Jaundice in newborns

Causes

Jaundice is caused by the normal breakdown of red blood cells. This process releases a chemical called bilirubin, which makes the skin yellow. Babies break down red blood cells very quickly, but their livers aren’t developed enough to get rid of bilirubin. This results in a bilirubin overload, which causes physiological jaundice.

Most newborns with jaundice will have ‘breastmilk jaundice’. This is when a chemical in the mother’s breastmilk interferes with getting rid of bilirubin. This type of jaundice usually sorts itself out without treatment, after several weeks.

A rare type of jaundice occurs when the mother’s and the baby’s blood groups are incompatible (usually ABO or Rhesus factor incompatibility). This isn’t usually a problem during a first pregnancy because the mother’s and the baby’s bloodstreams don’t mix. But during the delivery, some of the baby’s blood might mix with the mother’s blood. The mother then develops antibodies that become active during the next pregnancy and cross the placenta to attack a second baby’s red blood cells. Their destruction releases bilirubin into the baby’s bloodstream, and jaundice occurs.

If this has happened, it’s usually seen in the first 24 hours after birth.

Symptoms

Jaundice in a newborn causes the skin and the whites of the eyes to go a yellow colour. The jaundice typically starts on the face and head. If the level of bilirubin increases, the colour will spread to the body. Babies might also be drowsy and have feeding difficulties.

When to see your doctor

Jaundice is usually harmless, but a nurse or doctor should check and monitor all cases of jaundice in newborn babies. Some babies have severe jaundice, which very occasionally can lead to deafness and even brain damage if not treated promptly.

You should take your baby to the doctor if:

• your baby’s unwell, feeding poorly and not gaining enough weight
• your baby’s poo becomes pale or wee becomes dark
• your baby develops jaundice in the first 48 hours after birth
• the jaundice becomes more noticeable after a week
• the jaundice hasn’t gone away after two weeks.

Treatment

Treatment for jaundice depends on how bad it is and what’s caused it.

Babies who develop jaundice several days after birth usually just need careful monitoring, sometimes with heel prick blood tests to check the bilirubin levels in their blood.

If the bilirubin levels are high, your baby might have phototherapy treatment for a few days. This treatment uses ultraviolet light to help to break down the bilirubin overload. It involves your baby being placed naked in a cot under a blue phototherapy lamp for 2-3 days. Your baby’s eyes will be covered for protection. There are minimal side effects to phototherapy, although your baby might have a mild rash and runny poo for a few days. Some babies have small fluid losses during phototherapy, so your baby might need extra feeds at this time. Most babies tolerate phototherapy treatment well.

Severe jaundice, in which bilirubin levels are very high, might need treatment with an exchange transfusion. This is when your baby’s own blood is replaced by compatible fresh blood. This isn’t common.

Prevention

Only ‘incompatible blood type’ jaundice is preventable – if this is suspected, the mother will receive an anti-D injection immediately after delivery. This can prevent complications in subsequent pregnancies.

• Rated11 ratingsRate this item
• FeedbackTell us what you think of this item
• Your story Share your parenting tips