Newborn Jaundice: Causes, Symptoms, Treatment, and Prevention

Key Takeaways

  • Bilirubin levels naturally peak between days 3-5 of life as immature livers struggle to process the breakdown of excess red blood cells from birth, affecting 60% of full-term and 80% of premature infants.
  • Yellow discoloration follows a predictable pattern—starting on the face and head within 24-48 hours, then progressing downward to the chest, abdomen, and finally arms and legs as bilirubin levels rise.
  • Premature babies born before 37 weeks face the highest risk, along with those who are exclusively breastfed, have East Asian or Mediterranean heritage, or experience blood type incompatibility with their mother.
  • Phototherapy using blue-green LED lights breaks down bilirubin in the skin and typically reduces levels within 1-2 days, while severe cases may require exchange transfusion to prevent kernicterus brain damage.
  • Most cases resolve completely within 2-3 weeks without intervention, but bilirubin levels exceeding 25 mg/dL in full-term babies or 15 mg/dL in premature infants require immediate medical treatment.

Newborn jaundice is a common condition that causes a baby's skin and eyes to look yellow. It affects about 60% of full-term babies and 80% of premature babies in their first week of life. While it's usually harmless, it's important to understand the causes, symptoms, treatment options, and prevention tips for this condition.

What Causes Newborn Jaundice?

Newborn jaundice occurs when there is too much bilirubin, a yellow waste pigment, in the baby's blood. Bilirubin is created when red blood cells break down, and it's the liver's job to filter it out of the bloodstream. In newborns, the liver may not be able to keep up with the high turnover of red blood cells, leading to a buildup of bilirubin.

Some factors that increase a baby's risk of developing jaundice include:

  • Being born before 37 weeks

  • Having East Asian or Mediterranean ancestry

  • Being exclusively breastfed or having trouble feeding

  • Having a younger sibling who had jaundice

  • Being born to a mother with type O or Rh-negative blood

Symptoms of Newborn Jaundice

The most obvious sign of jaundice is a yellow color to the baby's skin and the whites of their eyes. The yellowing usually starts on the face and then spreads to the chest, stomach, and finally, the legs and arms. In babies with darker skin, it may be harder to spot the yellowing, so it's important to look for other signs, such as:

  • Not eating or having wet diapers

  • Being hard to wake up

  • Crying inconsolably or making a high-pitched cry

  • Being limp or stiff with their back arched

  • Moving their eyes strangely

Newborn Jaundice: Causes, Symptoms, Treatment, and Prevention

Diagnosing Newborn Jaundice

Doctors can usually diagnose jaundice by looking at the baby's skin and eyes. They may also perform tests to measure the level and types of bilirubin in the baby's blood, such as a bilirubin test or a transcutaneous bilirubin test. If the doctor suspects an underlying condition is causing the jaundice, they may perform additional tests, such as a urine sample, complete blood count, or liver function test.

Treating Newborn Jaundice

In many cases, jaundice goes away on its own within 1-2 weeks. However, if the bilirubin levels are high or the baby is at risk for complications, the doctor may recommend treatment, such as:

  • Extra feedings: Increasing the baby's intake of breast milk or formula can help them poop more often, which can help clear out bilirubin from the body.

  • Phototherapy: The baby is placed under blue-green lights, which helps bilirubin leave their body in their urine. The baby wears only a diaper and eye patches during the treatment.

  • Intravenous immunoglobulin (IVIg): If the baby's jaundice is caused by a different blood type from their mother, the doctor may give them a blood protein through an IV to help stop the breakdown of red blood cells.

  • Exchange transfusion: In rare cases of severe jaundice that doesn't respond to other treatments, the baby may need a blood transfusion to replace their blood with donor blood.

Preventing Newborn Jaundice

While it's not always possible to prevent newborn jaundice, there are some things you can do to help reduce your baby's risk:

  • Ensure your baby is well-fed by aiming for 8-12 feedings per day if breastfeeding or 1-2 ounces every 2-3 hours if formula feeding.

  • Expose your baby to indirect sunlight by sitting near a window or taking them for a stroll in the stroller on a sunny day.

If you notice signs of jaundice in your baby, don't wait to get them checked by a doctor. While severe jaundice is rare, it can lead to serious complications like kernicterus if left untreated. With prompt diagnosis and treatment, most babies with jaundice recover fully and experience no long-term effects.

The Bottom Line

While newborn yellowing affects most babies and usually resolves naturally, monitoring is crucial since untreated severe cases can cause permanent brain damage. Watch for progression of yellow coloring beyond the face and ensure regular pediatric follow-ups during the first week of life. If you notice concerning symptoms or have questions about your newborn's condition, Doctronic can provide quick guidance and peace of mind.

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