Newborn Jaundice Is Usually Benign

Most newborn babies will have at least some jaundice in the first few weeks of life.

Usually benign, it can occasionally lead to severe and permanent problems.

Jaundice — that yellow color a baby’s skin and the white parts of the eyes can have — is caused by the accumulation of the protein bilirubin in the baby.

Bilirubin is formed from the natural breakdown of the hemoglobin in red blood cells.

Babies, just like adults, constantly make new red blood cells and break down old ones.

Since a baby still inside the womb gets oxygen only through the uterus, the baby  makes extra red blood cells to carry as much of the oxygen as possible.

The mother’s liver processes most of the excess bilirubin.

When the baby is born, she gets more oxygen and gets rid of the extra red blood cells.

A baby’s inexperienced liver must handle the excess bilirubin (where it is processed and excreted in stool).

It takes a few days to get the hang of it.

Meanwhile, the bilirubin gets out of the bloodstream and into the skin.

The jaundice usually starts in the head and spreads down the body.

It can also show up inside the mouth and in the whites of the eyes.

Only when the bilirubin level gets really high does the bilirubin start to move into the brain.

There it can cause acute bilirubin encephalopathy — the baby can develop a high-pitched cry, stiffness, lethargy, fever, poor feeding, and vomiting.

The baby also can develop kernicterus, a syndrome that can include cerebral palsy, deafness and mental retardation.

Risk factors for jaundice include prematurity, certain differences in blood type from the mother’s, poor feeding, bruising from the birth process, infection, liver problems (rare), and enzyme deficiencies.

Sometimes breast milk can increase a baby’s bilirubin.

A blood or skin test can be used to determine a jaundiced baby’s bilirubin level.

Graphs and computer programs can help determine whether a baby needs treatment for a bilirubin level that is too high.

Treatment is done by placing the baby in or over special lights that break down the bilirubin in the skin so that it can be urinated out (bypassing the liver).

Only rarely does an exchange transfusion of the baby’s jaundiced blood have to be performed