Infant jaundice
DEFINITION
Infant jaundice is a yellow discoloration in a newborn baby’s skin and eyes. Infant jaundice occurs because the baby’s blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow-colored pigment of red blood cells.
Infant jaundice is a common condition, particularly in babies born before 38 weeks gestation (preterm babies) and some breast-fed babies. Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some cases, an underlying disease may cause jaundice.
Treatment of infant jaundice often isn’t necessary, and most cases that need treatment respond well to noninvasive therapy. Although complications are rare, a high bilirubin level associated with severe infant jaundice or inadequately treated jaundice may cause brain damage.
CAUSES
Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of “used” red blood cells.
Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract. A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.
Other causes
An underlying disorder may cause jaundice. In these cases, jaundice often appears much earlier or much later than physiologic jaundice. Diseases or conditions that can cause jaundice include:
- Internal bleeding (hemorrhage)
- An infection in your baby’s blood (sepsis)
- Other viral or bacterial infections
- An incompatibility between the mother’s blood and the baby’s blood
- A liver malfunction
- An enzyme deficiency
- An abnormality of your baby’s red blood cells that causes them to break
SYMPTOMS
Yellowing of the skin and the whites of the eyes is a sign of infant jaundice that usually appears between the second and fourth day after birth.
To check for infant jaundice, press gently on your baby’s forehead or nose. If the skin looks yellow where you pressed, it’s likely your baby has mild jaundice. If your baby doesn’t have jaundice, the skin color should simply look slightly lighter than its normal color for a moment.
Examine your baby in good lighting conditions, preferably in natural daylight.
When to see a doctor
Most hospitals have a policy of examining babies for jaundice before discharge. The American Academy of Pediatrics recommends that newborns be examined for jaundice during routine medical checks and at least every eight to 12 hours while in the hospital.
Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours following birth, make a follow-up appointment to look for jaundice within two days of discharge.
The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin. Call your doctor if:
- Your baby’s skin becomes more yellow
- Your baby’s skin looks yellow on the abdomen, arms or legs
- The whites of your baby’s eyes look yellow
- Your baby seems listless or sick or is difficult to awaken
- Your baby isn’t gaining weight or is feeding poorly
- Your baby makes high-pitched cries
- Your baby develops any other signs or symptoms that concern you
- Jaundice lasts more than three weeks
