Did your baby brother or sister come home from the hospital just fine — and then start to turn a funny color?  Don’t panic!  He or she probably has something called jaundice, which affects most newborn babies and is usually a mild case that goes away on its own.  In other words, your younger sibling won’t look strange forever!

What is Jaundice?

Babies have jaundice when they get too much bilirubin in their blood. Bilirubin is a yellow pigment (or coloring) that is found in red blood cells.  When a baby is still in its mother, its mother’s body will break down the bilirubin. After birth, however, the baby’s body must start breaking down the bilirubin itself — and that can be a tough job!

How Do You Know if a Baby has Jaundice?

This might sound weird, but the best way to tell if a baby has jaundice is if he or she starts to turn yellow!  Remember, bilirubin itself is yellow — and when a baby has too much of it, their skin or the whites of their eyes can turn yellow, too.  This usually happens 3-4 days after a baby is born.  If a baby is still in the hospital, the nurses and doctors will check him to make sure he is okay. However, if the baby leaves the hospital before he is 3-4 days old, the parents will have to make an appointment to see the doctor 2-3 days after they get home.

When Should Parents Call the Doctor?

The important thing to know about jaundice is that most babies get a mild case of it – and it will usually go away on its own.  However, sometimes the case is more serious. Parents should call the doctor if the baby:

  • Gets more yellow than it was before or turns yellow on this stomach, arms or legs
  • Doesn’t have much energy and is difficult to wake up
  • Doesn’t want to eat much and isn’t gaining weight
  • Has high-pitched cries
  • Has jaundice for more than 3 weeks
  • Has brown urine.  Brown or dark urine is a sign that the jaundice might be caused by an infection or obstruction in the gut, which is very serious.

What Causes Jaundice?

There are actually several reasons why babies get jaundice, some more likely than others. Too much bilirubin (in medical language, hyperbilirubinemia) is by far the most common reason babies get jaundice. Breaking bilirubin down can be difficult for a baby’s system, but if it is not broken down, it builds up and can’t be processed.  This condition is also called physiologic jaundice. Again, most cases are mild and resolve on their own with a little TLC.

There are other possible causes, too, but they are much more uncommon. They include:

  • The baby has internal bleeding (which means they are bleeding on the inside, but it can’t be seen).
  • The baby has an infection or sepsis, which is an infection in their blood.
  • The baby’s blood type is different from your mother’s blood type. The medical word for this is “rH incompatibility” and it can be serious if it is not treated.
  • The baby’s liver is not working properly.
  • The baby’s red blood cells are abnormal and break down more easily than they should.

What Babies are at Risk for Jaundice?

Again, it’s good to remember that most babies will get a least a mild form of jaundice.  However, some babies are at a higher risk for this, including babies who:

  • Were born earlier than they should have been. These are called “premature babies” or “preemies” for short.
  • Got severely bruised when they were being born — being born can be pretty tough work sometimes!
  • Have a different blood type from their mother.  Different types of blood don’t mix very well and this can cause red blood cells to break down faster than they should.
  • Are breastfed.  Breastfeeding is actually really good for babies! However, some babies have a hard time breastfeeding and they might get dehydrated or not get enough calories and this can make it more likely that they will get jaundice, too.

Are there Complications from Jaundice?

A complication is when something happens to make a condition worse.  Unfortunately, if jaundice goes untreated, there are two very serious complications from it:

  • Acute bilirubin encephalopathy. Ok, that’s a mouthful! What it means is that there is so much bilirubin in the baby’s blood that it is starting to affect its brain.  Babies who have this condition are not responsive, don’t feed well, can have a very high-pitched cry, will arch up their bodies and necks and will often throw up and run a fever.
  • Kernicterus. If the encephalopathy above is not treated, it can turn into a condition called kernicterus – which is very, very serious.  This can cause permanent damage to the baby’s brain and cause other problems like muscle movements that the baby can’t control, a permanent upward gaze, loss of hearing and tooth damage.

All that sounds pretty scary. However, keep in mind that these complications happen very rarely!

How does the Doctor Know if a Baby has Jaundice?

The doctor will diagnose a baby with jaundice based on many things, including:

  • The yellow appearance of the skin
  • Blood tests to measure how much bilirubin is in the blood
  • A skin test with a tool called a transcutaneous bilirubinometer, which uses light to help the doctor figure out how much bilirubin a baby has in their system.

How is Jaundice Treated?

Remember, for most babies, the jaundice goes away by itself! The best way to help this is for parents to feed their baby often.  If your mom is breastfeeding, she will have to feed the baby around 8-12 times a day!  If the baby is being fed with a bottle, feedings will need to happen every 2-3 hours, both day and night.  It’s a lot of work, but it can help the baby’s bilirubin levels start to go down.

Sometimes, however, a baby needs more care than your parents can give it at home.  In this case, the baby will have to go back to the hospital so the doctors and nurses can give it special care.  Treatment for this can include:

  • Phototherapy or “bili lights”.  The baby is placed under a special lamp that gives off a blue-green light.  This light can help because it actually changes the bilirubin and makes it easier for the baby to get rid of it when they go poop.  
  • IV IgG. Basically, IgG is part of the immune system.  Babies whose blood type is different from their mom’s are often given this to decrease the problems that come from this incompatibility. A baby cannot swallow IgG, so it has to be given through an IV, which is a very small tube that is put into one of the baby’s veins so that doctors can put the IgG right into the baby’s bloodstream.
  • Exchange transfusion.  This is when doctors take just a little blood from a baby at a time, then dilute it and put it back into the baby.  This helps decrease the level of bilirubin in the blood and can also help if the baby is having problems with rH incompatibility. This is only done as a last resort, if other treatments are not working. 

So now you know what’s going on if your baby brother suddenly looks like a baby banana!  Remember, while it does look strange, it will go away on its own most of the time — and without some of the scarier complications!  So play with your new sibling and get to know him now matter how strange he looks — he won’t be that way forever!