What is jaundice?
Jaundice is a condition that causes a yellowish discoloration of the skin and the whites of the eyes. If you press your finger against the nose or chest of a fair-skinned baby with jaundice, you can see this yellow tinge. If your baby has dark skin, you can see the yellowness in the whites of the eyes or in the gums.
The most common type of jaundice develops on the second or third day of life – about when the baby is being discharged from the hospital – which is why it's important to know about it and keep an eye out for it. Most of these cases, called physiologic jaundice, disappear on their own in two weeks.
What causes jaundice?
A newborn has more red blood cells than his or her body needs, and often, when a baby's immature liver can't process them quickly enough, a yellow pigment called bilirubin (a byproduct of the red blood cells) builds up in the blood. Much of this bilirubin leaves the body in the baby's stool, but about half of babies develop some degree of jaundice during the first two weeks of life. Preemies and babies with genetic diseases or infections are especially vulnerable.
Some breastfeeding babies develop jaundice if they don't get enough breast milk, because the bilirubin isn't able to exit the body through body waste. Breastfeeding jaundice usually shows up in the first two weeks of life.
When jaundice is detected within the first 24 hours, it may be due to a blood-group incompatibility with the mother (the mother is Rh-negative and the baby is Rh-positive), an infection, or an underlying liver problem.
Should I worry?
Most newborn cases of jaundice are harmless and require no treatment. The doctor may order blood tests to measure your baby's bilirubin levels, which usually involve taking a small amount of blood from your baby's heel.
In moderate cases of jaundice, the doctor may prescribe phototherapy (light therapy), which involves placing the baby naked under special blue lights that help his or her body break down the bilirubin so it can be excreted. This can be done in the hospital or at home with a portable unit. A special kind of fiber-optic blanket, called a bili blanket, has a similar effect.
In addition to phototherapy, it's important to keep your baby well hydrated and to identify and treat any underlying medical issues. Your doctor may recommend breastfeeding more often or supplementing with formula to give your baby more fluids and help him or her pass more bilirubin in stools.
The goal of treatment is to lower the bilirubin level to prevent the buildup of toxic levels in the baby's brain (a disease called kernicterus). With monitoring and treatment, the risk of kernicterus or other complications drops to almost none.