Terms Explained: what is jaundice?

Today, we’re learning about a common newborn ailment: jaundice.

Jaundice is a liver problem that manifests as yellowing skin and whites of the eyes. Left unchecked, jaundice can cause brain damage. But this is very very rare; around 60% of newborns have jaundice, but the treatment for it is so straightforward that very few experience lasting problems.

So let’s get into what jaundice is before we talk about how to solve it. Jaundice has to do with a pigment called bilirubin (pronounced: billy. RUE. bin.). Bilirubin is produced by the liver when it clears out waste. High levels of bilirubin in the blood are an indicator that the liver may not be functioning correctly (you can read more about the test that determines this here).

So why are newborns at particular risk for high bilirubin levels? Basically it’s because their livers are still “coming online.” Before birth, babies were ingesting nutrients that are already processed by a parent’s body; after birth, suddenly their bodies are in charge of many or all those processes. If the liver takes a little while to kick into gear, bilirubin levels can be high and can result in a medical diagnosis of jaundice. Newborns can develop jaundice for other reasons as well, including a blood type incompatibility between baby and baby’s parent.

How do we cure jaundice? Well, the short answer is pretty simple: food and light.

Here’s the more complicated version. For a long time, midwives in India put newborns who were jaundiced in the sun. In the 1950s, Sister Jean Ward (a Catholic nurse) invented contemporary “neonatal phototherapy” when she consistently brought infants, particularly the jaundiced ones, outside for fresh air and sunlight. A male doctor took notice of this technique when one of the infants, whose blanket had flipped up, partially covering a bit of skin, presented as nearly normal except for a very yellow patch of skin where the blanket had hidden the babe from the sunlight. Now, light is a – if not the – standard treatment for jaundiced babies.

Sunlight has these beneficial rays that help eliminate bilirubin, but also some potentially negative ones. So, you’ll often see babies with jaundice lying in a little light box. This is basically the same as getting a tan, but it’s helping their liver. Alternatively, there is a blanket (called a “biliblanket”) that provides that same therapeutic light and works in principle sort of like a heating pad but for light instead of heat.

A second strategy for minimizing jaundice is to feed the baby every few hours. The extra calories and liquid are thought to help lower bilirubin levels in the blood. This can be true when baby is consuming human milk, formula, or both.

In severe cases of jaundice, babies may undergo a blood transfusion. The new blood doesn’t have bilirubin, so this can be a straightforward treatment in worst case scenarios.

On a personal note, jaundice is something I worried about a lot my first few days parenting Eleanor. When a nurse came into the postpartum recovery room, gave her one look, and said, “She’s looking a little yellow,” my heart stopped for a split second before I remembered how common this is. Your child is more likely to have jaundice than not. That doesn’t minimize that having them under a light where you can’t hold them might be sad, or that having to hold them for a blood draw at the age of three days isn’t the worst feeling in the world at that time (it definitely was for me). It’s rough. And if it’s any consolation, it is common. Medical professionals handle this all the time. So, if you have concerns about your newborn, or if you see their skin or eyes yellowing, contact a medical professional immediately. Hopefully they can test for jaundice, get your baby into treatment, give them a quick tan, and get everything resolved.

If you have questions about jaundice or other newborn ailments, contact me about my next Infant Care Class! I’d love to have you join.