Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours after birth, make a follow-up appointment to look for jaundice within two days of discharge. The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin.
Call your doctor if:. Excess bilirubin hyperbilirubinemia is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of "used" red blood cells. Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life.
Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract. A newborn's immature liver often can't remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.
An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of infant jaundice. Diseases or conditions that can cause jaundice include:. Major risk factors for jaundice, particularly severe jaundice that can cause complications, include:.
High levels of bilirubin that cause severe jaundice can result in serious complications if not treated. Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there's a risk of bilirubin passing into the brain, a condition called acute bilirubin encephalopathy. If the level of bilirubin increases, the colour will spread to the body.
Babies might also be drowsy and have difficulty feeding. Jaundice is usually harmless, but a nurse or doctor should check and monitor all cases of jaundice in newborn babies.
Some babies have severe jaundice, which very occasionally can lead to deafness and even brain damage if not treated promptly. If your baby has jaundice lasting more than 2 weeks — especially if their poos are pale or their wees are dark — they'll need a blood test to check the 'conjugated bilirubin' levels in the blood.
They might then need more tests on their liver. Babies who develop jaundice several days after birth usually just need careful monitoring, sometimes with heel prick blood tests , to check the bilirubin levels in their blood.
The treatment is simple — they just need to have enough fluids. If your baby has mild jaundice ensure they are breast or formula fed regularly.
If the bilirubin levels are high, the baby might have phototherapy treatment for a few days. This treatment uses ultraviolet light to help to break down the bilirubin overload. It involves the baby being placed naked in a cot under a blue phototherapy lamp for 2 to 3 days. The baby's eyes will be covered for protection. Phototherapy has minimal side effects, although the baby might have a mild rash and runny poo for a few days. Some babies have small fluid losses during phototherapy, so they might need extra feeds at this time.
Most babies tolerate phototherapy treatment well. If your baby has breast milk jaundice, you do not need to stop breastfeeding. This type of jaundice is usually mild and should get better by itself with time. Talk to your child and family health nurse or doctor if you're worried about what to do. Severe jaundice, in which bilirubin levels are very high, might need treatment with an exchange blood transfusion. Only 'incompatible blood type' jaundice is preventable. If this type of jaundice is suspected, the mother will receive an anti-D injection after the birth.
This can prevent complications in subsequent pregnancies. Learn more here about the development and quality assurance of healthdirect content. Read more on Better Health Channel website. Kliegman RM, St. Digestive system disorders.
In: Kliegman RM, St. Nelson Textbook of Pediatrics. The neonate. Gabbe's Obstetrics: Normal and Problem Pregnancies. Updated by: Neil K. Editorial team. Newborn jaundice. It is normal for a baby's bilirubin level to be a bit high after birth.
Two types of jaundice may occur in newborns who are breastfed. Both types are usually harmless. Breastfeeding jaundice is seen in breastfed babies during the first week of life. It is more likely to occur when babies do not nurse well or the mother's milk is slow to come, leading to dehydration. Breast milk jaundice may appear in some healthy, breastfed babies after day 7 of life.
It is likely to peak during weeks 2 and 3, but may last at low levels for a month or more. The problem may be due to how substances in the breast milk affect the breakdown of bilirubin in the liver. Breast milk jaundice is different than breastfeeding jaundice. Sometimes, infants with severe jaundice may be very tired and feed poorly. Exams and Tests. Tests that will likely be done include: Complete blood count Coombs test Reticulocyte count Further testing may be needed for babies who need treatment or whose total bilirubin level is rising more quickly than expected.
Treatment is not needed most of the time. When treatment is needed, the type will depend on: The baby's bilirubin level How fast the level has been rising Whether the baby was born early babies born early are more likely to be treated at lower bilirubin levels How old the baby is A baby will need treatment if the bilirubin level is too high or is rising too quickly.
A baby with jaundice needs to take in plenty of fluids with breast milk or formula: Feed the baby often up to 12 times a day to encourage frequent bowel movements. These help remove bilirubin through the stools. Ask your provider before giving your newborn extra formula. In rare cases, a baby may receive extra fluids by IV.
But in most cases, the benefits of breastfeeding far outweigh any risks associated with jaundice. Treatment for newborn jaundice is not usually needed because the symptoms normally pass within 10 to 14 days, although they can occasionally last longer. Treatment is usually only recommended if tests show very high levels of bilirubin in a baby's blood. This is because there's a small risk the bilirubin could pass into the brain and cause brain damage. There are 2 main treatments that can be carried out in hospital to quickly reduce your baby's bilirubin levels.
If a baby with very high levels of bilirubin is not treated, there's a risk they could develop permanent brain damage. This is known as kernicterus. Kernicterus is very rare in the UK, affecting less than 1 in every , babies born.
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