KidsMD Health Topics

Jaundice

  • Jaundice is a condition that makes a baby’s skin and the white part of his eyes look yellow.

    • Jaundice occurs when there is a buildup of a brownish yellow substance called bilirubin in a baby’s blood.
    • Over half of all newborns develop some level of jaundice during their first week.
    • Premature infants are more likely to develop jaundice.
    • It is usually a temporary condition but may be a sign of a more serious illness.
    • The coloring of bilirubin causes the baby’s skin and white part of the eyes to look yellow.
    • The timing of when jaundice first appears in a baby helps diagnose it.

    Early recognition and treatment are important in keeping bilirubin from rising to dangerous levels.

    Newborn Medicine

    Boston Children's Hospital
    300 Longwood Avenue
    Boston MA 02115
     617-355-8076
     fax: 617-730-0902

    ADDITIONAL SERVICES THAT TREAT THIS CONDITION 


    Center for Childhood Liver Disease

    Boston Children's Hospital
    300 Longwood Avenue
    Fegan 5
    Boston MA 02115

     617-355-5837
     fax: 617-730-0716
  • What is jaundice? 

    Jaundice is a condition that occurs when a baby’s red blood cells break down, causing them to produce bilirubin, a brownish yellow substance that is difficult for a baby to discharge until his liver is fully developed and functioning. This can lead to a buildup of bilirubin in the baby’s blood, called hyperbilirubinemia. The coloring of the bilirubin causes the baby’s skin and the white part of his eyes to look yellow.

    Types of jaundice

    • Physiologic jaundice: occurs as a response to the baby's limited ability to discharge bilirubin in the first days of life
    • Breast milk jaundice: occurs in breastfed babies due to low calorie intake or dehydration
    • Jaundice from hemolysis: occurs due to hemolytic disease of the newborn, high red blood cell count, or bleeding
    • Jaundice related to inadequate liver function: occurs due to infection or other factors 

    What causes jaundice?

    Jaundice is caused by the buildup bilirubin in a baby’s blood.

    Is jaundice common?

    Over half of all newborns develop some level of jaundice during their first week of life. Premature infants are more likely to develop jaundice.

    What are the symptoms of jaundice?

    The most common symptoms of jaundice are:

    • yellow coloring of the skin, usually beginning on his face and moving down the body
    • poor feeding
    • tiredness

    Diagnostics

    The timing of when jaundice first appears in a baby helps diagnose it.

    First 24 hours of life:

    • can be very serious
    • usually requires immediate treatment

    Second or third day of life:

    • usually physiologic jaundice
    • can be a different, more serious form

    Third day through first week of life:

    • usually due to infection

    Second week of life and beyond:

    • often breast milk jaundice

    The following tests may also be conducted to determine if a baby has hyperbilirubinemia:

    • direct and indirect bilirubin levels (these levels show whether bilirubin is bound with other substances by the liver or is circulating in the blood)
    • red blood cell counts
    • blood type and Coomb's test (identifies certain proteins called antibodies that attack red blood cells)
  • While jaundice cannot be prevented completely, early recognition and treatment are important in keeping bilirubin from rising to dangerous levels. Treatment of jaundice depends on many factors, including the cause and level of bilirubin. The ultimate goal of all treatment is to keep the level of bilirubin from increasing to dangerous levels.

    Treatment may include: 

    • Phototherapy:
      • special therapy using blue spectrum light to reduce biliubin levels
      • may take several hours throughout the day and night
      • baby's position is changed frequently to allow full skin exposure
      • baby's eyes must be protected and temperature monitored
      • Blood levels of bilirubin are monitored to determine success.
    • Fiberoptic blanket:
      • form of phototherapy in which fiberoptic blanket is placed under the baby
      • can be used alone or in combination with standard phototherapy
    • Exchange transfusion:
      • alternating giving and withdrawing blood in small amounts through a baby's vein or artery
      • helps increase red blood cell count and lower levels of bilirubin
      • may need to be repeated if bilirubin levels remain high
    • Discontinued breastfeeding:
      • stopping breastfeeding for one or two days and giving the baby formula
      • Breastfeeding can be resumed after bilirubin levels are lower.

    Treatment of underlying conditions:

    • treating infection and other underlying conditions
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