- On January 12, 2015
Neonatal jaundice occurs in about 84% of newborns and is characterized as high levels of bilirubin in the blood. Bilirubin is a yellow substance created when the body replaces old red blood cells with new ones causing yellowing of the skin and whites of the eyes. The yellowing sometimes starts on the face and then moves down to the chest, belly area, legs, and soles of the feet. There are several types of neonatal jaundice including physiological, premature, breastfeeding and breastmilk jaundice. (1, 2).
“Physiological jaundice” is a type of neonatal jaundice that is normal for newborns because their liver is taking over the function of breaking down the bilirubin, which is excreted in the stool. “Physiological jaundice” is noticeable from 2-4 days old and usually disappears within two weeks (1,4).
Jaundice of prematurity occurs in premature babies because their bodies are not fully developed to excrete bilirubin effectively (5).
Breastfeeding jaundice (most often not serious) is usually seen within the first week of life and occurs when the mother’s milk is slow to come in or if there is a latching issue and the baby is not feeding properly (1,4). This type of jaundice usually resolves on its own when mother’s mature milk comes-in or latch is corrected.
Breast milk jaundice (most often not serious) occurs when the components of breast milk interferes with the breakdown of bilirubin in the baby. It is usually seen after 7 days old and peaks at 2-3 weeks old lasting at low levels for about a month. (1,3,4).
Severe newborn jaundice occurs when the baby has a condition in which the number of red blood cells has increased and needs to be replaced at a greater rate. These conditions include abnormal blood cell shape, infection, and different blood types between mother and baby (1,4).
Hospitals test bilirubin levels within 24 hours of birth through a probe that can detect levels just by touching the skin. High readings are usually confirmed with a blood test (4).
Normal bilirubin levels vary for full term and premature babies. Because most newborns have physiological jaundice , bilirubin levels below 19 mg/dl are considered normal in a full-term baby for the first few weeks of life. Levels above 20mg/dl are cause for concern and should be addressed with treatment. For premature babies (infants weighing less than 1000 grams), it is suggested to being treatment if levels of bilirubin get to 6mg/dl at 24 hours of age (5).
The most common treatment for severe cases of neonatal jaundice is phototherapy. Usually a blue light is used on the infants skin to alter the bilirubin molecule into a form that can be excreted in the urine and feces. In jaundice cases that are borderline cause for concern, it is usually recommended that the mother increase breastfeeding frequency to increase bowel movements as a form of ridding the body of the excess bilirubin (1,3,5).
1.) Newborn jaundice: MedlinePlus Medical Encyclopedia. (2013, December 4). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001559.htm
2.) Newborn Jaundice – American Pregnancy Association. (2013, January). Retrieved from http://americanpregnancy.org/first-year-of-life/newborn-jaundice/
3.) Jaundice in neonates: Neonatal ehandbook – Department of Health, Victoria, Australia. (2014, August 20). Retrieved from http://www.health.vic.gov.au/neonatalhandbook/conditions/jaundice-in-neonates.htm
4.) Jaundice in Healthy Newborns. Kids Health.(n.d.). Retrieved from http://kidshealth.org/parent/pregnancy_center/newborn_care/jaundice.html#
5.) Hansen, T, MD, Phd. (2014, February 28). Medscape. Retrieved from http://emedicine.medscape.com/article/974786-treatment
Written By: Alisha Varini
Georgia State University
Coordinated Masters of Health Science Program