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Am Fam Physician. 2002;65(4):613-614

What is jaundice?

Jaundice is an illness that can happen in the first few days of a baby's life. It turns your baby's skin, eyes, and mouth a yellow color. The yellow color is caused by bilirubin.

Bilirubin is made when the body breaks down old red blood cells. This is a normal process that happens all through life. Bilirubin goes to the liver, where it is changed again. Then it goes into the intestines and the kidneys, and then it goes out of the body. If too much bilirubin builds up in your baby's body, it makes a yellow color called jaundice (say this: john-diss).

Jaundice is common in babies and is usually not serious.

Why do some babies get jaundice?

Red blood cells have a shorter life in babies than they do in adults. This means more bilirubin goes through your baby's liver. If your baby's skin is bruised during birth, more red cells may need to be broken down. Then your baby's liver has to handle even more bilirubin. Sometimes a baby's liver is not mature enough to handle the extra bilirubin.

How can I tell if my baby has jaundice?

You should watch for color changes in your baby's skin. You should also check the whites of your baby's eyes and the pink skin inside your baby's mouth. If they get yellowish, you may want to see your baby's doctor. If your baby has pale skin, it should look white when you gently press it with your fingertips. If the skin looks yellow, your baby may have jaundice. If your baby has darker skin, it may be harder to check, except by looking at your baby's eyes and inside your baby's mouth.

Artificial light, especially fluorescent lights, can sometimes fool your eyes into seeing a yellow color that is not really there. So you might want to check your baby in daylight in a sunny room.

As the amount of bilirubin in the blood increases, your baby's body will get more yellow. As the bilirubin level rises, the yellow color can move from your baby's head down to the chest and even down to the toes.

If your baby's skin is yellow, see your baby's doctor right away. The doctor will take a small amount of your baby's blood and measure the bilirubin in it.

How is jaundice treated?

If the bilirubin level is not too high, your baby might not need any treatment. Your doctor might just want you to feed your baby breast milk or formula more often.

If the bilirubin level is very high or is getting higher very quickly, your baby will need light therapy. This is also called phototherapy. Phototherapy helps to break down bilirubin in your baby's skin.

For this treatment, your baby is placed under special white, blue, or green lights. The baby might also be placed on a special light-producing blanket. Your baby's eyes are covered to protect them from the bright lights. Phototherapy usually lasts for 1 or 2 days.

Phototherapy can give your baby loose stools, temperature problems, or dehydration. Your doctor will watch your baby carefully to prevent or treat these problems.

If your baby's bilirubin level gets too high, and phototherapy does not work well enough, the baby might need an exchange transfusion. In this treatment, some of your baby's blood is taken out, and it is replaced with blood from someone else.

Can jaundice hurt my baby?

Jaundice is not a serious problem in most healthy babies. However, very high bilirubin levels can be dangerous. It can give some babies brain damage.

Your doctor will measure your baby's bilirubin level a number of times. If necessary, your baby will be treated. This usually keeps the bilirubin level from getting high enough to hurt your baby.

How long will my baby have jaundice?

Jaundice lasts for a different time in different babies. Often, the bilirubin level goes up for the first 3 to 4 days and then slowly goes back down. A baby who is breastfed may have mild jaundice for a longer time than a baby who is formula-fed.

Where can I get more information?

You can learn more about jaundice at the Web side of the American Academy of Pediatrics:http://www.aap.org.

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