Newborns and Jaundice

Question: What is jaundice and should I worry about my newborn developing it?

Answer: by Edward Malphus, M.D.

Jaundice is a common condition among newborns that causes a pronounced yellow tint to the skin and the white part of the eyes. More than 60 percent of all infants develop mild jaundice within one to five days after birth. It usually disappears on its own within the first week or two after birth as the baby’s systems begin to mature.

Jaundice (also known as hyperbilirubinemia) is caused by the buildup of bilirubin in the blood and typically occurs when the liver is immature. (Bilirubin is a breakdown product of excess red blood cells, which many babies are born with.) In premature babies, symptoms of jaundice may emerge earlier and last longer than in full-term babies.

It can also occur when infants are learning to breast-feed and the volume of milk they are getting is too low, or they are not feeding often enough. In rare cases, jaundice may be caused by other conditions such as digestive system disorders, liver damage or infection.

It is important that all newborns be monitored for jaundice since excessive amounts of bilirubin in the blood may lead to brain damage, including hearing loss, mental retardation and behavior problems.

Generally, the diagnosis of jaundice is based on a physical exam and medical history. Your doctor may also want to do a blood test to determine the amount of bilirubin in the blood and to determine whether further evaluation or treatment is needed.

The most common treatment for jaundice is phototherapy. The wavelengths of light used in phototherapy are absorbed by the baby’s skin. As it is absorbed, the bilirubin in the baby’s body is changed into another form of bilirubin that can be easily excreted in the stool and urine.

Phototherapy, which is totally painless, is usually done in the hospital, although occasionally babies are treated at home. Some doctors use special phototherapy (fiber-optic) blankets to deliver the light treatment to newborns. The treatment lasts until the bilirubin has fallen to a safer level.

Most of the time, however, no medical treatment is needed for the common form of jaundice. Parents should, however, be aware of the symptoms of jaundice and watch their newborn for any skin color changes after they bring the baby home.

If the yellow tint in your baby’s skin becomes more intense after three days of age or if you notice that your baby is sluggish, irritable or has a high pitched cry, contact your doctor as these symptoms may indicate that the level of bilirubin in the blood may be rising to potentially harmful levels.

Generally, the most common form of jaundice is nothing to worry about, but you should make your pediatrician aware of it. Your pediatrician’s office should be a resource you can turn to with your concerns about any aspect of your newborn’s health.

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Edward Malphus, M.D. is a pediatrician at Saint John’s Health Center in Santa Monica. For more information, contact Saint John’s at 310-829-5511 or visit the hospital’s website at http://www.stjohns.org