Topic Overview

What is jaundice in newborns?
Jaundice is a condition that causes a pronounced yellow tint to the skin and the white part of the eyes as a result of a higher-than-normal amount of bilirubin in the blood (hyperbilirubinemia). Bilirubin is a substance produced by the breakdown of red blood cells and hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the rest of the body.

Usually jaundice in newborns develops about 24 hours after birth; in healthy breast-fed babies, jaundice almost always appears to some degree about 2 to 4 days after birth. Jaundice usually disappears or lessens on its own within a week or two without causing problems. In breast-fed babies, mild jaundice sometimes continues or returns about 10 to 14 days after birth and may last throughout breast-feeding.

As long as your baby is getting enough milk and is fed at frequent intervals (about 8 to 10 times or more in a 24-hour period), jaundice usually is not a problem. However, your baby should be watched closely. Rarely, excessive amounts of bilirubin build up in the blood and lead to brain damage (kernicterus), which can result in hearing loss, mental retardation, and behavior problems.

What causes jaundice in newborns?
Jaundice occurs from an imbalance between the production and elimination of bilirubin. Bilirubin is removed from the body through urine and stool. During pregnancy, the mother's body removes bilirubin from the fetus through the placenta. After birth, the body must remove the bilirubin on its own.

Newborns' bilirubin levels may increase to the point of jaundice because their immature organs cannot keep pace with the need to eliminate bilirubin from the body. Also, newborns can become dehydrated easily. Dehydration slows down a baby's elimination of waste, which increases the time it takes for bilirubin to exit the body through urine and stool. Components of breast milk likely also affect the way bilirubin is processed.

In rare cases, hyperbilirubinemia may be caused by an underlying disease or disorder, such as blood type incompatibility, digestive system disorders, or infections.

What are the symptoms?
Jaundice produces yellowing of the skin and the white part of the eyes. This yellow coloring usually develops in newborns between 1 and 5 days after birth and shows up first in the face and chest. If the yellow tint in your infant's skin becomes more intense after 3 days of age, notify your health professional.

Symptoms that begin to appear less than 24 hours after birth may be caused by an underlying disease or condition and need to be evaluated carefully.

Babies with bilirubin blood levels that can be harmful if not treated may develop a high-pitched cry and become sluggish and irritable.

How is jaundice in newborns diagnosed?
Your health professional will diagnose jaundice by doing a physical examination and taking a medical history. A blood test for bilirubin may be done to determine whether further evaluation or treatment is needed.

If the health professional suspects that another condition, such as a difference in the baby's and mother's blood types, is causing the hyperbilirubinemia, more tests may be done.

How is it treated?
Most of the time no medical treatment is needed for jaundice. Typically, jaundice begins to develop 24 hours after birth and usually disappears or decreases on its own within a week without causing problems. If you are breast-feeding, feeding your baby more frequently (8 to 10 times every 24 hours) may help minimize the degree of jaundice.

Phototherapy is sometimes needed, which involves exposing the baby to a type of fluorescent light. As the light is absorbed into the skin, the bilirubin changes so it becomes more easily excreted in the stool and urine. Standard phototherapy is usually done in a hospital, although occasionally babies are treated at home. Phototherapy with fiber-optic blankets or bands can be used for mild jaundice. These usually can be used at home; sometimes they are used in combination with standard phototherapy.

If your baby's jaundice is caused by an underlying condition, other treatments may be needed.