Jaundice in Newborns: What Parents Need to Know
Having a new baby is an exciting time, but it can also be a little nerve-wracking. One thing that might catch your eye is a yellow tinge to your baby's skin or eyes – this is called jaundice. While it's common and usually harmless, it's good to know the facts so you can be informed and prepared.
What is Jaundice?
Jaundice happens when there's a buildup of a yellow substance called bilirubin in the blood. Bilirubin is created when old red blood cells are broken down. Think of it like a bruise changing color as it heals! Normally, the liver processes bilirubin and removes it from the body, mostly through stool. But sometimes, especially in newborns, the liver can't keep up, and bilirubin builds up, causing that yellow color. Dehydration or infrequent bowel movements can also make it worse.
Who Gets Jaundice?
Many babies experience some jaundice in their first week. The stress of birth can cause more red blood cells to break down, and their little livers are still learning to do their job. It's even more common in preemies. This normal type of jaundice is called "physiologic jaundice."
Sometimes, jaundice can be a sign of something else, called "pathologic jaundice." This could be due to blood type differences between mom and baby, blood disorders, liver problems, infections, or even certain medications. There are also two types related to breastfeeding: "breastfeeding jaundice" and "breast milk jaundice."
Spotting the Symptoms
Jaundice usually shows up on the face first when bilirubin levels reach around 5 mg/dL. As levels rise, it spreads down the body. You might see it from the head to the belly around 15 mg/dL, and all the way to the soles of the feet around 20 mg/dL.
Physiologic jaundice typically appears on days 2-3, peaks around day 4, and doesn't go below the belly. It also rises slowly, less than 5 mg/dL per day. If jaundice appears earlier, later, rises quickly, reaches high levels, lasts longer, or is accompanied by other symptoms like vomiting, dark urine, lethargy, weight loss, or fever, it's important to call the midwife.
Breastfeeding jaundice: Happens in the first week, often due to baby not getting enough milk, leading to dehydration.
Breast milk jaundice: Less common, appears after a week, and peaks in the second or third week. It's caused by substances in breast milk that interfere with the liver's ability to process bilirubin. It rarely causes problems.
Is Jaundice Contagious?
No, jaundice itself isn't contagious, but some of the underlying causes might be.
How Long Does it Last?
Physiologic jaundice: Usually peaks around day 4 and disappears by day 7.
Pathologic jaundice: Continues until the underlying problem is treated.
Breast milk jaundice: Fades on its own, but can take 3-10 weeks.
Diagnosis and Treatment
Midwives and Doctors can often diagnose jaundice just by looking at your baby. We might gently press on the skin to see the color underneath. To be sure, we will measure bilirubin levels with a blood test if necessary. These results are plotted on a graph to predict if the levels might become dangerous.
The main treatment for pathologic jaundice is phototherapy. This involves exposing your baby to special blue lights that help break down the bilirubin into a safer form that the body can easily get rid of. Think of it like how sunlight fades colors! Keeping your baby hydrated and treating any underlying problems are also important. In rare cases, a special blood transfusion might be needed.
Prevention
The goal is to prevent kernicterus, a rare but serious condition where high bilirubin levels damage the brain. Early detection and treatment of pathologic jaundice are key. Frequent feedings and preventing dehydration can also help.
When to Worry
While most jaundice is normal, it's always best to talk to your pediatrician if you notice any yellowing of your baby's skin or eyes. They can assess the situation and recommend the best course of action. Trust your instincts and don't hesitate to seek medical advice if you're concerned!
