You made it! You crossed the pregnancy finish line and now you have a precious little bundle of joy to show for it. But, wait, why is your baby yellow?! Don’t panic — that distinctive tinge of color is indicative of jaundice in babies, and this common condition isn’t necessarily a cause for concern.
Granted, you’re a new parent and no one is going to look at you sideways if you do freak out just a little. Go ahead and have your minute of melting down, Mama. But know that you’re not alone in this as it’s a super common condition. In fact, according to the most recent search data available, the topic of jaundice in babies is searched for nearly 74,000 per month. Feel a little better? Okay, good. Here’s what you need to know about this newborn condition so you can feel as prepared as possible for your first parenting challenge.
What is jaundice in babies?
So, first things first, jaundice commonly presents within the first two to four days after a child’s birth. It’s estimated six out of every 10 full-term babies and eight out of 10 premature babies develop jaundice. In fact, your baby will be examined for signs of it within 72 hours of being born as part of their routine newborn physical examination. This medical condition, which causes baby’s skin and the whites of their eyes to appear yellow, occurs when baby has a high level of bilirubin in the blood. As such, it’s also known as hyperbilirubinemia.
What is bilirubin?
Per the Mayo Clinic, bilirubin (bil-ih-ROO-bin) is an orange-yellow substance made during the normal breakdown of red blood cells. It typically passes through the liver to be excreted out of the body in the stool. Accordingly, a buildup of bilirubin can cause jaundice and indicate possible medical issues.
What causes newborn jaundice?
You now know that newborn jaundice is a direct result of too much bilirubin in the blood. But why is there a build-up? Well, it could be an innocuous and perfectly logical reason — a newborn’s still-developing liver isn’t quite mature enough to remove bilirubin. This explains why jaundice is particularly common in babies born before 38 weeks whose liver didn’t get as much time to develop. Not to mention, all babies have a naturally higher level of bilirubin after birth since the excess red blood cells they had while in the uterus must get broken down. As the liver matures over the baby’s first two weeks of life, it also gets better at breaking down bilirubin and most cases of jaundice correct on their own.
Having said that, there are certain factors that can increase a baby’s risk of developing jaundice. These reasons are less common contributors to jaundice, says the American Pregnancy Association.
They include a blood incompatibility between mom and baby (such as rH or ABO incompatibility), certain genetic conditions, bleeding under the scalp or excessive bruising due to a difficult birth, race (studies show that babies of East Asian ancestry are at increased risk), infection, biliary artresia, enzyme deficiency, and issues with breastfeeding.
Yes, but don’t banish your boobs just yet. For reasons unknown, breastfeeding can increase a baby’s risk of developing jaundice. There are two ways this typically manifests.
Whether a baby can’t seem to latch or mom’s milk hasn’t come in yet, sometimes babies don’t get enough breastmilk in the first few days of life. This can lead to jaundice and is aptly called “breastfeeding jaundice.” In this scenario, it’s best to feed more often — and it’s always a good idea to consult a lactation consultant about any breastfeeding issues.
Another way breastfeeding leads to jaundice is known as breastmilk jaundice. In this scenario, the breastmilk actually prevents the liver from quickly removing bilirubin. It can take up to 12 weeks for the bilirubin levels to slowly improve in this scenario, which usually presents after the first week of life.
It goes without saying, though, that the rewards of breastfeeding far outweigh these risks.
What are the symptoms?
Fortunately, newborn jaundice is one of those conditions that doesn’t try to hide, making it relatively easy to diagnose. Weight loss, excessive fussiness, extreme lethargy, and poor feeding can all be associated with newborn jaundice. But a telltale yellow tinge of the skin and the whites of baby’s eyes usually gives it away. One can tell the extent of jaundice as the yellow tinge to the skin spreads from the baby’s face, to the chest and back, then the legs, and finally until the baby’s skin is entirely that hue. A baby with jaundice will often sleep longer as they are experiencing lethargy.
This can be slightly trickier to see in darker-skinned babies, but there’s a hack for that. Gently press on your baby’s forehead or nose — if the skin looks yellow where you pressed, your little one likely has a mild case of jaundice. If the skin color looks slightly lighter (not yellowish) and returns to its normal color momentarily, your baby probably doesn’t have jaundice.
Additionally, a baby with jaundice will often have urine that is light yellow in color and the poop will have a mustard yellow hue, or darker.
Of course, you aren’t Dr. Quinn, Medicine Woman. If you suspect your newborn has jaundice and wasn’t diagnosed before you left the hospital, get the doctor or a nurse practitioner on the phone ASAP to run your worries by them.
Is jaundice dangerous for babies?
Luckily, jaundice normally dissipates on its own. Not coincidentally, this often takes place around two weeks old once baby’s liver has had a chance to further mature. However, in rare cases, extremely elevated levels of bilirubin can put baby at risk of developing far more serious complications. Once bilirubin levels reach limits exceeding 25mg in babies, it can lead to cerebral palsy, deafness, acute bilirubin encephalopathy, kernicterus, and other brain damage.
How is newborn jaundice treated?
You obviously want to know the fastest way to cure jaundice in your baby, right? And wondering if you can treat your baby’s jaundice at home? Even though physiologic jaundice usually improves on its own as baby’s liver matures, it’s best to have baby checked out by the doctor. If the jaundice spreads to your little one’s chest or abdomen, their pediatrician will need to do a simple blood test to determine baby’s bilirubin levels.
Bilirubin levels high enough to warrant treatment are usually discovered in the days immediately following birth. Several factors go into the type of treatment your baby will receive, but there are a few standard options. If loss of fluids (often from poor feeding) is causing baby’s bilirubin level to spike, they may receive fluids. The most common treatment for moderate jaundice, though, is phototherapy.
In phototherapy, your baby will be placed on a specialized bed under a blue spectrum light — usually clothed in as little as possible, like a diaper, and special protective goggles. The light alters the bilirubin into a form that can be broken down by the liver and excreted in the stools more easily. Phototherapy treatment for moderate jaundice typically takes place in the hospital.
If it’s determined your baby’s case is mild enough, the doctor may send you home with a “BiliBlanket.” This portable phototherapy device allows you to treat baby at home while monitoring their bilirubin levels.
Unfortunately, if your baby’s jaundice is deemed very severe, intravenous immunoglobin (IVIg) or an exchange transfusion may be necessary. During the latter, baby receives small amounts of blood from a donor or blood bank. This blood effectively replaces baby’s damaged blood with healthy red blood cells.
Can newborn jaundice be prevented?
Sadly, not really. There are things you can do to be better prepared, though. After birth, you can have baby blood-typed to rule out the possibility of blood type incompatibility. This will either tell you that (a) your baby isn’t at greater risk for jaundice on that front or (b) your baby is at greater risk on that front and you should keep a watchful eye. Which, let’s be real, you’re doing already. Everyone knows that new moms master the art of not blinking while crib-stalking their tiny human all night long. Also good to know? The American Academy of Pediatrics suggests frequent feedings to help pass any excess bilirubin.