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Jaundice: Why Your Baby May Look Yellow
ATLANTA, Georgia (CNN) -- Jaundice is a common condition that affects six out of 10 newborns, according to the March of Dimes. CNN learned more about infant jaundice from Dr. Anne Hansen, a neonatologist at Children's Hospital in Boston, Massachusetts.
Light of a specific wavelength can turn bilirubin into a chemical easier for babies to excrete.
CNN: What is jaundice?
Hansen: Jaundice refers literally to the yellow discoloration of the skin and eyes of babies who have high bilirubin levels in their blood. Bilirubin is a yellow pigmented chemical that is released from red blood cells.
CNN: What causes it?
Hansen: Newborns have a higher red blood cell mass than older babies. So as those red blood cells break down, they release the bilirubin and there is more bilirubin in the blood. Newborns also have an immature liver, and the bilirubin is processed in a complex manner, but it requires the liver. So the combination of the increased red blood cell mass and the immaturity of the liver means that more is being produced and less is being excreted.
CNN: What are the symptoms?
Hansen: If a baby has mild jaundice, they will have no symptoms because they are not sick. They will just appear slightly yellow. Classically, the yellow discoloration starts at the top of the baby's head and moves down from there. The earlier signs of jaundice are seen on the scalp, the face and in the whites of the eyes. If the legs, soles of the feet and palms of hands are jaundiced, that probably means the baby has a high bilirubin level. 
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CNN: When should you call a doctor?
Hansen: If babies have very high bilirubin levels and are developing a brain injury, they will be lethargic, un-arousable and very sleepy. They may be agitated. They may have arching movements of their back. They may have a high-pitched cry or even seizures.
CNN: What is the relationship between breastfeeding and jaundice?
Hansen: Breastfeeding jaundice is the result of the fact that mothers who exclusively breastfeed their babies do typically have a little less volume of milk to offer in the first few days as their volume of milk supply is building. These babies are slightly dehydrated and they take in slightly fewer calories than a formula-fed baby.
CNN: How does that differ from another condition called breast-milk jaundice?
Hansen: Breast-milk jaundice is a bit more complicated. We know that there is some component in breast milk that does cause blood bilirubin levels to rise above formula-fed babies.
CNN: How do you treat these types of jaundice?
Hansen: The treatment for breastfeeding jaundice is to increase the frequency of the breastfeeding. Feed babies every two to three hours. It treats dehydration and increases caloric supply. The treatment for breast-milk jaundice is that mothers may be asked to pump and store their breast milk for two or three days and to give their babies formula in the meantime that will help the bilirubin to drop.
CNN: Many babies are treated with phototherapy. How does it work?
Hansen: The way that works is it takes advantage of the fact that the bilirubin makes its way out of the blood and into the baby's skin. When the skin is exposed to a particular wavelength of light that is in the blue range of the spectrum, it transforms the bilirubin into another chemical that is harmless and easier for the baby to excrete. The phototherapy tends to be only needed for a couple of days and babies usually go home without any long-term medical concerns. E-mail to a friend
Judy Fortin is a correspondent with CNN Medical News. Linda Ciampa of Accent Health contributed to this report.
Newborn Jaundice
Newborn jaundice is a common and usually harmless condition in which your new baby's skin and eyes look yellow. About 60% of babies get it.
Jaundice happens when too much bilirubin, a chemical that red blood cells release during their normal breakdown process, builds up in the blood. Sometimes it goes away on its own, or your doctor may suggest light therapy or other treatments to knock it out.
Some of the body's red blood cells break down every day and create bilirubin in the blood. It's the liver's job to filter it out of the bloodstream. When your baby is still in your womb, your liver clears out their bilirubin for them. After birth, your baby's liver takes over.
Sometimes, your newborn's liver can't break down bilirubin as quickly as their body makes it, and it starts to build up. Because bilirubin is a yellow compound, it turns your baby's skin and eyes yellow. It can also happen if the bile ducts are blocked or scarred, a condition called biliary atresia.
Babies have a greater chance of getting jaundice if they're:
Jaundice typically shows up 2 or 3 days after your baby is born and goes away within the first couple of weeks. Some types may show up sooner or much later.
Breastfeeding jaundice happens because your baby isn't eating enough. Your milk may not have come in yet or your baby is having trouble latching on. The more your baby eats, the more quickly their body clears waste, including bilirubin, from their system.
Breast milk jaundice appears after the first week. Doctors don't know exactly why it happens, but they think something in breast milk keeps your baby's liver from processing bilirubin effectively. This kind of jaundice can last for several months.
More serious kinds of jaundice are caused by a disease or condition, such as:
Jaundice may also happen if a mom has a different blood type from their baby. If that's your situation, your body may make antibodies that attack and break down your baby's red blood cells. In some cases, you can help prevent this by getting special shots when you're pregnant.
The telltale sign of jaundice is a yellow color to your baby's skin and yellow in the whites of their eyes. It typically starts on the face. Once bilirubin levels in the blood get higher, the yellow color moves to the chest and stomach, and then, finally, the legs and arms. Jaundice may be harder to notice on dark skin, so check the whites of your baby's eyes and under your baby's tongue to see if those areas look yellowish.
Severe jaundice can be an emergency situation, so call your doctor right away if:
Usually, a doctor can tell your baby has jaundice by looking. But they'll also want to know how much bilirubin is in your baby's blood to help decide on a treatment plan. They may:
If your doctor suspects that a condition is causing your baby's jaundice, they may do other tests, like:
In many cases, jaundice goes away on its own in 1 to 2 weeks. Your doctor will decide whether your baby should wait it out or start treatments like:
Extra feedings. Taking in more breast milk or formula will help your baby poop more often, which can help clear out bilirubin from the body. Or, if your baby is having trouble breastfeeding, your doctor may recommend you feed them breast milk from a bottle or also feed them formula.
Phototherapy. The doctor puts your baby under blue-green lights. It can help bilirubin leave their body in their urine. They'll wear a diaper only so that most of their skin can soak up the light. They'll wear patches to protect their eyes. The light may come from a special pad or mattress that puts out blue-green light.
Intravenous immunoglobulin (IVIg). If your baby's jaundice happens because they have a different blood type from their mom, your doctor may need to give them a blood protein through an IV that helps stop the breakdown of red blood cells.
Exchange transfusion. If your baby has severe jaundice that isn't getting better with other methods, they may need a blood transfusion called an exchange transfusion. In this process, your doctor repeatedly draws small amounts of your baby's blood and replaces it with blood from a donor. Your baby will need to stay in the neonatal intensive care unit (NICU) for the procedure. It's rare for babies to need this level of treatment for jaundice.
Don't hesitate to get your baby checked if you notice signs of jaundice. It's rare, but if severe jaundice is left untreated, bilirubin can enter the brain and cause permanent damage. This condition is called kernicterus, a complication that includes:
There isn't much you can do to prevent the typical jaundice in newborns. But you can help move it along by being sure your baby is well fed. If you're breastfeeding, aim for 8-12 feedings a day in the first days of your baby's life. If you're formula feeding, offer 1-2 ounces every 2-3 hours. Exposing your baby to sunlight also helps break down indirect bilirubin. Sit by the window indoors with your baby or take your baby for a stroll in the stroller if it is a nice day with sunshine.
766 Jaundice Of Newborn, Clinical And Anamnestical Character
Background and aims: A tendency to considerable growth of Jaundice in the structure of diseases of neonatal period is traced nowadays. Our investigation is the exposure of predisposing factors of conjugated hyperbillirubinemias of the newborns which would enable concentration on the mechanism of their development.
Methods: We've analysed the data of 52 newborns with Jaundice. In the newborns with the Jaundice were the prolonged icterus in 42,9. The greatest level of development of Jaundice was observed among the newborns with the body mass from 3000 to 3500 g (48,95%).
Results: We consider predisposing factors of the development of Jaundice: abortion(23,0%), 3-th or anymore pregnancy (48,0%), the breast feeding in 48,0% of contingent, feeding of the newborns was started within the first 30 minutes(51,89%). The pathology of Digestive Tract and nervous system was defined among those newborns. In the 82,6% of cases of labor there were the following complications: caesarian section, stimulation of labor, premature labor, premature rupture of the membranes, pathology of umbilical cord, swift births, prolonged labor and alt.
Conclusions: A leading sign in the newborns is an icteric syndrome. The greatest indexes of the appearance of icterus in the newborns was on the 3-rd day Epyκy were exposed the prevalent factors of the development of Jaundice in the newborns: the somatic pathology of mother and pathological development of pregnancy, complication of labor, hypoxic damage of the fetus of the newborn, breast feeding, disbioses, at 1-st and 2-nd pregnancies and labor.
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