Jaundice

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Baby with jaundice

Mild jaundice in babies occurs in about 50% of full-term newborn babies, and in up to 80% of premature babies.

You’re most likely to notice it from the third day after birth. Jaundice is usually harmless and disappears after one to two weeks.

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.
 
One 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 second baby’s bloodstream, and jaundice occurs. If this has happened, it’s usually seen in the first 24 hours after birth.
 
Biliary atresia is another rare cause of jaundice in babies. It happens when the tiny tubes that carry bile from the liver to the intestine get scarred. Babies with this condition usually grow normally and look well at first, but they will get very ill with serious liver disease if they aren’t diagnosed and treated early. Their jaundice will usually go on after they are two weeks of age, and they might also have pale-looking poo. 
 

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 is unwell, feeding poorly and not gaining enough weight
  • your baby’s poo becomes pale or baby’s 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.
 

Tests

If your baby has jaundice lasting more than two weeks – especially if their poos are pale or their wees are dark – they'll need a blood test to check the ‘conjugated bilirubin’ levels in the blood. They might then need more tests on their liver.
 

Treatment

Treatment for jaundice depends on how bad it is and what has 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, babies might have phototherapy treatment for a few days. This treatment uses ultraviolet light to help to break down the bilirubin overload. It involves the baby being placed naked in a cot under a blue phototherapy lamp for two to three days. The baby’s eyes will be covered for protection. There are minimal side effects to phototherapy, although the 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 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 a baby’s own blood is replaced with compatible fresh blood. This isn’t common.
 
If your baby has breastmilk jaundice, it doesn’t mean that you need to stop breastfeeding. This type of jaundice is usually mild and should get better by itself with time. Talk to your child and family health nurse or doctor if you’re worried about what to do.
 

Prevention

Only ‘incompatible blood type’ jaundice is preventable. If this type of jaundice is suspected, the mother will receive an anti-D injection immediately after delivery. This can prevent complications in subsequent pregnancies.
 
Source:
Raising Children Network - Jaundice in newborns
 
Date last reviewed: 
December, 2012

15 trusted resources for jaundice

  1. Jaundice

    myVMC Virtual Medical Centre

    The causes of jaundice can be divided as follows: Increased bilirubin production due to increased red blood cells being destroyed (this is known as haemolysis): collection of blood in the tissue, increased red blood cells destruction

    Read more
    Last reviewed: May, 2010
  2. Jaundice in babies

    Women's and Children's Health Network

    Jaundice (yellow colouring of the skin and eyes) can be seen during the first week of life in about 60% of full term babies . It is even more common in babies who are born early.

    Read more
    Last reviewed: November, 2012
  3. Jaundice in newborns

    Raising Children Network

    A guide to what causes jaundice in newborn babies and some common treatments for newborn jaundice.

    Read more
    Last reviewed: December, 2012
  4. Jaundice in newborn babies - NSW Multicultural Health Communication Service

    Multicultural Health Communication Service

    This fact sheet explains the causes, effects and treatment of jaundice in babies, including which babies are most likely to have jaundice.

    Read more
    Last reviewed: September, 2009
  5. Jaundice

    Pregnancy, Birth and Baby

    Mild jaundice in babies occurs in about 50% of full-term newborn babies, and in up to 80% of premature babies. You are most likely to notice it from the third day after birth. Jaundice is usually harmless and disappears after one to two weeks.

    Read more
    Last reviewed: February, 2014

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