Jaundice

Signs and Symptoms

There are several types of newborn jaundice. The following are the most common:

• Physiological Jaundice -- This type of jaundice affects 50percent to 60 percent of full-term newborns in their first week, typically three to five days after birth. It occurs when a baby's liver is not able to sufficiently process bilirubin. Typically this condition disappears within one to two weeks. Because their livers are less mature, preterm babies are more frequently affected by this form of jaundice.

• Blood Group Incompatibility Jaundice -- In some cases in which a baby and mother have different blood types, the mother produces antibodies that destroy her infant's red blood cells. As a result, bilirubin builds up in the baby's blood. This condition may be diagnosed before birth or may be noted the first day after birth. In some cases, it can be avoided by treating mothers with a drug that will prevent them from forming antibodies against their baby.

• Breast Milk Jaundice -- A very small number of breastfed babies, roughly 1percent to 2 percent, develop jaundice because of substances in their mother's breast milk that cause their bilirubin levels to rise.

Although not always obvious, the hallmark symptom of jaundice is a yellowish tint in a baby's skin and the whites of their eyes. Jaundice usually appears two to three days after birth. The yellowish tint typically affects the baby's face first, then their chest and stomach, and ultimately their legs. Jaundice also may occur with infection or with certain disorders of the gastrointestinal tract.

Because jaundice also may develop in your baby after discharge from the hospital, parents are advised to check their baby's skin tone for a yellowish tint in natural or fluorescent lighting. A simple test for jaundice is to press your fingertip to your baby's nose or forehead. If the pressed skin has a yellowish tint, then your baby may have jaundice and you should call your doctor immediately.

Diagnosis

In addition to a complete physical examination to check for signs of jaundice, the doctor also may conduct a blood test that will measure the level of bilirubin in your baby's blood. If your baby does have jaundice, their condition and treatment options will be explained to you before any therapy is started.

Treatment

Mild or moderate forms of jaundice usually will go away without specific treatment after five to seven days, as the baby's liver becomes more mature. In babies with higher levels of bilirubin, close monitoring and possible treatment is required.

Light therapy, also called phototherapy, which chemically breaks down the bilirubin in your baby's skin to non-toxic forms, is the usual treatment for jaundice. During this treatment, your baby is placed under special white or blue light for one to two days. Their eyes will be covered to protect them from the bright lights.

If phototherapy is not effective, and your baby's bilirubin levels continue to increase, a procedure known as an exchange transfusion, may be necessary. During an exchange transfusion, the infant's blood is gradually removed and replaced with donor blood. This procedure removes bilirubin and lowers the bilirubin to safer, non-toxic levels.