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by EBSCO Medical Review Board
(Hyperbilirubinemia)

Definition

Jaundice is a yellow coloring in a baby’s skin. The whites of the eyes can turn yellow sometimes, too. Newborn jaundice happens during the first weeks of life.

Baby with Jaundice
Jaundice Baby
Copyright © Nucleus Medical Media, Inc.

Causes

The yellow coloring is caused by bilirubin. Bilirubin is a waste product. The body makes it when red blood cells are broken down. Bilirubin normally leaves the body through feces (poop) or urine (pee). Jaundice happens when bilirubin builds up. This can happen when:

  • The baby's body does not get rid of bilirubin in the first few days of life
  • The baby does not get enough breastmilk
  • A substance in breast milk blocks bilirubin from leaving the body
  • Many red blood cells are broken down
  • The baby has liver problems, such as infection or liver disease

Risk Factors

Newborn jaundice is more common in East Asian babies as well as babies who are very sick or born early. It is also more common in babies who have a sibling who was treated for jaundice. Other things that may raise the risk are:

  • High bilirubin levels or signs of jaundice in the first 24 hours of life
  • Poor breastfeeding
  • Baby has a different blood type than the pregnant person—this leads to a lot of red blood cells breaking down
  • Large bruises or bleeding under the scalp due to labor and delivery
  • Certain liver problems

Symptoms

The main symptom of jaundice is yellow skin color. It often starts in the face and may spread to the stomach and legs.

Diagnosis

All babies are checked for jaundice at birth and again at 3 to 5 days of age. The doctor will ask about your baby’s symptoms and health history. A physical exam will be done. It will focus on the baby's skin.

Tests may be:

  • Transcutaneous bilirubin (TcB)—a light is passed through the baby's skin to check for high bilirubin levels
  • Blood test—to check the level of bilirubin in blood

Treatment

Most babies will not need treatment. Jaundice often goes away in 2 to 3 weeks. Babies who do need treatment may need:

Extra Feedings

More breastfeeding can help clear bilirubin from the baby's body. Babies who are formula-fed will need extra formula.

Phototherapy

This uses special lights to change the bilirubin in the blood. The bilirubin can then leave the body in urine or stool.

Exchange Transfusion

Babies with severe jaundice may need a blood transfusion. This will replace the baby’s blood with new blood. The extra bilirubin will be removed with the blood.

Prevention

Newborn jaundice cannot always be prevented. The risk can be lowered by feeding the baby often in the first days after birth.

Blood tests during pregnancy and after delivery could show if the baby and pregnant person have different blood types. This can help doctors catch and treat newborn jaundice early.

RESOURCES

Healthy Children—American Academy of Pediatrics  https://www.healthychildren.org 

March of Dimes  http://www.marchofdimes.org 

CANADIAN RESOURCES

AboutKidsHealth  https://www.aboutkidshealth.ca 

Health Canada  https://www.canada.ca 

References

Infant jaundice. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/infant-jaundice. Accessed April 19, 2022.

Jaundice in healthy newborns. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/jaundice.html. Accessed April 19, 2022.

Neonatal cholestasis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/neonatal-cholestasis-18. Accessed April 19, 2022.

Neonatal hyperbilirubinemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/neonatal-hyperbilirubinemia. Accessed April 19, 2022.

Neonatal hyperbilirubinemia. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/pediatrics/metabolic-electrolyte-and-toxic-disorders-in-neonates/neonatal-hyperbilirubinemia.html. Accessed April 19, 2022.

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