Newborn jaundice: Symptoms, testing and treatments parents need to know

Congratulations, you’ve welcomed a new bundle of joy into your world! However, having a newborn infant comes with a lots of questions and things to be aware of. One of these things to be aware of is neonatal, or newborn, jaundice. This will be a key aspect of your baby’s post-delivery hospital stay and first few clinic appointments.

Here, we’ll discuss some basic information about newborn jaundice, common tests and treatments for jaundice, and some tips and tricks for you to help your baby at home.

What is newborn jaundice?

In simple terms, jaundice is commonly thought of as “yellowing” of the skin and eyes. It is very common in newborn babies, but it’s still important to keep an eye on with your medical provider.

In medical terms, jaundice refers to the yellowing of the skin due to a high blood level of a compound called bilirubin. You may even hear of it being called as “the jaundice level.” Bilirubin is always high in newborn babies and is expected to decrease after a couple of weeks to normal levels.

Why do babies have elevated levels of bilirubin? There are many reasons, but the two most common reasons that are explored shortly after birth are: red blood cell destruction and mom-baby blood type incompatibility.

Newborns have a high rate of destroying and remaking their red blood cells. One reason why red blood cells can be destroyed shortly after blood is due to blood type. If the mom has a different blood type than the baby, then there is a chance that mom’s blood can carry antibodies that react to destroy the baby’s red blood cells. This is especially more common if mom has an O blood type. That is why it is important during OBGYN visits for the mom to make sure she has her blood type recorded. This can allow doctors to know if the baby will be at more risk ahead of time.

Signs of jaundice in babies

The biggest symptom of jaundice is that a baby’s skin will appear slightly yellow. This may be obvious in certain areas, like in the whites of their eyes, inside their mouth, on the soles of their feet or on the palms of their hands. If you press an area of skin down with your finger, the yellowing may increase.

Your baby will be examined as part of the newborn physical examination within a few days of birth, but don’t hesitate to call your doctor if you suspect jaundice at any time.

Testing for jaundice

Common tests for jaundice include:

• Hematocrit: hematocrit helps to measure the volume of red blood cells in the blood. If low, this could mean the baby is losing blood, thus leading to the jaundice.
• Reticulocyte count: reticulocyte count measures how fast the blood is remaking new red blood cells, so doctors like to see a normal or high value.
• Baby blood typing: the baby’s blood type will help us confirm if they are the same or different from mom, and if this is the main force at play for the high bilirubin.

While there are other reasons why bilirubin an be elevated, doctors will first test these factors. If further testing is needed, your doctor will discuss the reasons and options in detail.

Newborn jaundice treatment options

For new parents, a high bilirubin level (aka jaundice) can seem scary. The good thing is, there are several tools for doctors and yourself as the parent that can help you take care of your newborn baby. For doctors, there is a bilirubin curve that is used to determine whether a baby needs to be treated in the hospital, carefully watched at home or needs further testing.

Phototherapy

If the baby’s bilirubin level is higher than the curve’s expected level for their age, that’s when doctors recommend the use of phototherapy, which may also be known as “blue lights.” Phototherapy involves using blue light waves directly on the baby to help break down the bilirubin in the blood into a form that babies easily pee out of their system. In doing so, the levels will start to drop. This drop will be seen even hours into the treatment.

The baby’s levels will continue to be checked until the doctor feels it is a safe level for the lights to be stopped. Once the lights are stopped, levels will still need to be checked by your baby’s doctor, to be safe.

At-home tips for jaundice

Now, some babies don’t get to a level where they need treatment, but they do get close. For these cases, the doctor-parent team works closely together, with the baby being able to stay at home and not go to the hospital. Oftentimes, the doctor will want to see the baby back in 1-2 days to recheck bilirubin levels. This is to make sure that the levels are going down, staying the same or going up at a not dangerous speed.

If your baby’s bilirubin level is slightly elevated, doctors will advise you of some ways to help keep the bilirubin level down without going to the hospital. These tips may include:

• Indirect sunlight: it can help to expose the baby to indirect sunlight for 20-30 minutes a day, with your baby inside the house.
• Make sure the baby is well-fed: if babies do not eat well, they can become dehydrated, causing the bilirubin to increase. This is seen more often with solely breastfed babies, as mom’s milk is still starting to let down. You may consider breast pumping milk and supplementing with formula during the first few days of life.

Every baby is different. Talk with your personal doctor as to what is best for your child if this situation comes up for you and what signs to look for that your baby’s bilirubin levels are not improving.

Worried about jaundice?

The key thing to remember about newborn jaundice is this: it is very common. Almost all babies have high levels at birth, and there are easy first-line treatments and home tips that work well every day for many babies.

When you have a newborn, every little thing can seem scary—but remember, you’re not in this alone. Don’t hesitate to talk to your doctor about any questions or worries on your mind. Together, we can make sure your baby gets a strong start in life.

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