What is Jaundice?
Well first, let’s talk about bilirubin. Bilirubin is an orange-yellow coloured substance that is created while our bodies go through the normal process of breaking down red blood cells. Bilirubin passes through the liver and leaves the body through stool (poop!). Jaundice is the accumulation of this bilirubin in the newborn, which causes their skin and whites of their eyes to take on a yellow colouring.
“Jaundice is the most common problem encountered by babies within their first week of life.”
Why is this?
Babies have a very high amount of red blood cells circulating through their bodies when they are still in utero. These red blood cells have a shorter life span than yours or mine would. So, with a high number of red blood cells being broken down after baby is born, we expect to see an increased amount of bilirubin in baby’s body.
Bilirubin needs to go through a bit of a complex process from the time it is created to when it can be excreted from the body. Unfortunately, baby’s body isn’t super efficient at this process yet, and sometimes more bilirubin stays in baby, instead of being pooped out quickly. In normal cases of breast fed babies we see levels of bilirubin rise, fall, and rise again within the first 10 days of life, then drop gradually until baby is about 3 weeks old. This is NORMAL. We expect baby to have a bit of a yellow tinge to their skin during these peak times of the accumulation of bilirubin.
So what is NOT normal?
Certain babies may be more prone to having increased levels of biliruben. These include:
-Babies born before 38 weeks
-Babies who are not eating well (either breast or formula)
-Babies who do not pass their first stool within a normal time frame
-Babies who have lost more weight in the first couple days after birth than we’d expect
-Babies of mom’s who have diabetes
-Babies who have bruising or a hematoma (collection of blood) on their head from delivery
What does jaundice look like?
Jaundice starts from the head and works its way down. It is first visible in the forehead and face, and can be seen if you press on a bony spot (like the forehead) and then remove your finger to reveal the underlying colour. If your baby’s jaundice makes its way down their body to their nipple line or belly button, see your health care provider.
If jaundice appears within the first 2 days of life – this is NOT normal, and baby should be seen promptly by your health care provider.
Why do we worry about jaundice?
Baby’s brain being exposed to abnormally high levels of bilirubin can cause brain damage if jaundice is not treated.
So what do we do about it?
For normal newborn jaundice, our best course of action is prevention! If we can ensure baby is eating well in the early days of their life, we can avoid excess build up of bilirubin. The more baby eats, the more baby poops! It is also helpful to expose your baby to sun light through a window. Baby should not be exposed to direct sunlight outside – as this can cause burns. If at one of your check ups, your care provider notices more yellow then may be expected, they will likely test your baby’s bilirubin levels by using a device that reads the levels by shining light through their skin. They may also want to follow up with testing your baby’s blood if the initial reading comes back high.
If you are breastfeeding and your baby is jaundiced, we will want to support your breastfeeding and milk production to ensure that baby is getting enough to get rid of all the extra bilirubin. It may be suggested that mom pumps between feeds, and supplement her baby with her milk if breastfeeding is not well established. Usually, supplementation with formula is NOT needed. If the jaundice levels have risen above what is considered normal, your baby may need phototherapy – think a tanning bed without the tan. Baby’s eyes will be covered, and they will lay in the tanning bed other than when being fed. They will have their blood tested daily until their bilirubin returns to normal levels. At this point you will then be able to take your sweet bundle back home!
Having a baby with jaundice can be a bit unnerving. The good news is that in most cases a bit of newborn jaundice is normal, and even if your baby is detected to have higher than normal levels, very rarely it becomes a serious problem.
Relax, Feed Feed Feed, and reach out if you need support!