Jaundiced Newborn

Definition

• Jaundice means the skin has turned a yellow color.
• Bilirubin is the pigment that turns the skin yellow.
• The liver normally gets rid of bilirubin. But at birth, the liver may be immature.
• Half of babies have some jaundice. Usually, it is mild and doesn't need any treatment.

Judging Jaundice:

• Jaundice starts on the face and moves downward. Try to determine where it stops.
• View your baby unclothed in natural light near a window.
• Press on the skin with a finger to remove the normal skin tone.
• Then try to look if the skin is yellow before the pink color returns.
• Move down the body, doing the same. Try to look where the yellow color stops.
• Jaundice that only involves the face is always harmless. As it involves the chest, the level is going up. If it involves the stomach, arms or legs, the bilirubin needs to be checked. It also needs to be checked if the white of the eyes (sclera) turns yellow.

Causes of Jaundice

Physiological Jaundice (50% of newborns)

• Onset 2 to 3 days of age
• Peaks day 4 to 5, then improves
• Disappears 1 to 2 weeks of age

Breastfeeding or Malnutrition Jaundice (5 to 10% of newborns)

• Due to inadequate intake of breastmilk
• Pattern similar to physiological type
• Also, causes poor weight gain
• Goes away when baby gets enough milk

Breastmilk Jaundice (10% of newborns)

• Due to substance in breastmilk which blocks removal of bilirubin
• Breastmilk intake and weight gain are normal
• Onset 4 to 7 days of age
• Lasts 3 to 12 weeks
• Not harmful

Rh and ABO Blood Group Mismatch (Rare)

• Onset during first 24 hours of life
• Can reach harmful levels