Jaundice in newborns is often referred to as hyperbilirubinemia. It is a fairly harmless disorder that is prevalent in newborns for a variety of reasons. Jaundice in babies can lead to yellowing of the skin and eyes in its most mild form, to issues with brain development in very severe and rare forms. It is very easy to treat, and for this reason, jaundice levels or bilirubin levels are often checked frequently during the neonatal period.
Jaundice is the colloquial and medical term for high bilirubin in the blood, or hyperbilirubinemia. This is one of the most common reasons that babies have prolonged stays in the newborn nursery. The first sign of jaundice is yellowing of the skin and mucosa (eyes, mouth) which is considered normal in most infants. High bilirubin levels are indicative of jaundice and require treatment.
Jaundice in the newborn period occurs from two main physiologic phenomena including both breakdown of fetal erythrocytes and decreased hepatic processing of bilirubin.
Typically, bilirubin leads to yellowing of mucosal membranes first such as the whites of the eyes and the gums and mouth, then it will spread to the skin. Jaundice tends to spread in the cephalo caudal direction. If jaundice levels (bilirubin levels) increase rapidly in babies, then they may also experience the following symptoms:
In the newborn nursery all babies have their bilirubin levels checked in the first few days of life. Bilirubin levels peak in the blood between days 3-5 of life, so many babies have their levels checked after 24 hours of life and again before discharge from the nursery. Bilirubin levels can be checked via a blood draw or via a transcutaneous bilirubin machine. The transcutaneous method is less accurate but is a good screening test for low-risk infants who are not symptomatic.
If your baby has high levels of bilirubin, then the treatment usually involves blue light therapy. Blue lights or bilirubin lights are known as phototherapy. The blue light wave helps the body to break down bilirubin. Since bilirubin is also excreted in stool and in urine, treatment of jaundice often involves feeding the baby at regular intervals and supplementing with formula if the baby is breastfed. The more diapers the baby has, the more bilirubin they will excrete.