A common condition in newborns, jaundice refers to the yellow color of the skin and whites of the eyes caused by excess bilirubin in the blood. Black and brown skinned babies can exhibit yellowed whites of the eyes, palms of the hands and feet, and gums.
Bilirubin is produced by the normal breakdown of red blood cells. Normally, bilirubin passes through the liver and is excreted as bile through the intestines.
Jaundice occurs when bilirubin builds up faster than a newborn's liver can break it down and pass it from the body.
Reasons for this include:
• Newborns make more bilirubin than adults do since they have more turnovers of red blood cells.
• A newborn baby's still-developing liver may not yet be able to remove adequate bilirubin from the blood.
• Too large an amount of bilirubin is reabsorbed from the intestines before the baby gets rid of it in the stool.
• Newborn not breastfeeding well. High levels of bilirubin, usually above 25 mg, can cause deafness, cerebral palsy, or other forms of brain damage in some babies. In less common cases, jaundice may indicate the presence of another condition, such as an infection or a thyroid problem.
The American Academy of Pediatrics (AAP) recommends that all infants should be examined for jaundice within a few days of birth. Symptoms and Diagnosis Jaundice usually appears around the second or third day of life.
The yellow color of jaundice begins at the head and progresses downward toward the belly. A jaundiced baby's skin will usually appear yellow first on the face, followed by the chest and stomach, and finally, the legs. It can also cause the whites of an infant's eyes to appear yellow.
Since many babies are now released from the hospital at one to two days of life, it is best for the baby to be seen by a doctor within one to two days of leaving the hospital to check for jaundice. Parents should also keep an eye on their infants to detect jaundice.
If you notice your baby’s skin or eyes looking yellow, you should contact your child's doctor to see if significant jaundice is present. At the doctor's office, a small sample of your infant's blood can be tested to measure the bilirubin level. Some offices use a light meter to get an approximate measurement, and then if it is high, check a blood sample. The seriousness of the jaundice will vary based on how many hours old your child is and the presence of other medical conditions.
When to Call the Doctor:
• Jaundice is noted during the first 24 hours of life
• The jaundice is spreading or getting more intense
• Your baby develops a fever over 100° Fahrenheit (37.8° Celsius) rectally if your child starts to look or act sick.
• If the yellow color deepens or your baby is not feeding well, or if you feel your baby is sleepier than usual.
It is difficult to tell how significant jaundice is just by looking at a baby, so any baby who has yellow eyes or skin should be checked by the doctor.