Jaundice

A small amount of jaundice, or yellow color of the skin and eyes, is common in many full-term babies. It is even more common in premature babies. If jaundice occurs, it usually appears in the first three to five days of life and disappears by the end of two weeks without treatment.

Before your baby is discharged home from the hospital he/she will be screened for his/her risk of jaundice and the need for additional testing and/or early follow-up. If your baby goes home sooner than 72 hours after birth you will need to continue to monitor the baby's skin color at home every day. In addition, your infant should see a doctor or nurse within one to three days after going home.

Jaundice can be harmful if the bilirubin level in the baby’s blood is too high. Extremely high levels can harm the brain and cause hearing loss.

How to check for jaundice:

• Undress your baby and place him/her on a white sheet or blanket.
• Gently press on your baby’s nose, then chest and then leg. Note if there is a yellow color to the skin when you release your finger.
• Check inside of your baby’s mouth and whites of eyes for a yellow tinge.

Call your baby’s healthcare provider immediately if your baby is:

• If you note any yellow color to the skin after you gently press on the baby's nose, chest, or leg. The yellow color may range from lemon yellow to orange yellow.
• Very sleepy and does not wake up for feedings or skips two or more feedings
• Very fussy and does not eat or sleep
• Limp or floppy
• Seems still, especially arms or legs
• Screeching or has high pitched cry

Causes of Jaundice

Most jaundice occurs when a baby is born with more red blood cells than needed. When the blood cells break down, they release a yellow substance called bilirubin, which is eliminated from the baby’s blood through the liver. Most newborn’s livers are not developed enough to handle this, and bilirubin builds up in the baby’s bloodstream. This causes the skin and whites of the eyes to turn yellow. Call your baby’s healthcare provider if you notice your a baby’s skin or the whites of the eyes turning yellow after leaving the hospital or if you have questions.

Conditions that increase the likelihood of jaundice include:

• Not being fed often or long enough.
• Prematurity (babies born two weeks or more before their due date)
• Blood type incompatibility (When baby’s blood type is different from mother’s.)
• Bruising to the baby during birth

Bilirubin is measured by taking a small blood sample or sometimes by using a special device pressed against the skin.

If the bilirubin level is slightly high, treatment may include:

• Frequent breastfeedings or formula feedings (not water) to help eliminate the bilirubin.
• In some cases, you may need to supplement (add to) breastfeeding. If so, your expressed breast milk is a better choice than formula. Water is not recommended. Supplementation is usually short term. To protect your milk supply, it is important to nurse and/or pump your breasts 8-12 times in a 24 hour period.
• Phototherapy (exposing the baby’s skin to a special light source) to help break down the bilirubin. This may be done in the hospital, but can also be done in your home.

The best way to prevent jaundice is to follow the instructions from your baby’s healthcare provider about how often to feed and/or how much fluid to give your baby during the first few days of life.