Jaundice in newborns is a common condition, often causing concern among new parents. Characterized by a yellowing of the skin and eyes, neonatal jaundice affects more than half of all full-term infants and an even higher percentage of premature babies. While most cases are harmless and resolve on their own, it’s essential to understand when jaundice may signal a more serious problem.
In this detailed guide, we’ll explore what causes jaundice in newborns, how to identify it, the different types, diagnostic methods, treatments, and when to seek medical help.
What Is Jaundice in Newborns?
Jaundice in newborns refers to the yellow discoloration of a baby’s skin, eyes, and mucous membranes due to high levels of bilirubin in the blood. Bilirubin is a yellow pigment produced when red blood cells break down. Normally, the liver processes and removes it from the body. However, a newborn’s liver is often immature and may not efficiently eliminate bilirubin, leading to its buildup.
Why Is Jaundice Common in Newborns?
Neonatal jaundice is common because:
High red blood cell turnover: Newborns, especially premature ones, have more red blood cells, which break down more rapidly.
Immature liver: The newborn’s liver may not be developed enough to process bilirubin efficiently.
Increased bilirubin production: During the first few days after birth, the body produces more bilirubin than it can eliminate.
Types of Jaundice in Newborns
There are several types of jaundice in newborns, each with its own causes and implications:
1. Physiological Jaundice
Most common type
Occurs in about 60% of term newborns
Appears on the 2nd or 3rd day of life
Resolves on its own within 1–2 weeks
2. Breastfeeding Jaundice
Linked to insufficient breast milk intake
May result from poor latch or infrequent feeding
Starts within the first week of life
3. Breast Milk Jaundice
Appears later (5–7 days after birth)
Can persist for several weeks
Caused by substances in breast milk that slow bilirubin processing
4. Pathological Jaundice
More serious and requires immediate medical attention
Appears within 24 hours of birth
Caused by underlying conditions such as:
Blood group incompatibility (Rh or ABO)
Infections
Enzyme deficiencies
Liver disorders
5. Hemolytic Jaundice
Caused by excessive breakdown of red blood cells
Common in cases of Rh incompatibility
May lead to severe bilirubin levels
Causes of Jaundice in Newborns
The main causes include:
Immature liver function
Blood group incompatibility (Rh or ABO)
Premature birth
Internal bleeding during delivery
Bruising from birth trauma
Infections (e.g., sepsis)
Genetic disorders (e.g., G6PD deficiency)
Liver diseases
Symptoms of Jaundice in Newborns
Jaundice typically starts on the face and spreads downward. Common symptoms include:
Yellowing of skin and eyes
Poor feeding
Lethargy or excessive sleepiness
High-pitched crying
Dark urine (unusual in newborns)
Pale or clay-colored stools
How Is Jaundice in Newborns Diagnosed?
1. Physical Examination
Doctors look for yellowing of the skin, especially under good lighting.
2. Bilirubin Test
Transcutaneous bilirubin (TcB): A non-invasive method using a skin sensor.
Serum bilirubin test (TSB): A blood test to determine the exact bilirubin level.
3. Blood Type and Coombs Test
Checks for ABO or Rh incompatibility.
The Direct Coombs test determines whether antibodies are attacking the baby’s red blood cells.
When Is Jaundice in Newborns Serious?
Jaundice may become dangerous if bilirubin levels rise excessively, leading to kernicterus, a rare but severe form of brain damage. Immediate medical intervention is necessary if:
Jaundice appears within the first 24 hours
The yellowing spreads rapidly
The baby is extremely sleepy or difficult to wake
There are signs of dehydration or poor feeding
The baby has a high-pitched cry or arching of the back
Treatment for Jaundice in Newborns
1. Phototherapy (Light Therapy)
The most common treatment
Baby is placed under special blue lights that convert bilirubin into a form that can be eliminated
Eyes are protected with special goggles
2. Exchange Transfusion
Used in severe cases
Baby’s blood is replaced with donor blood to quickly reduce bilirubin levels
3. Adequate Feeding
Encouraging regular breastfeeding or formula feeding
Helps flush bilirubin through urine and stool
4. Intravenous Immunoglobulin (IVIG)
Used in cases of Rh or ABO incompatibility
Reduces the need for exchange transfusion
Home Care for Mild Jaundice
If jaundice is mild and not due to underlying conditions, the doctor may advise:
Frequent breastfeeding (8–12 times a day)
Ensuring the baby stays hydrated
Monitoring stool and urine output
Exposure to natural sunlight (brief, safe periods only)
Always consult your pediatrician before trying home remedies.
Prevention of Jaundice in Newborns
While not all cases are preventable, some strategies include:
Early and frequent feeding: Helps pass meconium and reduce bilirubin levels
Monitoring high-risk babies: Babies with blood type incompatibilities, preterm birth, or siblings with jaundice need closer observation
Rho(D) immune globulin injection: Given to Rh-negative mothers during pregnancy to prevent Rh incompatibility
Complications of Untreated Jaundice
If left untreated, severe jaundice can lead to:
1. Acute Bilirubin Encephalopathy
Early-stage brain damage from bilirubin toxicity
Symptoms include poor suck, lethargy, and muscle tone abnormalities
2. Kernicterus
Permanent brain damage
Can cause hearing loss, vision problems, cerebral palsy, and developmental delays
Prompt treatment is crucial to prevent these outcomes.
Frequently Asked Questions (FAQs)
Is jaundice in newborns dangerous?
In most cases, no. It’s common and resolves on its own. However, high bilirubin levels can be dangerous if untreated.
How long does newborn jaundice last?
Physiological jaundice usually clears within 1–2 weeks. Breast milk jaundice can last a bit longer but is generally harmless.
Can breast milk cause jaundice?
Breast milk jaundice is a type of prolonged jaundice, but it’s not a reason to stop breastfeeding unless advised by your doctor.
Can formula-fed babies get jaundice?
Yes, though less common than in breastfed babies.
How can I tell if my baby’s jaundice is worsening?
Watch if the yellowing spreads to the chest, abdomen, arms, or legs or if the baby becomes more lethargic, irritable, or feeds poorly.
When to See a Doctor
Seek medical help immediately if your newborn:
Shows signs of jaundice within 24 hours of birth
Appears very yellow or orange
Is not feeding well or has fewer wet diapers
Is extremely sleepy or unresponsive
Has symptoms such as high-pitched crying or arching back
Jaundice in newborns is a condition most parents will encounter, but understanding its causes, types, and treatments can make a big difference. While the majority of cases are benign and resolve naturally, vigilance is key. Regular checkups, adequate feeding, and timely intervention can help prevent complications.
If you’re concerned about your newborn’s jaundice, don’t hesitate to consult your pediatrician. With proper care and monitoring, your baby will be healthy and thriving in no time.
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Disclaimer:
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
