Jaundice in newborn babies

Introduction

Jaundice is a very common condition in newborn babies. It is when the skin and white parts of the eyes turn a yellow colour. Jaundice is caused buildup of a yellow substance called bilirubin. Bilirubin is created when red blood cells break down and needs to be processed by the liver to leave the body as waste. Newborn babies have more red blood cells than adults do, and their livers cannot break down bilirubin as well. Jaundice happens when red blood cells break down and produce bilirubin faster than the liver can process it.

Jaundice does not usually cause any problems and will fade by the end of your baby’s first week. Jaundice can be a concern if it happens within 24 hours of being born, or it lasts for longer than 2 weeks. Speak to your doctor or midwife if you are still in hospital or see your local doctor if you are at home. 

The main sign of jaundice is a yellow colour to the skin and white parts of the eyes. Jaundice can be difficult to see in babies with darker skin tones.

You can check whether your baby has jaundice by pressing gently on the skin of their forehead and seeing whether it appears yellow when you lift your finger.

Your baby may be more likely to have jaundice if they: 

• were born prematurely (before 36 weeks of pregnancy)
• have an infection - for example, a urinary tract infection
• have rhesus disease – a condition where antibodies in a pregnant woman's blood destroy the baby's blood cells
• have liver disease. 

Jaundice can happen in breastfed babies during the first few weeks as milk supply is increasing and becoming stable. Speak to your midwife or doctor if you are concerned about jaundice and breastfeeding.

Babies with liver disease may also have poo that looks very pale or the colour of clay. This colour is different from the normal yellow, green, or brown. If your baby has pale or clay coloured poo, contact your local doctor as soon as possible.

Jaundice that lasts for longer than 2 weeks can mean that your baby may have another health problem, like an infection. Contact your local doctor as soon as possible if your baby has symptoms of jaundice for longer than 2 weeks.

Newborn babies are screened for jaundice when they are checked by their doctor. The doctor will check their skin and eyes for a yellow colour.

Their doctor may use a tool called a transcutaneous bilirubinometer if they think your baby has jaundice. The transcutaneous bilirubinometer shines a light onto your baby’s skin and measures the level of bilirubin based on how the light is absorbed or reflected.

The doctor may also order a urine test to make sure there is no infection, and a blood test to look at:

• how well their thyroid is working
• how well their liver is working
• levels of bilirubin in the blood.

Your baby will be referred immediately to a paediatric gastroenterologist if there are signs of liver disease. Signs of liver disease include:

• pale or clay coloured poo
• dark urine
• high levels of bilirubin
• abnormal liver function test results.

Treatment will depend on the level of jaundice in your newborn.

Mild jaundice in the first week is treated with fluids as it can appear worse when babies have mild dehydration.

Moderate jaundice is treated with phototherapy. Phototherapy is done by placing your baby under a special overhead light, or using a special blanket that shines light onto the skin. The special light is a blue colour and can help break down the bilirubin in the skin. This makes the jaundice fade. Babies having phototherapy will need to be naked or in a nappy, with a protective mask over their eyes. Phototherapy can cause your baby to have loose poos, so they will be given more fluids.

Phototherapy is not the same as sunlight. Do not expose your newborn to direct sunlight to treat jaundice.

Severe jaundice can be treated with a blood transfusion. A blood transfusion is a procedure where donated blood is given to your baby to wash the bilirubin out of their system.