Jaundice in newborns


Usually, the first sign of jaundice is the yellowing of the skin, which may be noted on the baby’s face, and then moves to the trunk, arms, and legs if the bilirubin level continues to increase. You may also notice yellowing in the whites of the eyes. Here are some facts about jaundice for you to be aware of as you prepare for your new baby.

Most cases of jaundice are not harmful, are caught early, and are easily treated. If left untreated, a very high level of bilirubin can damage the brain. However, the condition is almost always diagnosed and treated before the levels become high enough to cause this damage. The American Academy of Pediatrics (AAP) recommends that all infants born in the hospital be screened for jaundice and its risk factors, in addition to having a bilirubin level drawn prior to being discharged home if indicated. The AAP also recommends that newborns have a follow-up appointment with a healthcare provider/pediatrician 3-5 days after birth, where the baby can then be screened again for jaundice and its risk factors.  This screening process allows for early detection of jaundice and thus, early treatment.

To determine if treatment is needed for your baby’s jaundice, the healthcare provider will look at your baby’s bilirubin level, how fast the level is rising, whether or not the baby was born early, and how old the baby is.  Treatment includes increasing feeds to encourage an increase in bowel movements to help excrete the bilirubin in the stools, usually with breastfeeding and sometimes supplementing with formula. Sometimes, in addition to increasing feeds the baby is placed under lights called phototherapy that help to break down the bilirubin levels in the skin.

Always contact your healthcare provider or pediatrician if you are concerned about jaundice once you are home from the hospital. All babies should be seen by a healthcare provider in the first 5 days of life to check for jaundice. If your baby as a high fever, is feeding poorly, is not making enough wet and dirty diapers, or if the coloring of the skin is darkening or spreading down the body to the legs.


About the author:
Boston NAPS, LLC is a Boston-based, private nursing company and team of qualified Registered Nurses that specializes in providing nursing care to expecting, new, and experienced parents and families. Boston NAPS services include prenatal, postpartum, lactation, and newborn support and education to families throughout Massachusetts. All services are offered in the privacy and comfort of your home, with some services also offered in a group setting. For more information about Boston NAPS, please visit their website at www.BostonNAPS.com.


Sources
  • American Academy of Pediatrics Clinical Practice Guideline “Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation” Pediatrics. Vol. 114 No 1, July 2014
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