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What is jaundice?

Jaundice is a very common condition in newborn infants where the skin develops a yellowish appearance. Most infants develop this in the first few days of life and in most infants it goes away on its own. Jaundice is caused by a build up of bilirubin, a natural substance in the body which is usually passed into the stool by the liver. This is one of the reasons infants have yellow-colored stools. Newborn infants have immature livers which cannot function as well as adult livers for the first few weeks of life, and this often leads to jaundice.

In older children and adults, jaundice is usually an indication of an infection or other disorder that is interfering with the liver. This must be brought to your pediatrician’s attention immediately.

What do I look for?
Look at your baby in natural or under fluorescent lights. The whites of the eyes may look yellow initially. As the jaundice worsens, you may notice yellow coloration of the face progressing to the chest, belly, and then to the legs. It may help to press the infant’s nose or forehead. If the skin looks yellow, then your baby has jaundice. If you notice this yellow color call your pediatrician. If your baby is very sleepy and not feeding well call your pediatrician immediately.

Is it dangerous?
If the bilirubin levels get very high, this can cause a problem. This level depends on the size and age of the baby, and if there are other medical conditions. A blood test can be done at our office to determine the bilirubin level.

Is it treated?
At low levels, bilirubin will clear up on its own after 1-2 weeks and does not require treatment. At higher levels, your doctor may tell you to place the baby in indirect sunlight (sunlight coming through a window–never direct outdoor sunlight). The light helps break down the bilirubin in the skin to assist the body in getting rid of it. You may also be asked to increase the frequency of breast or bottle feeding to every two hours to increase fluids and encourage the baby to have bowel movements.
If the level gets high enough, your doctor may admit your baby to the hospital for special bililight treatment under “bili lights”. These special lights can occasionally be used at home if available and your baby is feeding well.

How long does it last?
Most babies’ bilirubin will peak at 5-7 days of life and then slowly decrease to normal. There will be some cases, such as in breastfed infants, when the bilirubin may remain elevated to 3-4 weeks. This should continue to be monitored by your doctor.
Should I stop breastfeeding?
Breastfed babies do have an increased chance of jaundice and it may last longer (breast milk jaundice). This occurs for two reasons. First it takes a few days for breast milk to come in so those infants have less fluid and are less likely to have frequent bowel movements. Second, there are components of breast milk which may interfere with the elimination of bilirubin. This does not mean you should not breastfeed. Most doctors recommend feeding more frequently to encourage the milk supply and increase the baby’s bowel movements. At high levels requiring treatment, your doctor may ask you to temporarily interrupt nursing and supplement with formula for 24 hours. Talk with your doctor before you stop nursing or supplementing.

Remember, jaundice is a common problem of infancy and usually resolves without intervention. Keep in touch with your doctor to determine if your child has a more severe case.

The above information was obtained from a variety of sources including: Guide To Your Child’s Symptoms, Donald Schiff, MD and Steven Shelov, MD, American Academy of Pediatrics, 1997, and Your Baby’s First Year, Steven Shelov, MD, edited by AAP.