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Jaundice in newborns
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Jaundice in newborns

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CHILDREN'S HEALTH

Infants

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.

 

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Last Modified : 03/15/08 01:14 AM