Newborns Common Problems Jaundice

Jaundice is a yellowing of the skin and the whites of the eyes often see in newborns during the first week after birth. Although the signs of jaundice are alarming, the condition itself is not usually cause for alarm. However, in rare circumstances, jaundice symptoms indicate a serious underlying disease. As a result, any signs of jaundice should be carefully monitored by a doctor.

Jaundice Causes

Jaundice is not a disease itself. Instead, signs of jaundice indicate excessive amounts of bilirubin in a newborn’s bloodstream. Bilirubin is an iron byproduct produced by the destruction of red blood cells. The liver normally removes bilirubin from the blood.

A number of factors can produce the symptoms of jaundice in newborns. The baby’s liver may not be mature enough to remove all bilirubin from the blood, or there may be more bilirubin in the blood than the liver can process. A baby may also experience jaundice if he naturally reabsorbs bilirubin from the intestines faster than he excretes it.

Types of Jaundice

Most newborn jaundice signs result from an immature liver. Doctors refer to this type of jaundice as normal (or physiological) jaundice. Physiological jaundice signs are very common, affecting up to 60 percent of newborns. In general, the symptoms of jaundice appear between two and four days after birth. They diminish as the liver continues to mature, disappearing entirely within one to two weeks after birth.

Physiological jaundice is very common in premature babies, as their livers are not as well developed as babies that have been carried to term. This condition is known simply as jaundice of prematurity.

Breast milk jaundice is a much rarer form of jaundice that occurs in, at most, 2 percent of breastfeed babies. Although the exact cause of breast milk jaundice is unknown, a substance in breast milk results in high bilirubin levels (more than 20 mg of bilirubin is considered high). Signs of this type of jaundice tend to appear within four to seven days after birth. They can last as long as 3 to 10 weeks.

The most serious jaundice cases are those that develop within 24 hours of birth. Rh incompatibility occurs when the mother’s blood type is Rh negative and the baby’s is Rh positive. In these circumstances, the mother’s immune system produces antibodies that destroy the baby’s red blood cells, resulting in excessive bilirubin and signs of severe jaundice.

Other factors that cause signs of jaundice within 24 hours of birth include:

  • gallbladder disorders
  • infection
  • intestinal disorders
  • liver disorders
  • premature birth earlier than 28 weeks of gestation
  • trauma.

Signs of Jaundice

Yellowing of the skin and the eyes are the most common signs of jaundice. In general, the symptoms of jaundice first develop on the face. As jaundice symptoms progress, the chest and stomach may yellow. Severe jaundice can result in a yellowing of the arms and legs as well.

Jaundice Treatment

Because jaundice usually clears up on its own as the baby grows, jaundice treatment is typically simple. In fact, mild to moderate signs of jaundice don’t usually require treatment. Instead, doctors will monitor this condition as the newborn baby grows and jaundice resolves itself.

If treatment is required, increasing breastfeeding or formula feedings is often recommended. Frequent feedings increase the baby’s bowel movements, allowing the body to pass more bilirubin.

If the signs of jaundice result from breast milk, treatment usually requires that the mother stop breastfeeding until bilirubin levels drop. During this time, the mother can use a breast pump to express milk so she will be able to restart breastfeeding after the jaundice clears up.

For more serious cases of jaundice, phototherapy treatment may be necessary. In phototherapy, the baby is placed under a special bililight, an ultraviolet light that helps break down bilirubin so the baby can excrete it. Alternatively, treatment for jaundice may require the bili-blanket. This blanket, made from fiber optics that produce ultraviolet light, can be wrapped around the baby to help reduce his levels of bilirubin.

When jaundice is caused by Rh incompatibility, treatment may require a blood transfer known as an exchange transfusion, in which the baby’s blood is exchanged for donor blood.

Jaundice Complications

Although signs of jaundice rarely indicate health problems, get your baby checked out if he starts displaying symptoms of this condition. Your doctor can inform you if other, more serious underlying conditions are causing your baby’s jaundice.

Seek medical attention if your baby exhibits any of these symptoms in combination with jaundice:

  • a fever of 100°F
  • insufficient weight gain
  • jaundice that affects the arms or legs
  • jaundice that persists after 15 days of age
  • jaundice that takes on a darker color
  • signs of jaundice within 24 hours of birth.

If you have any concerns about jaundice symptoms, contact your doctor. Even if jaundice signs are no cause for alarm, visiting your doctor will give you peace of mind.

Resources

Baby Center (updated January 2005). Jaundice. Retrieved February 2, 2008, from the Baby Center Web site.

Mark, J. (Updated 24 February 2005). Jaundice. Retrieved February 2, 2008, from the MedicineNet Web site.

Nemours Foundation (updated April 2005). Jaundice in Healthy Newborns. Retrieved February 2, 2008, from the Nemours Foundation Web site.