What is Jaundice?

Some newborns have a yellow tint to their skin and the whites of their eyes just after they are born. Jaundice in infants, also called hyperbilirubinemia, is common and can be remedied quickly in most cases.

Jaundice in newborns usually occurs within the first couple of days after birth when an excess of bilirubin, the yellow pigment in red blood cells, builds up in the newborn’s bloodstream giving a yellow appearance to the skin and eyes.

What Causes Jaundice In Newborns?

There are two categories of causes for jaundice in newborns: normal newborn conditions and an underlying disorder.

The liver is responsible for filtering out bilirubin, and newborns make more bilirubin in the first days after birth due to more production and faster breakdown of red blood cells in infants. That excessive production of red blood cells coupled with an immature liver leads to the higher levels of bilirubin in a newborn, giving them the yellow color that is referred to as jaundice.

Levels of bilirubin are measured by taking a blood sample and plotting the amount of bilirubin and the age of the newborn on a graph with percentiles, similar to height and weight charts for children.

Occasionally jaundice is caused by a condition or disease. Some of the most common disorders that cause jaundice include:

• Internal bleeding
• Infection of the newborns blood
• Liver issues
• Enzyme deficiency
• Prematurity
• Incompatibility between mother and baby blood types
• Abnormality in the breakdown of red blood cells

Symptoms of Jaundice

The typical signs of jaundice are not the only ones to consider. Your baby may also have jaundice if she or he is:

• Sick or lethargic
• Has yellow skin and whites of the eyes
• Slow to gain weight
• Has trouble feeding/nursing

Jaundice symptoms begin in the first few days after birth and can appear after you leave the hospital and are at home, so it is important to know the signs of jaundice. A newborn check with a pediatrician is scheduled within the first week after birth to check for signs of jaundice.

How to Treat Jaundice in Newborns

There are a couple treatments for jaundice, which can be performed in the hospital, at home, or both. These treatments include:

• Light Therapy (Phototherapy): Your baby will be placed under a lamp, or lay on a pad with lights, that emit a blue-green color that change the shape and structure of the bilirubin molecules so they can easily be excreted through the urine and stool. To increase the surface area of skin that absorbs the light, your baby will wear only a diaper and protective eyewear when receiving light therapy.
• Intravenous Immunoglobulin (IVIg): When mother and baby have different blood types, the baby can carry antibodies from the mother’s blood, which causes red blood cells in the baby to burst with more frequency and release excess bilirubin. A blood protein can be administered to the baby intravenously to lower the levels of antibodies to decrease the levels of bilirubin in the newborn.
• Exchange Transfusion: In severe cases of jaundice, a newborn will visit an intensive care unit to receive an exchange of blood. Small amounts of blood are drawn from the newborn and replaced with donor blood to dilute the amount of antibodies in the blood quickly.

In addition to the therapies above, you can also help lower the amount of bilirubin by encouraging more feedings to flush out the bilirubin quickly through urine and stool. Since the body only makes a certain amount of breast milk in the first few days after birth, supplementing with formula may be necessary. Sunlight is also helpful in filtering out bilirubin, so placing your newborn by a window (not in direct sunlight) can also help lower bilirubin.

Jaundice Complications

If left untreated, certain serious complications can occur from jaundice.

Bilirubin is toxic for brain cells and, if left untreated, can lead to a condition called acute bilirubin encephalopathy, which can damage the brain. Fast treatment of jaundice can reduce the risk of developing acute bilirubin encephalopathy.

Kernicterus is the syndrome caused when a newborn develops acute bilirubin encephalopathy and causes permanent damage to the brain. Kernicterus may result in the following:

• Hearing loss
• Cerebral palsy
• Permanent upward gaze
• Improper development of tooth enamel