A health condition in which the skin and eyes become yellow in newborn babies is called jaundice. It often occurs due to a buildup of bilirubin in the baby’s blood. In this case, the baby’s liver is not developed enough to get rid of bilirubin. In general, this condition is common and usually disappears on its own. In rare cases, babies may need treatment with phototherapy.
The medical term for this condition is hyperbilirubinemia. Typically, bilirubin is a substance that the body makes when red blood cells break down. During pregnancy, the mother’s liver removes bilirubin for her baby, but after birth, the baby’s liver must begin to remove this substance. While it goes away on its own, severe forms of jaundice may cause brain damage.
Jaundice in newborns is a very common condition, and it affects about 60% of full-term babies and 80% of premature babies.
Types of Jaundice in Newborns
Healthcare providers have divided this condition into 3 categories. These include:
- Physiological jaundice – It happens by the second or third day of life, and it is the most common type of jaundice in newborns. When the baby’s liver develops, it begins to remove excess bilirubin, and this condition disappears. Most of the time, it takes 1-2 weeks.
- Breastfeeding jaundice – This type mostly happens in breastfed babies more than formula-fed babies. Usually, this type appears during the baby’s first week of life, and the baby does not get enough breast milk. Moreover, it often takes a longer time to go away.
- Breast milk jaundice – In this case, certain substances in the breast milk may negatively affect the baby’s liver’s ability to break down bilirubin. Usually, it takes about 30 days or even more to disappear.
In rare cases, babies may develop other types of jaundice, especially if they have an unrelated medical condition.
What Are The Symptoms of Jaundice in Newborns?
One of the primary symptoms of this condition is yellowing of the baby’s skin. Mostly, it can be noticed in natural lighting (such as in front of a window). While it usually appears in the baby’s face first, it may also affect the baby’s eyes and tongue. If bilirubin levels increase, jaundice may spread to the baby’s chest, arms, and legs. Usually, it is difficult to notice yellowing of the skin in babies with a darker skin tone.
Causes
This condition occurs in newborns when the liver is not developed enough to remove bilirubin. It is a substance that appears when red blood cells break down. After the liver removes this substance, it leaves the body through stools. However, if the liver does not remove bilirubin, it begins to build up, causing the skin to turn yellow. When a baby develops severe jaundice, it happens due to other causes. Check some of them below:
- Sepsis (a blood infection)
- Increased levels of red blood cells
- Hypoxia (reduced oxygen levels in the blood)
- Bruising from a difficult birth
- Liver conditions (including biliary atresia)
What Happens if Jaundice in Newborns is Left Untreated?
If a baby develops severe jaundice, it may lead to serious complications without treatment. Check some examples below:
- Acute bilirubin encephalopathy
- Brain damage – This complication can be reversed when it is caught in the early stages.
- Kernicterus – This is permanent brain damage caused by high levels of bilirubin.
- Cerebral palsy – In this case, the baby has uncontrolled body movements and tight muscles.
- Hearing loss (also known as deafness)
- Problems with vision and teeth – Some children may have problems with moving their eyes up and down or tooth enamel.
This article does not contain a full list of complications. However, you can talk with your doctor about measures to reduce the risk or even prevent those listed above.
How to Prevent Jaundice in Newborns?
There is no way to prevent this condition, but it is normal among newborns. However, it is important to prevent a severe form of jaundice by feeding them frequently. It helps stimulate their bowel movements, which often help them get rid of excess bilirubin from the body.
Usually, you should breastfeed your baby 8 to 12 times per day during the first week of life. Sometimes, the milk does not come right after birth, and you should give your baby 1-2 ounces (30 to 60 milliliters) of formula every 2-3 hours during the same period. Doctors should also check bilirubin levels regularly before you leave the hospital.
Diagnosis
Doctors will check for jaundice symptoms in your baby while you are in the hospital. Usually, the levels of bilirubin are high in the first 5 days of life. However, it is very important to check your baby’s bilirubin levels again within this period. To check your baby’s bilirubin level, doctors will perform a blood test. Typically, doctors use the American Academy of Pediatrics jaundice level chart to determine whether the baby needs treatment. This chart is based on total serum bilirubin (TSB) level and age. For example:
- Above 10 milligrams of bilirubin in the first 24 hours of life
- 15 milligrams between 24 and 48 hours of life
- 18 milligrams of bilirubin between 49 and 72 hours of life
- After 72 hours of life, the bilirubin level is above 20 milligrams
Treatment
Not every baby who has jaundice needs treatment. Mild forms of this condition disappear on their own when the baby’s liver begins to develop. It often takes 1-2 weeks, but you should breastfeed the baby about 10 to 12 times per day. When bilirubin levels continue to increase, doctors may recommend phototherapy. It involves placing the baby under special blue lights that help remove excess bilirubin. When the bilirubin levels decrease, you can continue treatment at home with light therapy. Sometimes, phototherapy may not work, and doctors may recommend an exchange transfusion.
When Should I Go To The ER?
Immediately call 911 or go to the nearest emergency room (ER) if you notice any of the following symptoms. These include a high-pitched cry, fever, stiff body, or arched body.
Frequently Asked Questions
Is jaundice common in newborns?
Yes, jaundice is very common in newborns, especially during the first few days after birth. It occurs because a newborn’s liver may not yet be mature enough to remove bilirubin efficiently. Most cases are mild and improve as the baby’s liver develops.
How can I tell if my newborn has jaundice?
The most noticeable sign is yellowing of the skin or the whites of the eyes. Jaundice often starts on the face and may spread to the chest, abdomen, arms, and legs as bilirubin levels increase. Yellowing may be harder to see in babies with darker skin, so healthcare providers may use a bilirubin test to check the level.
How long does newborn jaundice usually last?
Most newborn jaundice improves within one to two weeks. Breast milk jaundice can last longer and may continue for several weeks even in healthy babies. Persistent or worsening jaundice should be evaluated by a healthcare provider.
Can breastfeeding cause jaundice in newborns?
Breastfeeding itself does not usually cause harmful jaundice. However, jaundice can occur when a newborn does not receive enough breast milk during the first days of life, which can reduce bowel movements and slow the removal of bilirubin. Frequent feeding and help from a lactation professional can support adequate milk intake.
Can newborn jaundice go away on its own?
Most mild cases resolve without medical treatment as the newborn’s liver becomes better at processing bilirubin. However, babies with high or rapidly increasing bilirubin levels may need treatment to prevent complications.
How is jaundice in newborns treated?
Treatment depends on the baby’s bilirubin level, age in hours, gestational age, and other risk factors. Some babies only need frequent feeding and monitoring. Others may need phototherapy, which uses special blue light to help the body eliminate bilirubin. Severe cases may require an exchange transfusion.
Can newborn jaundice cause brain damage?
Severe, untreated jaundice can cause bilirubin to enter brain tissue and result in acute bilirubin encephalopathy. In very severe cases, this can lead to kernicterus, a form of permanent brain injury. Prompt monitoring and treatment greatly reduce the risk of these complications.
When should I call a doctor about my baby’s jaundice?
Contact your baby’s healthcare provider if the yellowing becomes more noticeable, spreads to the abdomen, arms, or legs, becomes darker, or does not improve. You should also seek medical advice if your baby is feeding poorly, is difficult to wake, has fewer wet diapers than expected, or appears unusually sleepy.
Is jaundice in newborns an emergency?
Most newborn jaundice is not an emergency, but severe jaundice can become dangerous. Seek emergency medical care if a jaundiced baby has a high-pitched cry, fever, unusual stiffness or limpness, seizures, difficulty waking, or an arched back or body. These symptoms may indicate severe bilirubin-related complications.
Can newborn jaundice be prevented?
Newborn jaundice cannot always be prevented because it is a normal response to the changes that occur after birth. However, adequate feeding can help reduce the risk of bilirubin becoming excessively high. Newborns should also receive recommended bilirubin screening and follow-up after leaving the hospital. Ask your healthcare professional if you have any other questions.
