Causes of jaundice in babies and how is it treated?

Jaundice in babies can be quite scary for new parents who might be expecting their newborn to look a certain way. Movies, TV and social media often depict an idealistic picture of what your baby will look like after birth; dimples, a full head of hair and that super-soft skin. But as you might now realise, this isn’t usually the case. Not only might your baby not have a single hair on its head, but they might also have baby acne or other skin concerns such as a yellowing of the skin and eyes. This is called Jaundice and it’s a lot more common than you might expect.

What is jaundice in babies?

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Jaundice is the yellowing of a newborn’s skin and the whites of the eyes. It typically occurs within 2-4 days after birth and disappears after 1-2 weeks. Mild jaundice is very common and occurs in around 60% of newborns and in around 80% of premature babies.

What causes jaundice in babies?

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Jaundice is caused by a high level of bilirubin, which is a yellow pigment made from the breakdown of red blood cells. At birth, babies have a high number of red blood cells to break down and their immature liver is unable to keep up with the demand. This leads to an overflow of bilirubin.

The most common type is often referred to as ‘breast milk jaundice’ and is when a chemical in the mother’s breast milk interferes with the baby’s ability to break down the bilirubin. This type of jaundice typically clears on its own without treatment, in 1-2 weeks.

‘Blood type incompatibility jaundice‘ is a very rare and occurs when the baby and mother’s blood are incompatible. Typically, this isn’t a problem during the mother’s first pregnancy however during delivery, if blood mixes together that the mother will build up antibodies in the placenta during her second pregnancy.
These antibodies can then travel across the placenta to attack the second baby’s red blood cells. This leads to a major buildup of bilirubin in the new baby’s bloodstream. Jaundice of this type will require treatment, however, it is preventable before birth with an anti-D injection after the first birth in order to avoid the buildup of antibodies in the next pregnancy.

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Babies that are at a higher risk for jaundice are:

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• Babies that might have a hard time feeding due to not getting the right amount of formula or breast milk
• Babies born prematurely
• Incompatible blood type with the mother (which is rare)

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What are the signs or symptoms of jaundice?

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Jaundice will appear typically with a yellow appearance to the baby’s skin and the whites of their eyes. It can also make babies more drowsy, so they might sleep more than other newborns and they can sometimes have difficulty feeding.

In some cases, the baby’s poo may appear light-coloured faeces and their urine dark

How is jaundice treated for babies?

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As your little one develops rapidly in the first two weeks, the liver usually starts removing bilirubin from the blood naturally. Continuing to feed your baby will also help pass bilirubin through the body and most cases will solve themselves within around 1-2 weeks.

If the jaundice is mild and the baby is otherwise healthy and well, no treatment is usually necessary. Your baby will be monitored in the days following their birth and you will need to make sure your baby is getting plenty of breast or formula feeds.

In cases where the bilirubin levels are high, your baby may undergo blue light (phototherapy) treatment. This treatment can have some minor side effects including a mild rash and runny stool so extra feeds are key. In more extreme cases the baby may be required to have multiple lights on their skin in which case they may be taken to the nursery.

In severe cases a blood transfusion may be required, however, this is rare.

When to call the doctor?

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Your baby will generally show signs of jaundice within the first 48 hours, where you will be at the hospital and they will respond accordingly. Bilirubin generally tends to peak at 3 to 7 days, so they may request that you come back in to have it checked.

Whilst this is perfectly normal and short-lived for most, there are occasions where there might not be an underlying issue. If your baby shows any of the below signs once you are home, you should consult with your doctor:

• They are unwell, not gaining weight, or not feeding properly
• The jaundice is lasting longer than 2 weeks
• It has spread or the colour deepens

It can be upsetting when your baby doesn’t look like you thought they would but remember jaundice in babies is very common and in most cases is something that will go away on its own with time. Be sure to follow the feeding guidelines for their age and the liver should work its magic and flush out the yellow in no time.
If you ever have any concerns with your little one or questions, always trust your instinct and reach out to your medical professional.