A common condition in newborns, jaundice refers to the yellow color of the skin and eyes caused by excess bilirubin in the blood. Bilirubin is produced by the normal breakdown of red blood cells.
Normally bilirubin passes through the liver and is excreted as bile through the intestines. Jaundice occurs when bilirubin builds up faster than it is cleared from the body. Reasons for this include:
There are several types of newborn jaundice. The following are the most common:
There are a number of risk factors for jaundice. These include:
Prematurity
Infection
Vacuum/forceps birth
Resuscitation
Bruising
Delayed feeding
Birth weight <2500g
Rh incompatibility
Newborn jaundice usually appears around the second or third day of life. It begins at the head and progresses downward. A jaundiced baby’s skin will appear yellow first on the face, followed by the chest and stomach, and finally, the legs. It can also cause the whites of an infant’s eyes to appear yellow.
Jaundice can make babies sleepy, which in turn can lead to feeding problems (a sleepy baby may not wake itself to feed and/or maintain a strong latch). This in turn can lead to significant weight loss (>10% of body weight). Because of this, it is recommended that jaundiced babies be fed frequently, even if it means waking them.
Extremely high levels of bilirubin – usually above 20 mg – can cause deafness, cerebral palsy, or brain damage in some babies. In rare cases, jaundice may indicate the presence of hepatitis.
Newborn jaundice usually appears around the second or third day of life. It begins at the head and progresses downward. A jaundiced baby’s skin will appear yellow first on the face, followed by the chest and stomach, and finally, the legs. It can also cause the whites of an infant’s eyes to appear yellow.
A simple test for jaundice is to gently press your fingertip on the tip of your child’s nose or forehead. If the skin shows white, there is no jaundice; if it shows a yellowish color, your baby has jaundice. It is most accurate to do this while holding your baby in natural light. It should be noted that this is a subjective test, resulting in over-diagnosis of jaundice in babies of Asian descent.
The most accurate test for jaundice involves taking a small sample of your baby’s blood with a heel-prick to measure the bilirubin level.
If your baby needs this type of phototherapy, you may be eligible for the Home Phototherapy Program. Ask your midwife.
You should call your midwife if jaundice is noted during the first 24 hours of life, the jaundice can be seen in the arms or legs, your baby develops a fever over 38 degrees Celsius (100.4 degrees Fahrenheit), or if your child starts to look or act sick.