What you need to know about newborn jaundice

Jaundice is mild in newborns, there's no need to worry. Here's how to treat and care for your baby.

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When Kara de Man looked into the eyes of her day-old son, Nick, she could see he was jaundiced. The whites of his eyes were cloudy yellow, and the skin on his nose and chest looked lightly bruised. A nurse determined Nick’s jaundice was mild by using a light meter on his forehead, but both mom and baby were kept in hospital for monitoring for four days.

“It was an emotional journey for us,” says the Saint John, NB, mom, who worried Nick wasn’t getting enough milk, as he lost weight and his yellow skin tone initially deepened (both of which are normal in newborn jaundice). Frequent feedings flush out the jaundice, but jaundiced babies are often sleepy and slow to eat.

“Feeding Nick was a two-person job those first few days,” says de Man. Her husband kept Nick awake by tickling and rubbing him with cold cloths while she compressed her breast. Under their nurses’ advice, the couple also held Nick by a sunny window, as exposure to natural light can help clear jaundice. When de Man’s milk came in on day four, Nick started gaining weight. Two weeks later, his skin was a healthy pink.

Will your baby have jaundice?
Newborn jaundice affects about three-quarters of preterm and half of full-term babies. It’s mild in most newborns and typically sets in a day after birth, peaks at four or five days, and then usually goes away on its own within a few days to a month.

“Parents get really worried about jaundice, because jaundice in an adult indicates severe illness,” says Karen Buhler, head of family practice at BC Women’s Hospital in Vancouver. “But jaundice is a normal part of the process of going from a fetus to a newborn.” Babies are born with extra red blood cells, and as the cells break down, a substance called bilirubin is produced. Some babies’ livers are not mature enough to efficiently expel bilirubin, which builds up in the blood and body tissues and causes skin and eyes to yellow.

Treatment
About five percent of all babies need to be treated with phototherapy, which turns bilirubin into a harmless substance that easily passes through the body, instead of depositing in the brain, where it can cause nerve damage. There are different kinds of phototherapy used in the hospital and at home. Newborns can be treated with a hand-held, blue light paddle, or wrapped in a “biliblanket,” a blanket with fibre optic cables that shine light on the skin. (Picture a bundled-up glow worm.) Most commonly, babies with newborn jaundice are kept in hospital and put in an incubator under blue lights for a few days while their bilirubin levels are monitored.

Annie-Rae Pennington’s daughter, Jordan, was 12 days old and traffic-cone orange when she was readmitted to hospital suffering from severe jaundice, dehydration and starvation. Jordan was given an IV and went under the lights for three days, in only her diaper and eyeshades. “I was a wreck. I wasn’t sleeping,” recalls Pennington, who lives in White Rock, BC.

She pumped milk, measured how much Jordan was drinking and weighed her diapers. Pennington struggled with the limited cuddle time, and the mommy guilt. In hindsight, she advises other parents to remember that a jaundiced baby is not your fault. “And it’s something that so many people go through,” she adds.

For some parents, the hardest part is not being able to hold their new baby all the time, says Buhler. “But jaundiced babies are only in the incubator for a short time, and they usually sleep really well in there,” she says. If your baby gets fussy, Buhler says, it’s probably a good sign—it means she’s getting better.

A version of this article appeared in our December 2012 issue, with the headline “Coping with Jaundice”, p. 66

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