Jaundice is common. Sixty percent of newborn babies become a little jaundiced towards the end of their first week. This increases to eighty percent of babies born before 37 weeks. Most babies do not require special treatment and it generally goes away by itself within a couple of weeks
What are the signs of jaundice?
You can tell your baby has jaundice as their skin and sometimes the whites of their eyes become a yellowish colour. The yellowing usually starts on the head and face and spreads to the chest and stomach. You might notice yellow palms and soles of the feet, or inside the mouth. Sometimes their urine will be darker and their poos will be paler than normal. A newborn with jaundice may also be sleepy and not want to feed, or not feed as well as usual.
Your baby will be checked for jaundice as part of their newborn physical examination. However, if you are already at home it is important to contact your midwife straight away if your baby’s symptoms become worse or if they become very reluctant to feed.
What causes jaundice?
Baby’s body is breaking down the extra red blood cells that are no longer required, and the liver creates a yellow bi-product called bilirubin. Most babies overcome this jaundice without special treatment, and there is some suggestion that it actually has a protective effect against baby developing sepsis. Jaundice tends to go by 10-14 days as the liver gets better at its job.
How is jaundice treated?
For most babies, no special treatment is necessary. As with all newborns, it helps if they have frequent feeds. It could be sensible to wake your baby if necessary to feed so that they have milk at least every 3 hours until they are better. Expose your baby to some sunshine if possible.
Unfortunately, some babies develop jaundice more quickly or more seriously than normal. About five percent get jaundiced to a degree where they do need treatment, because of the small risk of the bilirubin passing into the baby’s brain and causing damage. Midwives can test for jaundice with a heel prick blood test, or a hand held monitor that is placed against the baby’s skin. If your baby is above the threshold for treatment, they will most likely be given a feeding regime where you feed at specific times and top up with formula if necessary. They will also be given phototherapy, where they are put under a special light in their cot, a little like a tanning lamp, and will wear soft pads over their eyes to protect them. Some may be wrapped in a more portable biliblanket, that does the same job but allows more cuddles. They will be checked at regular intervals until their bilirubin levels have gone below the treatment “line.”
Rarely, a baby will require an exchange transfusion, where your baby’s blood is removed using a thin tube placed in their blood vessels and replaced with blood from a matching donor.
Most babies respond well to treatment and can leave hospital after a few days.
Sometimes jaundice can be caused by another health problem. This is pathological jaundice. Causes of pathological jaundice include hypothyroidism, blood group incompatibility or rhesus factor disease, urinary tract infection, or blockage in the bile ducts of gallbladder. In the unlikely case that any of these apply to your baby, your medical team will be able to tell you more.