Jaundice In Newborns

WHAT YOU SHOULD KNOW:

• Jaundice is a condition where there is too much bilirubin in the blood. Jaundice can occur in newborn babies. Bilirubin is a yellow pigment (coloring) released during the normal breakdown of your baby's red blood cells (RBC). Blood carrying bilirubin goes to the liver, where it is prepared before removal by the intestines (bowels). Bilirubin then leaves your baby's body through his bowel movements (BM). When the body has problems removing bilirubin, it stays in the blood and builds up in the skin. These problems usually happen because the baby's liver is not yet well developed. Jaundice may also occur when the body makes too much bilirubin. It may also result from a blood mismatch between the mother and baby, infections, and other liver problems.
  
  
• Jaundice usually starts on your baby's face and moves down his body. Blood tests will be done to learn how much bilirubin is in your baby's blood. Liver function tests and ultrasonography may be done to check for other causes of his jaundice. Treatment will depend on the amount of bilirubin in the blood and your baby's health. Jaundice in a full term, healthy baby usually goes away on its own as the baby’s liver matures. Caregivers may treat your baby with phototherapy or exchange transfusion if his bilirubin is very high. When monitoring and treatment begin as soon as jaundice is diagnosed, jaundice usually goes away without causing further medical problems.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.

RISKS:

Treatment for jaundice may cause unpleasant effects. During phototherapy treatment, your baby may become too cold or too warm, and more irritable or tired. He may get dehydrated (lose too much body fluid) if he becomes too warm. Your baby's skin may burn or his eyes may be damaged by phototherapy. Exchange transfusions may cause bleeding, allergic reactions, or infections. If left untreated, the bilirubin level may become very high and cause problems to the brain. Your baby could have hearing loss or brain damage, and could even die. Ask your baby's caregiver if you are worried or have questions about his jaundice, care, or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Diet:

You may need to feed your baby more often, especially if you are breast feeding. Ask your baby's caregiver if you should feed your baby at least 8 to 12 times a day for the first few days. Ask your baby's caregiver if you should feed your baby milk formula as well as breast milk, or if you need to make other changes to your baby's diet. Ask caregivers for more information about feeding your baby.

Intake and output:

Caregivers may need to know how much liquid your child is getting and urinating. Your child may need to urinate into a container in bed or in the toilet. A caregiver will measure the amount of urine. If your child wears diapers, a caregiver may need to weigh them. Do not throw away diapers or flush urine down the toilet before asking a caregiver.

Tests:

Tests may be done to monitor your baby's bilirubin level and to look for the cause of jaundice:

• Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  
  
• Imaging tests:
  
  
  • Abdominal ultrasound: An abdominal ultrasound is a test that looks inside of your baby's abdomen (belly). Sound waves are used to show pictures of his liver, gallbladder, and bile ducts on a TV-like screen.
    
    
  • Scintigraphy: This is a test to look at the flow or movement of blood through the liver and bile ducts. Your baby is given a small, safe amount of dye in an IV. Pictures are then taken of his abdominal organs and blood vessels.
  
  
• Liver biopsy: This test checks your baby's liver by taking a sample from it. Guided by an ultrasound, caregivers will put a needle through your baby's skin and into his liver. Tissue samples are taken and sent to a lab for tests.
  
  
• Urine tests: Caregivers may test your baby's urine for white blood cells, protein, sugar, blood, and bacteria (germs) that should not be there. A urine culture may also be done if your baby has an infection.

Treatment options:

Your baby may need any of the following treatments if the bilirubin level in his blood becomes very high:

• Phototherapy: This treatment uses a type of light to help break down the bilirubin in your baby's body. Decreasing the bilirubin will take out his skin's yellow color. Your baby may lie under bright lights undressed or in a special diaper. Small eye masks will be placed over his eyes to keep them from being damaged. Caregivers will turn your baby frequently so different areas of the skin can be exposed to the lights. Depending on how high the bilirubin level is, phototherapy may be used all of the time, or only sometimes.
  
  
• Exchange transfusion: This is a procedure to remove and replace your baby's blood. Exchange transfusion may be done if your baby has too much jaundice. This may be needed especially if your baby's jaundice is caused by a mismatch with your blood types. During this procedure, caregivers replace some of your baby's blood with donor blood. Ask your baby's caregiver for more information if your baby needs an exchange transfusion.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Jaundice In Newborns (Inpatient Care)