Nov 7, 2019, 9:23:53 AM CST Nov 7, 2019, 10:03:45 AM CST

Jaundice in newborns: Causes and treatment

When to be concerned about this common condition in newborns

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As many as half of all newborns experience jaundice, a yellowish discoloration of the skin and eyes, during their first weeks of life – and in most cases, the condition can be easily managed. But despite its high occurrence, jaundice is always something to pay attention to urges Amal Aqul, M.D., a pediatric gastroenterologist at Children's Health℠ and Assistant Professor at UT Southwestern.

"Jaundice by itself is not a dangerous condition, however, it might be a sign that something else is going on in the liver," Dr. Aqul says.

Dr. Aqul explains why some causes of jaundice may be more serious than others and what new parents should know.

What causes jaundice in babies?

Jaundice, also called hyperbilirubinemia, occurs when a baby's liver cannot process bilirubin (the waste left over when red blood cells break down naturally). When bilirubin collects in the bloodstream, it can cause a yellowish tint to the skin and eyes. All babies, whether or not they look yellow, are tested for jaundice with a simple blood test after birth.

Most causes of jaundice are benign and go away quickly after birth. Babies have higher levels of red blood cells and a high percentage of red blood cells that breakdown, which can make it hard for their immature livers to remove bilirubin. If your child receives a bruise during delivery, that may lead to jaundice. Babies may also experience "breast milk jaundice," which can occur when breast milk temporarily slows the liver from breaking down bilirubin.

"Most of the reasons for jaundice are a normal part of being a baby," Dr. Aqul says. "But it's very important to check what kind of jaundice the baby is having."

If bilirubin levels are high, your doctor will check what kind of bilirubin is elevated: indirect bilirubin or direct bilirubin. Indirect bilirubin is the most common cause of jaundice in babies. However, if blood tests reveal your baby has higher levels of direct bilirubin, they may need more tests to determine the cause.

One possible and more serious cause of jaundice is biliary atresia. In babies with this condition, the bile ducts around the liver are either missing or are too small. Babies with biliary atresia need surgery to correct this problem, and early diagnosis is vital.

Other conditions such as cystic fibrosis or hepatitis may also cause jaundice in newborns.

Signs of jaundice in newborns

While most babies who have jaundice show signs in their first few days of life, your baby may be at home before they experience any symptoms.

Symptoms of jaundice in newborns may include:

  • Yellowing of the skin or eyes
  • Increased irritability
  • Sluggishness
  • Poor sucking during breastfeeding
  • A high-pitched cry

If your baby has these symptoms, call your pediatrician's office. They can schedule an appointment to check your child's blood for bilirubin. You should also tell your doctor if your child has decreased amounts of urine (less than 8 wet diapers per day) or pale-colored or chalky stools. These can be signs of a more serious issue.

How is jaundice treated in newborns?

The treatment for jaundice depends on its cause. In many cases, jaundice usually goes away on its own within a few days to a couple of weeks. Regular feedings, whether breastfeeding or formula feeding, can help your child grow and get rid of bilirubin.

Your child's doctor may do repeat blood tests to check their bilirubin levels while they are in the hospital. If the bilirubin levels are rising or are already high, phototherapy may be offered as a treatment option.

During phototherapy, the child's diaper remains on, an eye mask is placed over the eyes and the baby lays on a warm bed with blue lights shining on them. This blue light helps your child's body break down bilirubin. Phototherapy treatment takes one to two days to complete. Your child may also be able to receive therapy at home with a specialized light-emitting blanket.

For more serious cases of jaundice, a child may need a blood transfusion or surgery. Additional plasma or immunoglobin can help the body get rid of bilirubin.

While severe cases and causes are rare, it's important that jaundice is monitored and that its cause is pinpointed.

"The earlier you diagnose the problem, the better the outcome will be," Dr. Aqul says. "It's crucial that whenever an infant has jaundice, parents bring it to the pediatrician's attention so that appropriate testing can be done."

Learn more

The Pediatric Liver Disease Program at Children's Health provides comprehensive treatment for pediatric liver disease, including the only pediatric liver transplant program in North Texas. Specialists diagnose and treat everything from newborn jaundice to biliary atresia, and other complex liver conditions. Learn more about our hepatology program.

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