Is it the hospital lighting? Is fatigue or hormones affecting your eyesight? No, it’s not just you: your precious newborn baby appears to be a bit yellow. Newborn jaundice- or the yellowing of the skin and eyes- is a very common condition among babies. It’s typically benign and will go away on its own within two to three weeks. However, severe jaundice can be dangerous if it's left untreated. In Canada and the United States, all newborns are evaluated for jaundice before being discharged from the hospital, and the follow-up evaluations will be scheduled to monitor the condition also.
Jaundice occurs when high levels of a chemical called bilirubin build up in a newborn’s blood. Bilirubin, a yellow pigment, is the byproduct of the normal breakdown of old red blood cells. High levels of bilirubin can be toxic, but healthy livers will filter it from the blood so that it can be safely excreted from the body. When in the womb, a baby’s still-developing liver isn’t able to clear the excess bilirubin on its own; instead, bilirubin is removed by mum through the placenta. At birth, a baby’s liver must start to work on its own to remove excess bilirubin, and it typically takes a few days for a brand-new liver to clear it all.
The diagnosis of newborn jaundice is straightforward– its lone sympthom is the yellowing on the skin and/or in the whites of the eyes. Once a newborn has been diagnosed, skin tests or blood tests may be performed to determine the severity of bilirubin levels in the blood, or if there are any underlying conditions. Bilirubin levels- and consequently jaundice levels- will typically peak between three to seven days after birth. If jaundice appears less than a day after birth, it may be a sign of infection, a problem with baby’s digestive system, or an Rh incompatibility.
In most cases, mild jaundice will go away on its own within three weeks. Parents will be told to monitor their baby’s skin colour daily to ensure that both their skin and eyes are returning to normal. It’s vital that te baby is given enough to eat so that the extra bilirubin can be excreted through their urine and stools. Breastfed babies should be fed eight to 12 times every 24 hours, while formula fed babies should be fed six to 10 times a day.
For cases of severe jaundice, your doctor will recommend more aggressive forms of treatment. That's because if enough bilirubin accumulates in your baby's the blood, it can get passed through to their brain and cause permanent damage. The most common form of treatment is called phototherapy, which uses a special light to break down the bilirubin in the baby’s body. This treatment is typically performed at the hospital; your baby wears special protective goggles, and is then placed under a blue spectrum light. In even more severe cases, your baby may need a blood transfusion to reduce their bilirubin levels.
While jaundice is rarely dangerous, it's important to monitor symptoms closely. Contact your doctor immediately if jaundice spreads or becomes more intense- especially after the first three days of life, when bilirubin levels are typically highest. If your baby has been diagnosed with jaundice, seek medical attention if they develop a fever, make high-pitched cries, appear listless or lethargic, or if they have trouble eating. Finally take heart in that even if your newborn needs extra help to get rid of that pesky bilirubin, properly managed jaundice rarely leaves any permanent problems.