Understanding Newborn Jaundice
When I learned that my newborn had to be admitted to the hospital due to jaundice, I was devastated. As a pediatrician, I knew exactly what jaundice was, yet it was still such a scary experience. Thankfully, his levels came down quickly, and we were sent home the next day.
Fortunately, for most babies, jaundice causes no lasting harm, but it’s extremely important to check for it and treat it when necessary.
What is newborn jaundice?
Jaundice causes a yellow cast to appear in someone’s eyes and skin. It happens in newborn babies because their liver is still developing, and it’s unable to properly process a compound in the blood called bilirubin. As the bilirubin builds up in the bloodstream, your baby may develop jaundice and appear yellow. This yellowing often starts within the first few days of life and then decreases as their liver matures. Jaundice may be more easily seen on babies with lighter skin tones, but it can happen to all babies regardless of their skin color.
Why do we worry about jaundice?
While most babies recover smoothly from elevated levels of jaundice, when it gets too high (usually 25 mg/dL or above), bilirubin can cross the blood-brain barrier and cause brain damage. We never want this to happen, so timely treatment is critical.
Which babies are more likely to get jaundice?
If your baby has one or more of the following, it may increase their risk of getting jaundice after you bring them home from the hospital:
- Jaundice in the first 24 hours of life.
- High levels of jaundice prior to being discharged.
- A parent or sibling who had jaundice and needed phototherapy.
- A large bruise under the scalp due to a traumatic delivery.
- A disease called G6PD. If you or any of your family members were told not to eat fava beans, there may be a chance that this could affect your baby.
How is the bilirubin level (or jaundice level) measured?
There are two ways to measure bilirubin.
One is with a simple hand-held device. While your baby was in the hospital after birth, you might have noticed their clinician press a small machine up to their chest. While convenient, this device gives only an estimate of your baby’s bilirubin or jaundice level.
The other way is using a heel stick – drawing a small amount of blood from your baby’s heel. While it’s not easy to see your baby hurt by the needle prick, this is the more accurate way to find the actual bilirubin level in their bloodstream. It’s also the most accurate way to determine if your baby has jaundice if they have a darker skin tone.
What will happen if my baby’s jaundice level is high?
Depending on the level, there are a few possibilities that may occur. Sometimes, your doctor may ask you to come back for a repeat check in the office, or they may request that you go get a heel stick.
If the number is at a certain level, your baby may need a treatment called phototherapy. Phototherapy can often be done at home with a “bili blanket,” or you may be asked to bring your baby to the hospital for phototherapy there.
What else can I do to help the jaundice go down?
Feed, feed, feed! The more your baby poops, the more bilirubin they release, and that will help their jaundice level go down. Placing your baby under the sun is not a safe treatment for jaundice, and we do not recommend it.
When should I call my doctor?
If you see your baby getting sleepier, becoming more difficult to wake for feedings, or looking more yellow in the skin and/or the eyes, please seek medical attention right away.
Once the jaundice level is stable, your pediatrician will no longer need to check it again, and you can celebrate—your baby is safely out of the woods!
Resources for Parents:
My Doctor Online
American Academy of Pediatrics
Featured Author
Elaine Yang, MD, MBA, is a pediatrician at Kaiser Permanente’s Garden Grove Medical Center in Southern California who thought she knew everything there needed to know about kids—until she had her very own. In many ways, she found being a parent to two rambunctious kids was harder than being a pediatrician! From then on, she had a newfound appreciation and respect for all her patients’ parents struggling to raise their children. She believes that there is no one way to parent; rather, there are many good ways to raise healthy, thriving children. Dr. Yang’s full biography can be found on her webpage. Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.