Jaundice in Newborns (Hyperbilirubinemia)

Jaundice (hyperbilirubinemia) is when there is too much bilirubin in baby’s blood. Bilirubin (bil-ee-ROO-bin) is made when the body breaks down old red blood cells. This waste leaves the body through stool and urine.

Jaundice in Babies

Jaundice in babies is common as babies’ livers are not yet able to get rid of extra bilirubin in the blood. About 2 out of 3 babies have jaundice within 2 to 7 days of life. Too much bilirubin, if not treated, can cause brain damage. Quick treatment prevents nearly all cases of brain damage.

Symptoms

Babies with jaundice may have:

• Yellow skin and eyes (color may start in the baby’s head and move down the body)

• Increased sleeping

• Poor eating
  

How It Is Diagnosed

Skin color alone, is not enough to tell if your baby has jaundice. Babies will need a blood test to measure the bilirubin level.

Treatment Options

Treatment depends on the cause of jaundice and the level of bilirubin.

Phototherapy: High bilirubin levels often decrease when a baby is put under special blue spectrum lights. This is called phototherapy. It may take several hours for this treatment to start working. The bilirubin absorbs light and changes so that your baby’s body can get rid of it through stool. It is important to expose as much of your baby’s skin as you can during treatment.

Fiber optic blanket: This treatment can be used alone or with overhead lights. The blanket has a pad that the baby lays on that gives off light. The pad is covered to protect baby’s skin while still allowing light through.

Overhead LED light: This treatment uses 1-3 overhead lights depending on the baby’s size and bilirubin level.

Care During Treatment

Your baby’s eyes will be protected while the lights or blanket are on. The eye shields can be taken off when the lights and blanket are off.
Your baby will only wear a diaper and will be in a special bed that has a heater to keep your baby warm. Your healthcare providers will check your baby’s temperature while under the lights.

Rash

As bilirubin levels decrease, your baby may get a bluish-red skin rash (bilirash). This rash is painless.

Feeding During Treatment

Feeding your baby often will provide the nutrition needed to get rid of the extra bilirubin through stool. Feeding your baby about 8 to 12 times a day, or every 2-3 hours, may help decrease jaundice. A hydrated baby will have 4-6 wet diapers and 3-4 stools a day.
Some breastfeeding mothers think they should stop breastfeeding once their babies become jaundiced. The American Academy of Pediatrics encourages mothers to keep breast-feeding and focus on increasing the frequency of feedings. Lactation consultants are available if you need help with breastfeeding.

Going Home

Your baby will be sent home when their bilirubin is at a safe level. The level is decided by your treatment team.

Your baby may need blood tests after discharge. In some cases, jaundice will come back once treatment is stopped. Often this corrects itself without any more treatment. It is important to keep all your baby’s health care visits.

In some cases, a baby may go home with phototherapy. We will work to arrange this home therapy and plan for close follow up with your baby’s primary care provider.

Do not place your baby under fluorescent lights, near a window in the sunlight, or outside in the sun. These will not lower the amount of bilirubin. These are all dangerous.

Water or sugar water should not be used to supplement breast milk or formula. This type of hydration can cause other problems and doesn’t work as well at getting rid of bilirubin.

Who to Call

If you have questions or concerns, call your baby’s primary care provider.