Jaundice may sound dire, like a jungle malady straight out of the classic novel Heart of Darkness. But it's no reason to panic. It's a common enough condition among otherwise healthy babies, isn't painful, and typically corrects itself without a problem. In fact, more than half of all full-term infants and four out of five premature babies develop the condition.

If your newborn's skin takes on a yellowish tinge two or three days after he's born, he may just have an everyday case of baby jaundice.

Jaundice commonly affects newborns because of excess bilirubin in their bodies. Bilirubin is a molecule produced during the body’s normal process of breaking down old red blood cells. But in most cases of jaundice, the newborn's immature liver cannot efficiently metabolize the bilirubin, so the substance builds up in his body. Because their livers are not fully developed, premature babies are even more likely to get jaundice.

Women whose blood types are different from their babies' are also more likely to have a jaundiced infant. And if your baby is not producing enough urine or feces in her first few days, bilirubin may build up.

This type of jaundice is also called "physiologic jaundice," because it is part of normal body function. Infant jaundice won't hurt your baby, and it should disappear in a week or two as her system matures and the number of red blood cells levels off. However, your baby's doctor should be aware of the condition, because lasting jaundice can lead to severe complications. That's why many newborns are re-examined by a doctor or nurse three to five days after birth, a time when bilirubin levels are at their highest.

You may notice that her skin, the inside of her mouth, or the whites of her eyes are yellow. If you suspect that your newborn has jaundice, bring her to a sunny room and look at her in natural light. Touch her lightly on the forehead, and if the area you touch shows yellow, she likely has jaundice. Jaundice shows up on the face first, and the more jaundice, the farther the yellow tint spreads down the body. If the jaundice has spread below the belly button or down to the groin, your doctor or nurse may want to order a bilirubin blood test.

Some babies will also show signs of fatigue, but this may be hard to detect since newborns spend so much time sleeping anyway. Jaundice may be harder to detect in babies with darker skin.

Certain other factors increase the likelihood that a baby will develop jaundice:

•Prematurity. The more premature a baby is, the greater the risk he will develop jaundice, simply because his system is less developed. Premature babies are also more susceptible to jaundice because they tend to feed less and consequently have fewer bowel movements, which help the body eliminate bilirubin.

•Race and gender. Boys are more likely to develop jaundice than are girls. Asian and Native American infants are also more susceptible to the condition than children of other ethnic backgrounds.

•Bruising. If your infant is bruised during childbirth, he is more apt to develop jaundice, because he will have more blood cells for his system to break down as a result of the bruising.

•Blood Type. If you and your infant have different blood types, this can increase your baby's risk of developing jaundice after birth.

•Breastfeeding. A breastfed baby is more likely to develop jaundice than a bottle-fed one, although no one is completely sure why. Physicians believe that some element in breast milk may be the cause. Breastfed babies also tend to consume less in the first few days of life as baby and mother adjust to the process. This lower consumption results in slower elimination of bilirubin from the body. Jaundice also seems to last slightly longer in breastfed infants.

This does not mean you should stop breastfeeding your baby if he has jaundice. Experts say that the risk of developing jaundice does NOT outweigh the benefits of breastfeeding. If babies do develop jaundice, doctors often suggest supplementing the infants' diet with formula for a couple days as mothers continue breastfeeding.

If you suspect that your infant has jaundice, let his or her doctor know immediately. The doctor will want to determine how severe the case is. If the condition is mild, then the doctor is likely to monitor the condition and not attempt treatment.

Some doctors recommend that breastfeeding mothers use formula for several days -- in addition to breast milk -- when a newborn has jaundice, to more quickly eliminate bilirubin from the infant's body. You may be able to feed your baby a couple of ounces of formula after each breastfeeding to be sure that she is getting enough fluids to eliminate waste. Meanwhile you can use a breast pump to encourage continued milk production. If you are have questions about how bottle feeding may affect your nursing, talk to a lactation specialist before introducing formula and a bottle.

If your baby has a mild case of jaundice, instead of turning to a bottle, try to step up the number of feeding times each day. This may mean waking her and struggling to interest her in eating when she'd rather be dozing. But it's worth the effort, and more feedings will help eliminate the bilirubin more quickly from her system.

If the doctor believes treatment is necessary, your newborn will undergo blood tests and phototherapy, a treatment in which infants are exposed to special ultraviolet lights for one or two days. In extremely rare cases, if the jaundice is very serious, a baby may receive a blood transfusion.

If your baby is premature, you should be particularly vigilant for signs that the jaundice is worsening and call your doctor immediately. In serious cases, the skin grows more and more yellow, and the color persists for more than a week or two. Jaundice in the arms and legs, failure to gain weight, or running a fever of more than 100 degrees F are all good reasons to call the doctor.

Very severe jaundice can trigger a condition called "kernicterus," which is uncommon but extremely dangerous. In kernicterus, bilirubin levels are so high that they can result in brain damage, vision and tooth problems, cerebral palsy, hearing loss, and other developmental delays. In cases of severe jaundice, the skin becomes deep yellow, even orange. Other symptoms include weakness, extreme sleepiness, and a high-pitched cry.

In rare cases, infant jaundice that lasts two or more weeks may be caused by a more serious physical problem. Possibilities include liver problems, severe infection, blood abnormalities, or an enzyme deficiency. Although it's unlikely that your baby has these conditions, your doctor will at least be able to rule them out.

-- Connie Matthiessen is a former staff writer for the Center for Investigative Reporting who has written widely on health and medical issues.

References

First published August 22, 2005
Copyright © 2005 Consumer Health Interactive

Find more on:

Back to top of page