Jaundice baby and treatment: What you need to know

Is your newborn a yellow skin baby or yellow eyes baby?

Soon after your little one is born, his health will be monitored quite closely by doctors and nurses at the hospital. One fairly common condition they look out for is jaundice.

What can you read in this article? 

• What is Jaundice baby?
• Newborn Jaundice level
• Yellow skin baby: Jaundice baby treatment

Jaundice is quite normal in most newborns (occurring 2-3 days after birth), and only if it goes above the ‘normal’ range will medical staff intervene.

This condition is more common among babies who are breastfed, and lasts a bit longer too among them too, say medical experts.

What is jaundice baby?

Jaundice is a yellowing of the skin and/or whites of the eyes, that is caused by higher bilirubin levels in a newborn’s blood.

It is most obvious when you lightly press on a newborn’s skin to drain away from the red color, and when you lift your finger, the yellowish tinge of the skin becomes clear.

Bilirubin is a yellowish substance the body produces when it replaces old red blood cells.

Newborn jaundice level

When your baby is still in your womb, your placenta removes bilirubin from your little one’s body. However, after birth, your baby’s liver takes overdoing this job — and it may take some time for it to do this properly.

Jaundice baby poop

Bilirubin is removed from the body through the stool after being filtered by the liver. This is a natural occurrence that occurs throughout life. However, babies can have a bilirubin accumulation in their bodies. It’s possible that your baby’s liver isn’t yet grown enough to filter out the bilirubin. 

Because of this, it is quite normal for a baby’s bilirubin level to be a bit high after birth, and it is this that causes jaundice. Once your little one is a bit bigger and the red blood cell amounts diminish, with this, jaundice usually subsides too, often 1-2 weeks after birth.

Usually, jaundice appears first on a newborn’s face, moving down the body to the chest, tummy, arms, and legs. This condition can be harder to detect in darker-skinned babies and is best seen in natural light.

If your doctor suspects your little one has jaundice, then he/she will check your baby’s bilirubin levels through a blood test, and recommend the best course of action accordingly.

What causes jaundice?

SingHealth presents the following causes of jaundice:

• Some babies develop jaundice because of the breakdown of blood due to bruising during birth, or superficial blood clots on their heads.

• When a baby’s blood group is different from his mother’s, the mother’s antibodies may attack the baby’s red blood cells, resulting in jaundice.

• Some babies have an inherited glucose-6-phosphate dehydrogenase (G6PD) deficiency that causes jaundice. G6PD is an enzyme in the body that helps red blood cells function normally.

• Occasionally, little ones develop jaundice because of an infection of the urinary system or blood.

• Jaundice lasting for more than two weeks could be due to an infection, abnormal bile ducts, or a metabolic disease.

• Prematurity (babies born between 34 to 36 weeks) can cause jaundice due to these babies’ less mature liver.

Do keep in mind that in many babies, the underlying cause for jaundice might not be found.

READ MORE:

Mom warns against dangers of home remedies for jaundice

What causes jaundice in newborn babies?

Premature baby problems: 14 Short-term and long-term health issues faced by premature babies

Types of jaundice

1. Physiologic Jaundice

This is the most common type of jaundice baby, affecting up to 60% of full-term babies in their first week of life, says the American Pregnancy Association (APA).

It is caused by elevated bilirubin levels, as explained earlier in this article.

2. Breastmilk jaundice

This is jaundice that lasts after physiologic jaundice subsides, and is seen in full-term, breastfed babies. According to the National University Children’s Medical Institute (Singapore), this type of jaundice typically occurs at 4 to 7 days of age and may last from 3 to 10 weeks.

While medical experts say there is no known cause for breastmilk jaundice, there are theories that it might be linked to a component of breastmilk that blocks the breakdown of bilirubin. This kind of jaundice tends to run in families.

Most newborns who have true breast milk jaundice (only 0.5% to 2.4% of all newborns) might experience another increase in their level of bilirubin at about day 14; however, these levels will gradually decline.

If your baby has breastmilk jaundice, please do not assume something is wrong with your milk and stop breastfeeding because of this. As long as your little one is nursing well and his bilirubin levels are monitored, serious complications are rare.

In the words of an internationally renowned pediatrician and lactation expert Dr. Jack Newman, “Do not stop breastfeeding for breastmilk jaundice.”

3. Breastfeeding jaundice (not-enough-breastmilk jaundice)

High levels of bilirubin or jaundice that linger on for longer than usual may occur when a baby is not getting enough breastmilk.

When a baby gets insufficient breastmilk, his bowel movements are less, causing the bilirubin that was in the gut to get reabsorbed into the bloodstream instead of leaving the body with the bowel movement, explains Dr. Newman.

This causes breastfeeding jaundice — this is not related to breastmilk jaundice.

The reasons for this type of jaundice to emerge are due to one or a combination of the following:

• an improper latch
• the mother’s milk taking longer than usual to “come in”
• when the baby is given other substitutes that interfere with breastfeeding
• limitation of breastfeeding due to hospital routines

Quite clearly, the best way to avoid breastfeeding jaundice is to get breastfeeding established well, and early. If a baby has this type of jaundice, increased feedings and help from a lactation consultant to ensure the baby is taking in enough milk will help resolve the condition quickly.

Up next: what should you do if your baby has breastmilk jaundice or breastfeeding jaundice? What can we do as jaundice baby treatment?

What to do about jaundice in the breastfed baby?

The APA recommends the following courses of action for breast milk jaundice and breastfeeding jaundice in the full-term, healthy infant if bilirubin levels are below 20 milligrams:

• Feedings should be increased to 8-12 times daily. This will result in more bowel movements, which will help get rid of the bilirubin.

• A lactation consultant should work with the mum to ensure her little one has a good latch. An improper latch can impact the amount of breastmilk a baby drinks.

• If supplementation is needed to increase the baby’s intake, then using a lactation aid to give expressed breast milk or a mixture of breast milk and formula is the best way to not interrupt the breastfeeding relationship. Again, a lactation consultant can help with this.

• It is very rare that you need to stop breastfeeding to treat your baby’s jaundice. However, if your baby’s bilirubin levels go above 20 milligrams, then it is usually recommended that breastfeeding be stopped for 24 hours, along with phototherapy (to be discussed later in the article). This usually results in a dramatic drop in bilirubin levels, and after 24 hours, you can start nursing again.

• If the above treatment is needed, it’s important that mums continue pumping to maintain their breastmilk supply. A lactation aid can be used to nourish the baby during this time.

• If phototherapy is needed, speak to your doctor about using fiber-optic blankets. You can take these home and continue breastfeeding uninterrupted.

Do NOT do the following jaundice baby treatment

• Supplementing with sugar water: This can make jaundice worse by interfering with breastfeeding and can also delay the reduction of bilirubin levels.
• Stop breastfeeding: This too can make jaundice worse and can hinder a mum’s effort to give her baby the best possible nutrition during his newborn days and beyond. Continuing breastfeeding is one of the best ways to decrease and eliminate jaundice.

Phototherapy or Bili lights: What is this?

When the need is determined by a doctor, Bili lights — a type of light therapy (phototherapy) — are used to treat newborn jaundice.

This therapy involves shining a blue fluorescent light on the baby’s bare skin. According to MedlinePlus, “a specific wavelength of light can break down bilirubin into a form that the body can get rid of through the urine and stools” — which is what phototherapy does.

If your baby has to undergo phototherapy, he’ll be placed under the lights wearing just a diaper and his eyes will be covered to protect them from the bright light. He will also be turned often for even distribution of the light on his skin.

During phototherapy, doctors and nurses will carefully monitor your baby’s progress by noting down his temperature, vital signs, and response to the lights.

Sometimes, the lights may contribute to dehydration; if this happens, fluids may be given intravenously during the treatment.

Your baby’s bilirubin levels will be monitored during phototherapy. Once they have dropped, the treatment is complete.

In the rare case that bilirubin levels rise very rapidly, a blood therapy exchange is conducted to lower these levels and prevent brain damage.

Myth-busting: jaundice baby

You may get advice from well-meaning acquaintances (including in-laws, nannies, maybe even your own mother!) about how to reduce jaundice.

Please note the following common ‘treatments’ are ineffective, according to NUH:

• Giving water or glucose feeds: this will not lower jaundice, and could even be harmful to your baby’s health.
• Exposure to sunlight:  Sunlight does not effectively reduce jaundice. In fact, exposing your newborn’s delicate skin to sunlight could cause sunburn and dehydration.

Jaundice in babies when to worry: signs to look out for

Jaundice usually emerges on the 2nd or 3rd day since your baby is born. Mild jaundice is nothing to be concerned about if your baby is fully developed and healthy. It will go away on its own in a week or so. 

A premature or sick newborn, or a baby with extremely high bilirubin levels, will require strict observation and medical treatment. 

Symptoms of Jaundice in newborns:

1. Yellow skin and the white of the eyes
2. The Baby’s abdomen, arms, or legs looks yellow
3.  Sick or is difficult to awaken
4. The baby isn’t gaining weight or is feeding poorly
5. Have a high pitch cries

When jaundice persists for more than 14 days after delivery, it is referred to as persistent or extended jaundice in newborns. Your child will be tested to see whether he or she has any disorders that could be causing recurrent jaundice, and will be treated accordingly.

Here are other things you can look out for on a newborn jaundice level:

1. Your baby develops jaundice during the first 48 hours of life. If the level of jaundice increases rapidly to involve the lower tummy and legs, or jaundice is still present after day 14 of life.
2. You have difficulty with breastfeeding. And the baby does not pass an adequate amount of stool and urine. Plus, baby appears more jaundiced.
3. Your baby’s stools turn cream-beige or chalky-white or if the urine is dark (tea-colored). And the baby continues to have jaundice after day 14 of life.

We hope you’ve found this article helpful. Let us know your thoughts on the topic of newborn jaundice and breastfeeding in a comment below.

This article was originally published on theAsianparent Singapore