Jaundice is a medical term used to describe the yellowing of a baby’s skin. Jaundice is extremely common – in fact, the vast majority of babies develop a degree of jaundice, most of whom do not require treatment.
Jaundice is caused by a yellow pigment in the blood called bilirubin. Bilirubin is a normal by-product of red blood cell breakdown. Newborn babies are born with extra red blood cells, and when these break down, bilirubin enters the blood. The bilirubin can then be passed out in the poo. If the body cannot keep up with getting rid of the bilirubin, this can build up and cause jaundice.
Jaundice can occur without any underlying cause. Breastfed babies are more likely to develop jaundice, but this should not in any way put you off from breastfeeding – breastfeeding is still our recommended option for all of its wonderful benefits. Sometimes there is an underlying cause, such as an infection or an incompatibility between the mother and baby’s blood types. Very occasionally there is a blockage of the bile duct, which may require an operation.
If you have a family history of jaundice, it is worth letting your midwife or medical team know.
Jaundice is specifically looked for in the newborn check, but it is worth keeping an eye out for it over the first few days. With jaundice, babies’ skin starts to become yellow – it is often best to have a good look in natural light. As well as having yellow skin, the whites of their eyes may also become tinged with yellow.
In some causes of jaundice, babies may have pale stools and dark urine.
If you notice your baby has jaundice, you should speak to a health professional, be it a midwife, health visitor, GP or other doctor, to determine whether your baby requires treatment.
Most often, jaundice appears within the first few days of life and normally disappears within the first two weeks of life, although in premature babies it is common to last a bit longer. Rarely, it can appear within hours, and these babies may require extra monitoring and tests.
If you notice your baby has developed jaundice, you should discuss with your midwife (if an inpatient) or your GP/health visitor (if an outpatient).
Once your baby has been identified as having jaundice, they will need a test to assess the level of their bilirubin.
There are two main ways of testing the jaundice level in babies.
Sometimes, further blood tests will be required. It can be useful to test for the blood group, red blood cells or infection markers if an underlying cause is suspected.
Jaundice will require treatment above certain bilirubin levels. There are jaundice graphs which tell doctors the levels that require treatment, as this depends on the gestational age and the number of days old your baby is. If your baby’s jaundice does not require treatment, it is important to continue feeding regularly. They may need to be woken for feeds, or even topped up if necessary.
The most common treatment for jaundice is phototherapy, where a blue UV light is used to help the bilirubin dissolve. Most often, babies can have brief pauses from being under the lights to be breast/bottle feed. However, they may require intravenous fluids through a drip if they are dehydrated or if the level is high. Rarely, other treatments such as a blood transfusion might be required.
During treatment, regular blood samples will be checked to monitor their bilirubin levels.
At low levels, jaundice will not affect your baby at all. At higher levels, babies may become sleepy and might have feeding difficulty, with poor suck.
Health professionals are very interested in making sure bilirubin does not reach levels that are too high, as it can cause damage to the developing brain, called ‘kernicterus’. These days, this is almost unheard of because of the way we identify and treat jaundice.
Jaundice is an extremely common condition in newborn babies due to the ways their bodies are adjusting to their life outside the womb. If treatment is required, this is most often in the form of UV light, but there are other treatments that may be required through a drip. It is important to treat jaundice to prevent brain damage at high levels, which is very rare.