Jaundice in your newborn: what you need to know

When it comes to yellow flags in paediatrics, newborn jaundice is not necessarily always that serious, say the experts.

by Vanessa Rogers

What is jaundice?

Jaundice is a condition in which there is a yellowing of the skin, and/or the whites of the eyes, which indicates an excess of the bile pigment, bilirubin, in the blood. The condition affects as many as 50 percent of newborn babies and an even greater percentage of preemies. 

A jaundiced baby receiving light treatment

While newborn jaundice usually rectifies itself without treatment in around seven days, if tests show the unconverted liver waste is above a certain amount, your baby will receive treatment that involves them being placed under special fluorescent lights for 48 hours. During this time, their liver will mature and begin to cope with this waste material, until they are able to convert it into a form that can be easily excreted.

Should you be concerned about jaundice in your newborn?

According to Sister Cindy Homewood, who heads up the Bowwood Baby Clinic in Claremont, Cape Town, “Most babies will be slightly yellow in the first week or so of life – especially those who have been born prematurely. This is usually just a result of the immaturity of the liver and commonly resolves without any interference,” she advises.

Reasons to be more concerned than usual, adds Homewood, include:

  • When your baby’s whole body is yellow, including their legs
  • When your baby is abnormally sleepy, e.g. they attempts to feed at the breast, but only manage a few sucks before falling asleep again
  • When your baby is not passing urine or stools;
  • When your baby is sleeping for long periods of time between feeds

It is important to report your baby’s jaundice to your doctor right away, so the necessary tests can be performed and treatment can commence as soon as possible, if needed.

Newborn jaundice and fluorescent lights – could they cause harm?

New moms and dads often express concerns as to what harm the fluorescent lights may have on their baby. Fortunately, no side effects have been reported to date – your baby’s eyes will be kept covered while they are under the lights and they will be brought to you regularly for feeds. “Express teaspoons of breast milk and give these to your baby as often as possible. The kilojoules in the breast milk will give your baby the energy they need to help them suck more efficiently. This, in turn, will lead to more stools and should kick start the breakdown of the bilirubin that will, in turn, get rid of the jaundice.” 

So there is, in effect, no need for worry when it comes to newborn jaundice. Even the impact that the fluorescent lights have on your baby’s urine and stools – often turning them shades of brown and green - should not cause undue alarm. But, you will undoubtedly be delighted when their yellowish-tinged skin returns to a healthy hue, and you can take them home to embark on your journey together. 

A lethargic baby could be a jaundiced baby 

“It is important to note that a jaundiced baby who sleeps for long periods could be mistaken for a “good baby” – but, could actually indicate that they don’t have the energy they need to wake up and feed sufficiently frequently,” cautions Homewood. She says that while some jaundiced babies are only slightly yellow in color, they may appear very sleepy and lethargic; and most certainly need their condition addressed. Healthcare practitioners (general practitioners, paediatricians, midwives etc) should therefore assess and question the behaviour of the baby whom they are treating, and not necessarily be swayed by their colour, she advises.

Jaundice in older children

If you notice jaundice in an older child, it could be caused by something more serious. Make a doctor’s appointment immediately so a diagnosis can be made and treatment can begin. This may involve antiviral drugs, e.g. in the case of hepatitis B or C or, at the very least, the management of symptoms of nausea and fever until a virus, such as Epstein-Barr, leaves your child’s system.

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