Jaundice in Babies and Newborns: Causes, Symptoms, and Bonding During Treatment
When your newborn has jaundice, it means their skin has a yellowish tint. This comes from the buildup of a substance in the body called bilirubin. When red blood cells break down, they release bilirubin, and normally the liver helps to excrete it. However, a newborn liver is immature and may not be able to remove it fast enough.
About half of all newborns will have jaundice. So while this is completely normal and usually goes away on its own in 2 to 3 weeks, sometimes the level gets too high. Your baby will be monitored for jaundice and if necessary, treated to bring the level down. Here's everything to know about this common condition.
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Jaundice Causes in Babies
First, since jaundice occurs in about half of all babies, just the fact of being born and having a very young liver puts your baby at a higher chance of having jaundice. But it can be caused by other reasons as well, as Joe Aracri, M.D., pediatrician and chair of the AHN Pediatric Institute explains. Most commonly this is a viral or bacterial infection, but other causes can also include:
- Prematurity or being born before 37 weeks
- Blood problems such as spherocytosis, an abnormality of red blood cells
- Blood type incompatibility between the female parent and baby
- Not getting enough breast milk or formula to flush out excess bilirubin
- Liver problems
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If your baby is jaundiced, they will have a yellowish color to their eyes and skin. The best way to see this is in natural or under fluorescent light. If your baby has darker skin this can be harder to see. The yellowing usually starts in the face and then spreads downward to the trunk, arms, and legs as increased bilirubin builds in the body.
Aside from the color of your infant's skin, your baby might be sleepier or harder to wake up. They might also have a hard time sucking and feeding and might be losing weight.
It's rare, but you might also notice your baby's stool is different, which is referred to as jaundice baby poop. Normally, newborn stool has a mustard yellow color, but with the increased bilirubin leaving the body through the intestines, this color might be a light beige or sandy color. The urine could also turn dark brown. Call your provider if you notice any changes in your baby's urine or stool.
Understanding Jaundice Levels in Newborns
Your baby's bilirubin levels will be monitored before going home after birth. Typically, this is done at 24 and 36 hours by a simple blood test. Jaundice peaks on day four or five and the levels for what's considered normal vary based on how your baby's age.
Jaundice Treatment for Babies
Nursing or bottle feeding helps to flush bilirubin out of your baby's system, so treatment might be that your baby needs to eat more frequently. For other baby's, phototherapy may be needed. This involves light therapy, specifically blue-green light that your baby lies under to help the bilirubin break down better.
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This could be done at home with a biliblanket, a fiber-optic pad that wraps around your baby's midsection. If not, or if the bilirubin levels are too high, they might need extra phototherapy in the hospital, according to Dr. Aracri. A biliblanket can be used at home in some cases and allows you to hold your baby during treatment. But phototherapy in the hospital is more effective since devices will put out more light and provide quicker the treatment. In some rare cases, your baby may need a blood exchange transfusion which would also be done in the hospital.
While phototherapy has been the gold standard for jaundice treatment since the 1950s, it requires babies to be under the lights as much as possible and removed only for feedings. Alexa Jones, CEO and founder of TheraB Medical is working to provide a better bonding experience for parents and babies receiving jaundice treatment. Her team has invented the SnugLit, a wearable battery-powered swaddle that provides full coverage phototherapy treatment. Still in development, Jone's is anticipating the SnugLit to be used for babies in the hospital and home next year.
"[With the SnugLit] we're trying to get hospital-level treatment in terms of surface area coverage and intensity in a format that allows for uninterrupted treatment while they're being held or comforted or breastfed," Jones explains. Her goal is to provide parents continuous bonding whether in-home or in the hospital while their baby gets the treatment they need.
When to Worry About Jaundice
You want to make sure your baby is feeding well with a good suck, and wetting diapers at least every six hours. They should be active whenever awake, aren't lethargic, and can easily be woken, says Dr. Aracri. They shouldn't lose too much weight or look too yellow in the whites of their eyes or on their skin. "If it looks like the jaundice is going down on the belly or legs, that can be concerning," Dr. Aracri explains.
But Dr. Aracri reassures that jaundice rarely causes problems in newborns. It's important to have your baby monitored and make sure you're going to your baby's checkups to uncover any concerns early on.