you have any questions or concerns about jaundice in your baby. You can also call the Warm Line at 1-800-711-7011. The Warm Line is staffed by registered nurses who will answer questions you may have about your baby. The Warm Line is open Monday thru Friday, from 9 a.m. to 9 p.m., and from 9 a.m. to 5 p.m. on Saturday and Sunday.
Are there different types of jaundice?
There are two types of jaundice. Normal jaundice happens in about half of all full-term babies and in about 80 percent of babies born early (before 37 weeks). Jaundice may last longer in babies born early.
Pathologic jaundice is caused by an illness or other medical problem like an infection. Sometimes the baby's blood type is different than the mother's and that causes problems such as jaundice. Other causes can be liver or intestinal problems, or being born too early.
When will I see the color change?
Jaundice usually starts to show on about day two or three of life. Bilirubin levels reach the highest level at about day three or four in a term baby. The levels in a late pre-term baby (born at 35 to 37 weeks) will peak between day five and seven. Jaundice usually disappears in about one week, but can last longer in babies who are born early.
The yellow is first seen in the eyes and face, and then it spreads down the body. If the baby is yellow just in the face, it is okay. If the baby is yellow to the belly button or you cannot wake the baby for a feeding, call the baby's doctor or the Warm Line (1-800-711-7011).
How can I tell if the baby is getting jaundiced?
In natural lighting, press on the baby's skin with your finger tip. When you raise your finger, the skin should be white. If it is yellow, your baby is jaundiced to that point. In babies whose skin color is darker, you need to watch the white of their eyes and palms of their hands for the yellow color.
How will they test for jaundice?
A small bit of blood will be taken from your baby's heel and tested to see how much bilirubin is in the blood.
How does my baby get rid of the bilirubin?
The bilirubin collects in the baby's stool. When the baby has a bowel movement, the bilirubin goes out. If the baby doesn't have a bowel movement, the bilirubin goes back into the body and levels get higher. So we want babies to have bowel movements. It is very important to feed them. They do not need water. Water will make them urinate, but not have a stool. They need calories (food) to make them move their bowels.
If you are breastfeeding, make sure you feed the baby eight to 12 times in 24 hours. If you are bottle feeding, feed the baby six to eight times in 24 hours.
How do they treat jaundice?
Treatment may include:
- The baby is fed breast milk or formula (not water or sugar water). This helps the baby to have a bowel movement and get the bilirubin out of his/her body.
- The baby is sometimes put under special lights to help break the bilirubin down. All the baby's clothes are taken off and the eyes are covered to protect them. Your baby's doctor will decide if this is necessary.
- If jaundice appears in the hospital, some babies will go home with instructions to follow up with blood tests.
- If you have any questions about jaundice, ask your baby's health care provider, nurse or call the Warm Line (1-800-711-7011).
Does breastfeeding cause jaundice?
If a breastfed baby is jaundiced, it is often because he or she is not nursing enough and not having a stool. Breastfeeding on cue day and night may help prevent jaundice. Breast milk is a natural laxative and feeding your baby frequently will help remove the jaundice. Sometimes a breastfed baby can become jaundiced when he or she is two or three weeks old. This may be due to something in the breast milk that prevents the bilirubin from being removed. Treatment is not usually needed. If there are no other causes for the jaundice, continue breastfeeding. It may take as long as three months for the levels to return to normal.