Neonatal jaundice

Obstetrics & Gynaecology

patientinformation

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What is jaundice? Jaundice is the name given to the yellowing of the skin, the whites of the eyes and the inside of the mouth. Jaundice in newborn babies is common. It is usually harmless and often clears up on its own after 10-14 days.

Jaundice appears when there is too much of a substance called bilirubin in your baby’s blood. Bilirubin is made naturally in the body, when red blood cells that are not needed any more are broken down. Usually the liver changes the bilirubin into a form the body can get rid of as waste in the stool (poo).

Why do newborn babies get jaundice?Newborn babies normally get jaundice for these main two reasons:

l���They produce twice as much bilirubin as adults (They have more red blood cells than adults and the red blood cells do not last as long)

l���Their liver is not properly matured and cannot process the extra bilirubin that their body makes

The most common cause of jaundice in newborns is called physiological jaundice. This type of jaundice is usually first seen between day 2 and 4 of life. Physiological jaundice increases to a peak at day 7 and then fades and disappears by day 14.

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Jaundice may also be caused by a serious problem. There is more likely to be a serious cause if:

l��It starts in the first day of life

l��It is severe (the bilirubin level is high)

l��Your baby is also unwell

l���It is present at two weeks after the birth

l���Your baby has pale stools (looks chalky) or the urine causes dark staining of the nappy

Which babies are more likely to develop jaundice that needs treatment?

l���Babies who were born early (at less than 38 weeks gestation)

l���Babies who have a brother or a sister who had jaundice that needed treatment as a baby

l���Some babies whose blood groups are different from that of their mothers’ blood group

l���Babies who have signs of jaundice in the first 24 hours after birth

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How to check baby for jaundicel��Do the whites of the baby’s eyes look yellow?

l���Do the gums or roof of the baby’s mouth look yellow? (during crying)

l���Does the baby’s skin look yellow?

The yellow colour usually starts on the face and forehead and then spreads to the body, arms and legs.

From time to time, in a bright light (preferably natural light) gently press the baby’s skin to see if you can see a yellow tinge.

What should I do if I think my baby has jaundice?Tell your midwife or doctor. If this happens in the first 24 hours contact them urgently

What tests will be done?l���A small hand-held device may be placed against

the baby’s skin to estimate the level

l���If necessary blood sample from the baby’s heel may be taken to measure the level of the bilirubin

l���Other blood tests may be done by the doctors if they suspect the cause of the jaundice is serious

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What treatment will the baby receive?Mild jaundice Mild jaundice does not need any treatment. Continue to feed your baby adequately and correctly.

Phototherapy (Light treatment)Your baby may be treated with phototherapy if their bilirubin level is high. Baby will be put on a special light blanket or under a special lamp naked, except for a nappy and a pad for the eyes. More than one lamp may be needed if the bilirubin level is very high.

Exchange transfusion Babies with extremely high bilirubin levels may need some of their blood taken out and replaced with blood from a donor (exchange transfusion).

Does jaundice cause any long-term problems?For most babies jaundice does not cause any long-term problems. Very rarely if the bilirubin level is so high it can lead to hearing problem or brain damage.

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What should I do if my baby’s jaundice does not clear up?If your baby has jaundice for more than 2 weeks (or for more than 3 weeks for babies born prematurely), tell your midwife, health visitor or doctor.

�Check that the stool is not pale or chalky and the urine does not stain the nappy

Breast fed babies can have jaundice lasting for a longer period. If other causes of persisting jaundice are excluded this is harmless. Continue to breast feed.

Where can I find more information?Neonatal Jaundicewww.patient.co.uk/print/28710

Jaundice in newborn babies: information for parents and carerswww.nice.org.uk/guidance/CG98

Patient information from BMJ GroupJaundice in newborn babies

Yellow Alert - Baby Jaundicewww.yellowalert.org/Baby-Jaundice

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Notes

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Notes

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Produced by: Kate Bollington, March 2015. Updated April 2019Next Revision Due: April 2021. Version: 2.0 ©The Rotherham NHS Foundation Trust 2019. All rights reserved.

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