Half of all newborns develop jaundice;
a yellowing of the skin and eyes. Most often, jaundice isn't a concern,
but severe cases can cause serious complications.
Jaundice itself isn't a disease. In most cases it
occurs because your baby's liver isn't mature enough
to metabolize a molecule called bilirubin, which
normally forms when the body recycles old or damaged
red blood cells.
In the first few days of life, more than half of
all full-term babies and as many as 80 percent of
premature infants who are otherwise healthy develop
jaundice, a yellowish discoloration of the skin and
eyes. Although some babies are jaundiced at birth,
most develop the condition during the second or
third day of life. That's why you may not notice it
until after your baby is home.
Risk factors
Boy babies tend to be at higher risk of jaundice than are girls. Asian
and American Indian infants also are more likely to have jaundice. Other
factors that may put your newborn at risk of jaundice include:
-
Premature
birth.
Because your premature baby may not be able to process bilirubin as
quickly as full-term babies do, he or she is at higher risk of
jaundice. Your preemie may also feed less at first and have fewer
bowel movements, which means less bilirubin is likely to be
eliminated in your baby's stool.
-
Bruising during
birth.
Sometimes babies are bruised during birth. If your newborn has a
bruise, he or she may have a higher level of bilirubin from the
breakdown of more red blood cells.
-
Blood type.
If your blood type is different from your baby's, your baby may have
received antibodies through the placenta that cause his or her blood
cells to break down more quickly. Blood groups are determined
according to whether you have certain protein molecules on the
surface of your blood cells. The rhesus (Rh) factor is one of these
blood groups. If you have the Rh factor in your blood cells, you're
considered Rh positive. If you don't, you're Rh negative. There is
nothing inherently wrong with being either Rh positive or Rh
negative. But problems can arise when an Rh-negative woman is
pregnant with an Rh-positive baby. During pregnancy, fetal cells
cross the placental barrier and mix with the mother's cells. If the
mother's immune system detects the baby's opposing Rh factor, it
produces antibodies against it. These antibodies then attach to the
baby's red blood cells, causing them to break apart and release
bilirubin. To minimize the likelihood of problems, Rh-negative women
receive injections of Rh (D) immune globulin (RhoGAM), which
prevents the mother's body from producing unwanted antibodies,
during the pregnancy and immediately following birth.
-
Breast-feeding.
Breast-fed babies have a higher risk of jaundice, but for most
newborns the risk is slight and is far outweighed by the benefits of
breast-feeding. In addition, if a mother's milk is slow to let down,
her baby may not gain weight as readily, which makes jaundice more
pronounced. Breast-feeding more than the usual eight to 10 times,
which will encourage your baby to have more bowel movements, day
might reduce the risk. Breast-milk-related jaundice normally appears
four to seven days after birth and may last for several weeks.
-
Early discharge
from the hospital.
Because bilirubin levels tend to rise during the second and third
days of life, babies who are released from the hospital less than 72
hours after birth are at increased risk of developing jaundice after
they're home. Before early discharges were common, jaundice was
usually recognized and treated in the hospital nursery.
When to seek medical advice
During the first few days after your baby goes home, be alert for the
development of jaundice. Call or see your baby's doctor if your newborn
develops jaundice or begins to look or act sick. In addition, check with
your baby's doctor if your newborn's jaundice is severe — the skin is
bright yellow, if it lasts longer than one or two weeks, if your baby
isn't gaining weight, or if your baby develops any other symptoms that
concern you.
If your baby was born at 36 to 38 weeks gestational age — several weeks
early — be particularly careful to watch for the development of jaundice
or poor feeding. Babies born in this age range have a higher likelihood
of needing medical treatment for jaundice after their discharge from the
hospital. Arranging with your doctor to have the baby's weight checked
within several days after going home makes it easy to monitor both
weight gain and jaundice. Don't hesitate to ask about having your baby's
weight checked: It's easy, quick to do and reassuring.
