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Jaundice and Your Newborn

Jaundice is a high level of bilirubin in the blood of newborns. Bilirubin is a yellow substance the body creates when it replaces old red blood cells. This high level of bilirubin happens because a baby's liver is not good at removing bilirubin from their bloodstream in the first few days after birth. 

In some babies, jaundice can be seen through yellowing skin and in the whites of their eyes. Jaundice is not always visible; it is recommended that your baby's bilirubin level is tested. 

Jaundice is common in newborn babies. About half of full term babies (born after 37 weeks) become jaundiced. It is most noticeable when your baby is 2 to 4 days old. 

A few things can increase your baby's chance of having jaundice. These include:

  •  being born before 37 weeks (prematurity);
  •  being of Asian descent;
  •  baby having a different blood group than mom; 
  •  being born with the help of a vacuum or forceps;
  •  bruising;
  •  birthweight less than 2500 grams.

‎Testing a small sample of your baby's blood to measure their bilirubin level is the best way to check for jaundice. This is done by doing a heel prick blood test about 24 hours after birth. The heel prick test may need to be repeated several times if your baby's bilirubin level is high. The test will monitor changes in your baby's bilirubin levels.

Jaundice can make babies sleepy, which can lead to feeding problems. Babies may not wake themselves to feed or maintain a strong latch. This can lead to significant weight loss in babies (more than 10 per cent of their body weight). Because of this, it is recommended that jaundiced babies be fed at least every 2-3 hours, even if it means waking them.


Extremely high levels of bilirubin can cause deafness, cerebral palsy, or brain damage in some babies, if not treated.


Most of the time, mild jaundice goes away on its own within 1 to 2 weeks.  If your baby's bilirubin level is too high or is rising too quickly, your baby will need treatment. 

Mild increases in bilirubin usually don't require treatment. You can help your baby with frequent feedings – feed your baby at least 8 times in a 24-hour period. This can speed up the rate that stool (poo) passes through their intestine which can reduce the amount of bilirubin.


Higher bilirubin levels can be treated with phototherapy. This is where your baby is placed under a special blue light. This light makes it easier and quicker for your baby's liver to process bilirubin. Eye shades will protect your baby's eyes from the light. You can continue to breastfeed your baby by removing baby from under the blue light when it is time to feed. 


Phototherapy usually takes place in hospital, and the treatment lasts between 1 to 3 days. A home phototherapy program is also available through BC Women's. Talk to your care provider about the phototherapy options for your family. 

 

When to call for help

Call your doctor, midwife or community health nurse if:

  •  baby's skin looks yellow during the first 24 hours of life;
  •  baby's skin turns from light yellow to more orange-yellow which can also be seen on your baby's arms or legs;
  •  baby is sleepy and difficult to wake up for feeding or stops feeding;
  •  baby is not peeing or pooing for more than 12 hours (diaper is dry);
  •  baby starts to look or act sick, has a high-pitched cry, or is becoming more irritable.
SOURCE: Jaundice and Your Newborn ( )
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