Jaundice in Newborn Babies

About jaundice?
Many newborn babies develop jaundice. If your baby has jaundice, their skin will look slightly yellow or suntanned. Sometimes the whites of the eyes or the inside of the mouth or gums will also look yellow. If your baby has dark skin, the main sign may be a yellowing in the whites of their eyes or inside their mouth. For most babies jaundice is harmless and nothing for you to worry about. But if you think that your baby has jaundice, it is always best to let your midwife or doctor know. Jaundice is caused by too much ‘bilirubin’ in the blood. Bilirubin is a chemical in the body that is normally passed out of the body in urine (wee) and stool (poo).

Which babies require more attention for jaundice?
Some babies have a greater risk for raised levels of bilirubin including:
• Early birth (more than 2 weeks before the due date).
• Jaundice in the first 24 hours after birth.
• Breastfeeding that is not going well.
• A lot of bruising or bleeding under the scalp related to labour and delivery.
• A parent or brother or sister who had high bilirubin and received
phototherapy.
• Babies with an infection.

How will I know if my baby has jaundice?

To confirm whether your baby has jaundice, your midwife or doctor will
measure the amount of bilirubin in your baby’s blood.
This can be done by using a small hand held device that does not puncture the skin and is placed on your baby’s forehead or chest.
A blood sample may also be required and may be repeated.

What treatment will my baby be given?

Mild jaundice does not normally need any treatment, but your midwife will need to give you extra advice and support with breastfeeding to make sure that your baby is feeding adequately and correctly. If the level of bilirubin in your baby’s blood is high, your baby may be given light treatment known as ‘phototherapy’. Your baby will be placed under a lamp that shines a special type of light onto the skin. This light helps to break down the bilirubin, which will then be passed out of your baby’s body in their urine and stools. Your baby will be placed in the incubator under the light naked, apart from a nappy. This is to make sure that the light shines on as much of your baby’s skin as possible.
The babies eyes are protected by applying felt goggles.

A blood test to measure the amount of bilirubin in your baby’s blood will be
taken. You will be encouraged to take your baby out from under the lamp for short breaks for feeds, nappy changes and cuddles.

If your baby’s bilirubin level is very high, more than one lamp will be used at the same time and your baby will need to stay under the lamps without breaks.
You can usually continue to breastfeed your baby during phototherapy.
Babies with extremely high bilirubin levels may need to be treated in an intensive care unit. These babies may need an ‘exchange transfusion’ which involves replacing the baby’s blood with new blood from a
donor.

Your doctor will discuss all treatment options with you and answer any questions that you have.

Does jaundice cause any long term problems?
For most babies, jaundice does not cause any long-term problems.
Very rarely, the amount of bilirubin in a baby’s blood is so high that it does
cause long-term problems such as hearing loss or cerebral palsy. But you should remember that this is extremely rare and that with the right
treatment this small risk is reduced even further.

What should I do if my baby’s jaundice does not clear up?
For most babies, jaundice clears up within a few days.
If your baby has jaundice for more than 2 weeks (or for more than 3
weeks for babies that were born premature), make sure that you tell
your midwife or doctor.
Your baby may need further tests to check for other medical problems.