Infant Jaundice Common & Treatable

Jaundice is one of the most common things that can happen to your baby after birth.  Jaundice affects 50-60% of all full term babies. That is babies born after 38 weeks.  Preterm babies have a risk of 80% of developing jaundice. These percentages are very high, but the thing about jaundice is that it is very easily treatable.  Studies do not show that jaundice affects boys more than girls, so there is no additional risk depending on gender. Though it is more popular in breastfed babies than formula fed babies. 

With more than 200,000 new cases per year. Jaundice is when the bilirubin is too high. Bilirubin is a yellow pigment released in the normal breakdown of red blood cells. When there is excess bilirubin in the body it causes jaundice.  Babies have the largest percentage of developing jaundice but you can get jaundice at any age. Newborns produce more bilirubin when first born, there is a higher production of red blood cells in those first few days so more bilirubin is needed to keep the process normal.  Sometimes though with how fast the bilirubin production is the liver is sluggish and cannot keep up expelling the bilirubin causing the buildup of excess.

After your baby is born, they go through a number of different tests to make sure they are healthy and don’t need any medical interventions.  One of the tests that your baby will have done after the first twenty four hours of their life is the bilirubin number test. A normal bilirubin for an infant is a level under 5.2mg/dL.  If your babies number is lower than the 5.2mg/dL then they don’t have the excess bilirubin meaning there is no jaundice present.

Jaundice though does not always present itself at the twenty four hour mark.  It can sometimes take up to four days for symptoms to be present. In some types of jaundice it could even take two to three weeks for it to become apparent. No matter when jaundice presents itself though it is still easily treatable.

Risk Factors

There are some risk factors of jaundice.  If your child suffers from sickle cell anemia they have a higher chance of getting jaundice. Other risk factors include a lack of proteins in the body, excessive bruising during delivery, infections whether they are viral or bacteria, or an enzyme deficiency. You will need to take your child to the doctor though so they know how to treat it.

Types

There are three main types of infant jaundice. 

The most common one is physiological jaundice. This occurs two to four days after birth, so it is usually caught before you are dismissed from the hospital.  This type of jaundice is usually in relation to the delay of liver function. The body is creating too much of the bilirubin and with a sluggish liver it is not filtering the bilirubin out of the body like it should be.  This type of jaundice is usually not very serious. It could delay your discharge from the hospital.

The second type of jaundice is breastfeeding jaundice. This usually occurs in the first week after birth. This is caused by the baby not feeding well or low milk supply.  This again is not serious, usually can be fixed with either formula feeds, or supplemental feeding. Sometimes with this type of jaundice the baby has problems processing substances in the breast milk, which can cause jaundice too. This reaction can sometimes take two to three weeks after birth for symptoms to show.  If this happens your doctor may want you to stop breastfeeding and switch to formula.

The third type of jaundice is called erythroblastosis fetalis, which is when the blood types of mom and baby are different. This can cause there to be extra antibodies in the body that are attacking the red blood cells in the baby, causing the bilirubin levels to increase.  This can turn serious if not treated appropriately.  

Symptoms

The most common symptom of jaundice is a yellowing of the skin.  Even though this is the symptom most associated with jaundice it does not always show up right away.  It can take two to four days after birth for the first symptoms to start showing. If not treated symptoms will increase overtime.  Another symptom to look for is the white’s of the eye turning yellow. Other signs to look for that can be signs the bilirubin is increasing are the baby is difficult to awaken, poor feeding, not gaining weight, or high pitched cries.  

Diagnosis

Usually jaundice is caught while still in the hospital after delivery.  After birth the hospital will monitor for jaundice every 8-12 hours until dismissal.  On the types of jaundice that can happen in the first few weeks of life they are often caught at one of your initial pediatrician appointments.  The pediatrician either at the hospital or at your pediatrician’s office will start with a physical exam of your baby. They may press on the baby’s forehead, or nose to see if the skin turns yellow.  If the physical exam comes back OK they may do a blood test. At the hospital after birth they will do a heel stick to test the blood regardless of physical exam. There is a device called a transcutaneous bilirubinometer, which measures the light reflection of a light shone on the skin, this is another skin test your doctor may want to do if they suspect jaundice. 

Treatments

Once diagnosed with jaundice there are a few different things that your doctor can do.  If it is extremely mild where levels are not much higher than that 5.2mg/dL level, your doctor may wait to see if the levels go down on their own.  If the levels do not go down you may have to stay longer at the hospital and do one of the other treatments. The most common treatment for jaundice is light therapy.  This is when your baby is placed naked with only a diaper on under a special lamp. The light is of blue-green spectrum that helps manipulate the bilirubin molecules to change so they can be expelled through urine and stool.  Your baby will have to lay under this light for a certain amount of time, sometimes all day unless feeding or diaper change. Your baby will have an eye mask placed on to protect their eyes from the light. If you baby suffers from breastfeeding jaundice, your doctor may suggest that you do supplemental feedings, or switch to formula.  In cases that the baby and mom’s blood types differ your baby may need an IV immunoglobulin. This will help eliminate unwanted antibodies. If the jaundice is too severe your baby may need an exchange transfusion, meaning that some of the baby’s blood is removed and replaced with donor blood. This helps dilute the bilirubin. If you are at home and your baby has jaundice you can take them out into the sunlight to help them as well, this has a similar effect of the light therapy. 

Jaundice affects nearly half of the babies born at full term.  Though if left untreated it can become very serious, and can lead to brain damage.  This is not the normal. It is usually not serious and easily treated when diagnosed appropriately.  Make sure your newborn is checked and you go to all the pediatrician appointments. If you notice any yellowing of the skin make sure to call your pediatrician immediately.