About jaundice in newborns
Jaundice in newborns happens when there’s an overload of bilirubin in a baby’s blood. This can make the baby’s skin and the whites of their eyes go yellow.
Bilirubin is a waste product that’s made when old red blood cells break down. Usually, bilirubin is processed in the liver, where it’s mixed into bile. The bile goes from the liver to the digestive tract and comes out of the body in poo. In newborns, several things can stop this happening properly, which leads to a bilirubin overload.
Types of jaundice in newborns
Physiological jaundice
If your baby has physiological jaundice, it’s because their liver isn’t yet developed enough to process bilirubin.
This type of jaundice is very common. It happens in about 3 in 5 babies born at term. And if your baby is premature, their chance of having physiological jaundice is higher.
Physiological jaundice usually gets better as your baby’s liver develops and can process bilirubin properly.
Breastmilk jaundice
If your baby has breastmilk jaundice, it’s because a chemical in breastmilk is interfering with their ability to get rid of bilirubin.
Breastmilk jaundice is common in breastfed babies. It often happens a few days after birth.
Breastmilk jaundice isn’t harmful and usually sorts itself out after several weeks.
Breastfeeding jaundice
If your baby has breastfeeding jaundice, it’s because problems with breastfeeding are making your baby dehydrated. Your baby needs fluids to reduce their bilirubin levels.
Breastfeeding jaundice usually gets better as your baby gets more fluids.
Jaundice from delayed cord clamping
Doctors might recommend delaying the clamping and cutting of your baby’s umbilical cord after birth. This allows more red blood cells to enter your baby’s blood. But it can sometimes lead to jaundice. This is because your baby’s liver has more red blood cells to process, so bilirubin builds up.
This type of jaundice usually just needs monitoring and gets better by itself after 1-2 weeks.
Jaundice from birth interventions
Your baby might get this type of jaundice if they’re bruised because of interventions at birth, like forceps birth. The red blood cells from this bruising break down and bilirubin builds up.
This type of jaundice usually just needs monitoring and gets better by itself after 1-2 weeks.
Blood type incompatibility jaundice
This is a rare type of jaundice, which happens when the blood groups of a mother and her baby are incompatible.
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 can cause serious health problems in any babies the mother has in the future.
In a future pregnancy, the mother’s antibodies become active and cross the placenta to attack the baby’s red blood cells. The destruction of these red blood cells releases bilirubin into that baby’s bloodstream, which results in jaundice. If this happens, you usually see it in the first 24 hours after birth.
Babies with this kind of jaundice need treatment.
Biliary atresia
Biliary atresia is a rare cause of jaundice in babies.
It happens when the tiny tubes that carry bile from the liver to the intestine are missing, damaged or blocked. Babies with this condition usually grow as expected and look well at first, but they get very ill with serious liver disease if they aren’t diagnosed and treated early.
Babies with this kind of jaundice usually start to show signs at 2-8 weeks of age.
Babies with this kind of jaundice need surgical treatment.
Symptoms of jaundice in newborns
Newborn jaundice causes your baby’s skin and the whites of their eyes to go a yellow colour.
The jaundice typically starts on the face and head. If the level of bilirubin increases, the colour spreads to the body.
Your baby might also be drowsy and have feeding difficulties.
Babies with biliary atresia also have pale-looking poo and darker urine.
Medical help: when to get it for newborns who have jaundice
Your child and family health nurse, midwife, GP or paediatrician should check and monitor your newborn for jaundice.
You should take your baby to the GP if your baby:
- is unwell, feeding poorly and not gaining enough weight
- has pale poo or dark wee
- looks jaundiced.
Tests for jaundice in newborns
Medical staff might measure the level of your baby’s jaundice using a bilirubinometer, which is a special machine that’s briefly placed on your baby’s skin. They might also need to do a heel prick test to get a more accurate measurement of the level of bilirubin in your baby’s blood.
Sometimes if the levels of jaundice are high or medical staff are worried that your baby has a more serious condition, your baby will need other tests to find the cause.
Treatment of jaundice in newborns
Treatment for newborn jaundice depends on how serious it is and what has caused it.
Physiological jaundice and jaundice from delayed cord clamping or birth interventions
Babies who develop jaundice several days after birth usually just need careful monitoring by their parents. These babies don’t usually have to stay in hospital.
If your baby’s bilirubin levels are high, your baby might have phototherapy treatment for a few days. This treatment uses a special type of blue light that helps break down the bilirubin overload.
Your baby will probably get phototherapy by being placed naked in a cot under a phototherapy lamp for 2-3 days in hospital. Some hospitals offer a biliblanket. This is a special blanket for wrapping your baby. You can use a biliblanket to give your baby phototherapy treatment at home. It’s important to supervise your baby when they’re wrapped in a biliblanket.
Most babies cope well with phototherapy treatment. Phototherapy has minimal side effects, although your baby might have a mild rash and runny poo for a few days. Some babies have small fluid losses during phototherapy, so they might need extra feeds.
Breastmilk jaundice
If your baby has breastmilk jaundice, it’s recommended that you keep breastfeeding. This type of jaundice is usually mild and should get better by itself with time. Talk with your child and family health nurse or GP if you’re worried about what to do.
Breastfeeding jaundice
If your baby has breastfeeding jaundice, this will get better if they have more feeds. Your child and family health nurse or a lactation consultant can help with breastfeeding.
Severe or blood type incompatibility jaundice
Severe jaundice, in which bilirubin levels are very high, might need treatment with an exchange transfusion. This is when a baby’s own blood is replaced with compatible fresh blood. This is usually a treatment for blood type incompatibility jaundice, but it isn’t common.
Biliary atresia jaundice
If your baby has jaundice caused by biliary atresia, they’ll need an urgent operation to help with bile drainage.
If severe jaundice isn’t treated, it can cause brain damage.
Prevention of jaundice in newborns
Only jaundice caused by a certain type of blood incompatibility is preventable.
If your doctor or health professional thinks this type of jaundice might be a problem, you’ll get an anti-D injection immediately after delivery. This can prevent complications in subsequent pregnancies.