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November 15, 2024Jaundice and Bilirubin in Newborns
Jaundice is a yellowing of the skin and sometimes the white part of the eyes. It is caused by an excess of a chemical called bilirubin in the blood stream.
Bilirubin builds up in the blood stream naturally and is filtered out of the body through the liver. In newborns, it takes a few days for the liver to get efficient at removing bilirubin from the body which is why jaundice occurs so frequently.
50% of newborns develop mild normal jaundice. This is often referred to as “physiologic jaundice”.
Normal newborn physiologic jaundice usually starts between day 2 and 3 of life, and usually peaks by day 5, with complete resolution in 1-2 weeks.
Bilirubin levels are tested prior discharge from the hospital in all newborns and sometimes earlier or more frequently if needed to monitor and assure bilirubin levels do not reach a harmful level.
Testing is done by either a transcutaneous (through the skin) light test or a blood test.
Poor feeding, malnutrition, excessive weight loss, incompatibility between mother and babies blood types, and prematurity can all be risk factors for elevated bilirubin levels leading to jaundice.
More frequent monitoring, earlier treatment, or early follow-up appointments may be needed in these situations.
Why does jaundice (or bilirubin level) matter?
If the bilirubin level gets too high or rises too quickly it can put your newborn at risk of complications, including brain damage, leading to cerebral palsy, hearing loss, learning difficulties, involuntary movements including of the eyes.
To prevent these complications, your pediatrician in the hospital and at follow up appointments will monitor closely for jaundice and other risk factors to ensure that bilirubin does not reach a harmful level.
Treatment to lower elevated bilirubin/jaundice is with specialized light or “phototherapy”. This is usually done in the hospital but sometimes can be done at home depending on the circumstances, including bilirubin level and age of the newborn.
Call your pediatrician or seek care right away if at any time your newborn has new or worsening yellowing of the skin or eyes, if they have jaundice with poor feeding, pale white stool, or become lethargic or difficult to wake.
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