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JAUNDICE IN NEWBORNS

(BILIRUBIN ENCEPHALOPATHY)
Jaundice in Newborns

WHAT YOU NEED TO KNOW:

What is newborn jaundice? Newborn jaundice is excess bilirubin in your newborn's blood. Bilirubin is a yellow substance found in your newborn's red blood cells. Excess bilirubin will cause your newborn's skin and the whites of his eyes to turn yellow. Jaundice is also called hyperbilirubinemia.

What causes newborn jaundice? Increased bilirubin occurs when your newborn's body breaks down old red blood cells as it should, but cannot remove the bilirubin. Jaundice is common in newborns.

What increases the risk for newborn jaundice?

  • Bruised during birth: A narrow birth canal may cause bruising on his head. Large bruises release bilirubin in the blood.

  • Lack of breast milk: The mother's body may not produce enough milk, or the newborn may not be able to latch onto the breast the right way. He may not get enough nutrition or fluids if this happens. This may raise bilirubin levels in his body.

  • Premature birth: Your newborn may be at risk for jaundice if he was born too early. His liver may not have fully developed yet. The liver is needed to help flush out bilirubin from his body. He may also be at risk if he weighs less than an average newborn.

  • Infection or a blood disorder: Sepsis (blood infection) or a blood disorder, such as hemolysis, may increase the risk for newborn jaundice. Hemolysis causes breakdown of more red blood cells, which can lead to excess bilirubin. This can also occur if the mother and newborn have different blood types.

How is newborn jaundice diagnosed? Your newborn's healthcare provider will check your newborn's skin and eyes. Tell the healthcare provider how long your newborn has had signs of jaundice. Tell him if you or your newborn have a blood disease, different blood types, or if any siblings also had jaundice. Tell the healthcare provider if your newborn was bruised during birth or has trouble breastfeeding. Your newborn may also need blood tests to check for bilirubin and to measure red blood cell levels. These tests will show if he has or is at risk of developing jaundice.

How is newborn jaundice treated? Your newborn will likely be treated in the hospital. You will be able to stay with him so you can continue to breastfeed. Treatment for jaundice includes the following:

  • Phototherapy: This treatment uses light to turn bilirubin into a form that your newborn's body can remove. One or more lights will be placed above your baby. He will be placed on his back to absorb the most light. Your baby may also lie on a flexible light pad, or his healthcare provider may wrap him in the light pad. Eye covers may be used to protect his eyes from the light.

  • Exchange transfusion: Your newborn's healthcare provider may replace a portion of your newborn's blood with blood from a donor. This will be done if your newborn has severe jaundice.

What are the risks of newborn jaundice? Too much bilirubin in your newborn's blood may lead to brain damage. The damage may cause disorders such as hearing loss and cerebral palsy. Rarely, severe jaundice may lead to breathing problems, seizures that cannot be controlled, and coma. Severe jaundice may be life-threatening.

How can I help decrease my newborn's risk for jaundice?Breastfeed your baby as early and as often as possible. You may use formula along with breast milk if you do not produce enough breast milk alone. Look for signs of thirst in your baby, such as lip smacking and restlessness. Try to breastfeed 8 to 12 times daily for the first few days to boost your milk supply. Ask your healthcare provider for help if you have trouble breastfeeding.

When should I follow up with my newborn's pediatrician?You may need to follow up with a pediatrician 2 to 3 days after you leave the hospital, following your baby's birth. Ask for a specific follow-up time. Your newborn may need more blood tests to check his bilirubin levels. Write down your questions so you remember to ask them during your visits.

Where can I find more information?

  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org

When should I contact my newborn's pediatrician? Contact your newborn's pediatrician if:

  • You cannot make it to a scheduled follow-up visit.

  • Your newborn has new or worsened yellow skin or eyes.

  • You do not think your newborn is drinking enough breast milk, or he is losing weight.

  • Your newborn has pale, chalky bowel movements.

  • Your newborn has dark urine that stains his diaper.

When should I seek immediate care? Seek care immediately or call 911 if:

  • Your newborn has a fever.

  • Your newborn is limp (too weak to move).

  • Your newborn moves his legs in a cycling motion.

  • Your newborn changes his sleep patterns.

  • Your newborn has trouble feeding, or he will not feed at all.

  • Your newborn is cranky, hard to calm, arches his back, or has a high-pitched cry.

  • Your newborn has a seizure, or you cannot wake him.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.