What is Newborn Jaundice?
Almost two-thirds of babies will experience some level of newborn jaundice, usually appearing in the first 2-3 days of life. Bilirubin, which is released when dying red blood cells are broken down, can make the eyes and skin appear yellow. Babies are born with extra red blood cells that helped them obtain oxygen before birth. When a baby begins breathing air, these extra cells begin to die. The liver filters these old cells out of the blood. Under normal circumstances, newborn jaundice requires no special treatment. The bilirubin binds to albumin in the blood, and is excreted through the digestive tract. For most healthy term babies, newborn jaundice is mild and lasts only a few days.
Newborn Jaundice Can Be Serious
One cause of newborn jaundice in breastfeeding newborns is low milk intake due to an unrecognized breastfeeding problem. Babies born at less than 39 weeks are at higher risk because they are less mature. Babies born to diabetic mothers may have more extra red blood cells than average. Sometimes the mother’s blood group and the baby’s blood group are not compatible. Bruising that occurs at birth can also contribute to jaundice. If bilirubin in the baby’s blood reaches an unsafe level, serious health complications can result, including brain changes. Physicians use a chart called a nomogram to determine what level is acceptable.
How Newborn Jaundice is Treated
Today babies are carefully screened in the hospital before discharge to make sure the level of jaundice is within the acceptable range for the individual baby’s age in hours, gestational age, and health status. If the level is too high, the baby’s doctor will treat the jaundice. Phototherapy, a blue light, is used to help eliminate the bilirubin in the blood. In addition, the baby is fed frequently to encourage frequent bowel movements. This type of treatment is usually all that is required to eliminate jaundice. The doctor may order a blood test for your baby after you leave the birthing center just to make sure the jaundice level remains acceptable.
How To Prevent Breastfeeding Jaundice
To prevent newborn jaundice caused by low milk intake, it’s important to begin breastfeeding as soon after birth as you and your baby are ready, usually within the first hour. Holding your baby skin-to-skin will encourage frequent feedings, and hand expressing to feed extra milk in the first couple of days can significantly increase the volume of milk your baby receives. More milk means more bowel movements. Not all forms of jaundice are preventable, but increasing milk intake can prevent breastfeeding jaundice. Ask for help. A breastfeeding expert can provide valuable tips to get breastfeeding off to the best start.
The American Academy of Pediatrics recommends a breastfeeding evaluation 3-5 days after you and your baby are discharged from the birthing center. Your milk will have increased in volume, and you and your baby will have had a few days to practice. A lactation consultant can observe a breastfeeding, determine if your baby is getting plenty of milk, and help to ensure breastfeeding is going well. Any problems can be addressed early so you and you baby can breastfeed successfully.
After you return home from the birthing center, if you are concerned that your baby is jaundiced, or is more yellow than when you were discharged, call you pediatrician right away so your baby can be evaluated.