After months of waiting, your baby has finally arrived. As you navigate the excitement of these first few days, you’re probably paying close attention to the many ways you’re already growing and the advice your doctor has given you at the hospital and during well-baby checkups. During this time, changes in the texture or color of your baby’s skin are common. But if you’ve noticed a yellow tint to the skin, your child may have jaundice and you’re wondering what this means for your baby’s health.
Jaundice is a condition that adds a yellowish color to the skin and the whites of the eyes. According to the American Academy of Pediatrics, about 80% of newborns will have jaundice to some degree, and some research indicates that jaundice is more likely to affect babies who are born prematurely or who have other risk factors.
Most of the time, jaundice is mild and improves on its own within a few weeks. However, babies with jaundice should be evaluated and their symptoms monitored in case treatment is necessary. Read on to learn what jaundice is, what causes it, the symptoms to look out for, and what the treatment is like.
Jaundice in newborns is caused by the buildup of a substance called bilirubin.
Jaundice in babies, also known as neonatal jaundice or hyperbilirubinemia, is caused by a buildup of bilirubin, a substance created during the natural breakdown of red blood cells. It is processed in the liver and leaves the body during bowel movements.
Before a baby is born, the placenta processes bilirubin. But after birth, many newborns cannot completely eliminate excess bilirubin on their own and often need time to adjust to the amount of bilirubin they have to process. This is known as physiological jaundice and most cases improve within the first week or two. During this time, the baby will be closely monitored. If bilirubin levels do not go down, a doctor may recommend treatments to help them recover.
Jaundice can also be caused by an underlying health condition such as an infection, difficulty with digestion, or a blood type discrepancy. This is called pathological jaundice. Jaundice caused by an underlying health condition will usually improve once the underlying cause is treated.
Possible causes of pathological childhood jaundice.
Pathological jaundice can be caused by health conditions that affect the baby’s red blood cells, liver, metabolism, or growth. These causes include:
- Blood type mismatch – If a baby and his mother have different blood types, the baby’s red blood cells may break down faster.
- Blood cell conditions – Conditions such as sickle cell anemia and G6PD enzyme deficiency can affect the way red blood cells form and function.
- Infections – Various viral and bacterial infections can affect your baby’s blood or liver. Examples include hepatitis, sepsis, and urinary tract infections.
- internal bleeding – If something causes bleeding inside a baby’s body, there may be an increase in bilirubin as the blood is reabsorbed.
- Hormonal disorders – Conditions such as hypothyroidism (an underactive thyroid) or hypopituitarism (and an underactive pituitary gland) can prevent your baby’s body from growing as it should.
- Genetic conditions – Some inherited conditions can contribute to jaundice. Examples include Gilbert syndrome, which affects the way the liver processes bilirubin; Alagille syndrome, which interferes with the removal of waste from the liver; and galactosemia, which causes systemic problems and feeding difficulties.
- liver problems – Conditions such as cystic fibrosis, biliary atresia (a blockage in the bile ducts), and bile duct cysts can affect liver function and its ability to remove waste.
Other risk factors for jaundice in babies
In addition to health conditions, there are certain risk factors that can make a newborn more likely to develop jaundice:
- bruises which can occur during childbirth, creates additional bilirubin as the injured area heals.
- premature birth It means that a baby’s liver may be less developed than if born full term and cannot process as much bilirubin.
- Difficulty breastfeeding such as difficulties latching on, can mean that your baby is not eating as much as he or she could. This can lead to fewer bowel movements, which leaves more bilirubin in the body.
How to identify the symptoms of jaundice in a baby
Physiological jaundice usually appears around 24 hours after birth. It usually gets worse for a few days before getting better over the course of a few weeks. Pathological jaundice may appear within 24 hours of birth and continue or worsen until the underlying cause is treated. Your baby’s care team will perform a jaundice test by measuring your bilirubin levels before taking your baby home.
The telltale yellow discoloration of jaundice usually appears on the face before spreading to the chest, abdomen, extremities, and eyes. If your baby’s bilirubin levels are particularly high, he or she may have additional symptoms. Call your baby’s doctor if:
- Your skin looks very yellow or orange.
- Their stomach, limbs or the whites of their eyes are yellow.
- They are very sleepy or seem fatigued.
- They have problems feeding
- They are in a bad mood or irritable.
- Their stools are light gray, beige or white.
Call 911 or take your baby to a hospital if:
- Your baby cries inconsolably or at a high pitch
- They arch their back or neck backwards.
- Your body is stiff or limp.
- They move their eyes in strange ways.
How do doctors diagnose neonatal jaundice?
Your baby’s doctor will test your baby for jaundice before you leave the hospital and again as needed over the next few days. A doctor can usually identify jaundice by its symptoms during a physical exam, but will still need to confirm your baby’s bilirubin levels.
They may do this with a blood test and a skin test, in which a special light is used to look at your baby’s skin. Additional blood, urine, and other tests may be required if the doctor suspects that an underlying condition is causing your baby’s jaundice.
The main goal of jaundice treatment is to reduce bilirubin.
If your baby’s bilirubin levels don’t seem to improve on their own, your doctor will prescribe a treatment plan. As a starting point, you may be told to feed your baby more frequently so that your baby has more bowel movements and can expel more bilirubin.
If additional treatments are needed, your doctor will likely prescribe phototherapy. This treatment uses a special blue light that makes it easier for your baby’s body to process and eliminate bilirubin. Your baby will lie under a set of lamps or a light-covered blanket so his or her skin can absorb the light.
Other treatments will depend on the severity of your baby’s jaundice and whether it has an underlying cause. In extremely rare cases where other treatments do not work, the baby may need an exchange transfusion. This involves repeatedly replacing small amounts of blood with donor blood to reduce the overall level of bilirubin in your body.
If you suspect your baby has jaundice, talk to your baby’s doctor.
If your baby has jaundice, try not to worry too much; It is very likely that it will go away on its own. But stay in touch with your baby’s care team and follow their instructions in case treatment is necessary. If left untreated, jaundice could have serious health risks. So if you notice changes in your baby’s skin color or behavior, make an appointment with your doctor to make sure your baby gets the care he or she needs.
