Jaundice is a yellow skin color which is usually not present at birth but may appear within the first four days of life. It is caused by the accumulation in the body of a yellow pigment called bilirubin. Bilirubin is a breakdown product of hemoglobin, the red pigment which resides in red blood cells and carries oxygen. Bilirubin is cleansed from the blood by the liver. Before birth, it is the mother’s liver that does the cleaning, but after birth the baby’s liver must take over this vital function. At birth, the livers of many babies are not mature enough to take over this cleaning function. As a result, the baby may accumulate bilirubin and become jaundiced. If a baby has been bruised, has a cephalohematoma or has a blood type different than his mother, he may become even more jaundiced than if these were not present.
About 7 out of 10 babies develop some degree of jaundice which is usually of no concern. However, very high levels of bilirubin have been reported to cause brain injury. Jaundice usually begins in the face and eyes and spreads down the body as the bilirubin accumulates. During the first week of life examine your baby’s skin twice daily in daylight from a window. If you notice a yellow or orange color (especially if the color appears not only on the face, but also on the chest and abdomen), please call the office or take your child to the nearest hospital laboratory and ask for a Total Bilirubin test. The laboratory will notify your pediatrician of the test results and we will call you back within two hours. If no one calls you back, please call the office.
If your child becomes jaundiced, be sure to breastfeed frequently (every 2-3 hours) or offer plenty of formula. Dehydration can worsen jaundice. If the bilirubin approaches high levels, it may be necessary to treat your child with phototherapy. This consists of shining special lights on the skin that helps rid the body of bilirubin.