Infant Jaundice: Why and When You Should Worry
It is estimated that up to 60 percent of all healthy full-term babies have at least a small degree of jaundice. This would lead new parents to believe that neonatal jaundice is “normal” and certainly nothing to be overly concerned about. But undiagnosed and untreated jaundice in a newborn baby can have severe consequences.
What is jaundice? Why do newborn babies get jaundice?
Jaundice is the medical term for a yellow discoloration of the skin and eyes from an abnormally high level of bilirubin in the blood. Bilirubin is a yellow-colored pigment that is a byproduct of red blood cell breakdown. Normally, the liver removes bilirubin from the body. But in some newborn infants, an immature liver is unable to do this efficiently, leading to high levels of bilirubin in the blood, i.e., jaundice.
Why is it important to diagnose and treat infant jaundice?
If a baby’s yellow skin and whites of the eyes are unrecognized or dismissed as “normal” and the jaundice is not treated, a dangerous medical condition known as kernicterus can develop. This occurs when the blood contains abnormally high levels of bilirubin which builds up in the brain. Kernicterus is associated with several serious complications such as vision problems, hearing loss, cerebral palsy, and intellectual disabilities. Early diagnosis and prompt treatment of jaundice are critical in newborn infants to prevent kernicterus and its associated complications.
Does my baby have jaundice?
Infant jaundice is easy to diagnose and treat. Babies should be kept well fed (this keeps bilirubin levels down). The CDC suggests that parents remain vigilant for the following symptoms:
- Yellow or orange-tinged skin that first develops in the head area and gradually spreads towards the baby’s toes
- A baby who doesn’t sleep or is overly sleepy
- A fussy baby who will not breastfeed or bottle-feed well
- A baby with very few wet diapers
In addition, the following signs and symptoms warrant emergency medical attention:
- A high-pitched cry
- Inconsolable crying
- Arching of the body
- A floppy body
- A stiff body
- Strange eye movements
At particularly high risk of developing infant jaundice are:
- Preterm babies
- Babies with dark-colored skin
- Babies of Asian or Mediterranean ancestry
- Babies who have siblings with jaundice
- Babies with a tendency to bruise
- Babies born to mothers with blood type O or Rh-negative
- Babies with cephalohematoma birth injuries
How is jaundice diagnosed and treated in newborn infants?
A baby’s bilirubin level can be easily estimated with a device called a light meter. A blood test is needed to confirm the exact bilirubin level. A level of more than 20 is considered dangerous. After birth, the bilirubin level should be checked roughly every 12 hours for the first two days and again when the baby is 5 days old.
Treatment for infant jaundice is also relatively easy. It involves phototherapy, a noninvasive treatment where the baby is placed under special lights. In severe cases, an exchange transfusion may be necessary.
Infant Jaundice: When Things Go Wrong
Cal Sheridan of Boise, Idaho, was born to his mother Susan in 1995. Susan noticed her newborn son had yellow skin, was lethargic, and did not feed well. Doctors and nurses dismissed her concerns, telling Susan this was “normal.” In the mid-1990s, routine testing of a newborn baby’s bilirubin level was not common. Unfortunately, Cal developed kernicterus, but this too was overlooked by a neurologist. By this time, the baby was arching his back, wailing inconsolably, and trembling. Cal finally received treatment, but it was too little, too late. In his 20s now, Cal suffers from severe cerebral palsy, speech and hearing impairment, and ambulatory difficulties. He will need specialized care for the rest of his life.
Undiagnosed and untreated infant jaundice can be dangerous. If you think your baby might have jaundice, see your pediatrician immediately.