Jaundice in Newborns

Jaundice is present when there is a yellowish discoloration to the baby’s skin. The whites of his or her eyes may appear yellow as well. This is usually a normal process in a newborn’s body due to an excess of bilirubin, a yellow-colored pigment of red blood cells. When a baby is born, he or she has an excess of red blood cells from the mother and placenta. The body begins to break down the red blood cells resulting in a large amount of bilirubin circulating in the body. The baby’s liver will eventually remove the bilirubin but it takes some time for this to occur.

Babies most at risk for jaundice are those who are premature, not breastfeeding well or when major differences occur between the mother and infant’s blood types. For this reason, it is important to monitor your child’s jaundice. This usually involves visually inspecting your child but occasionally, may involve obtaining a drop of your child’s blood to measure the bilirubin level.

Most newborns will have this normal, or physiological, jaundice begin when the baby is 2 to 4 days old. It will usually disappear by the time the baby is 2 weeks old. Occasionally jaundice remains for a longer period of time. If this is case your provider will evaluate and monitor your baby. If indicated they might recommend phototherapy to help lower your infant’s bilirubin level. You can continue breastfeeding if this is needed.[/pane]

  1. What Can I Do to Help Decrease My Baby’s Jaundice?
    Getting breastfeeding off to a good start will help. Jaundice can increase if babies are not stooling regularly. We recommend a visit in this first week with one of our lactation consultants for assurance and guidance through the beginning of the breastfeeding. At this visit we will also check your child for jaundice and determine if additional tests or treatments are needed. Here are a few tips to help your baby with jaundice:

    • Make skin-to-skin contact with your baby soon after birth and then often in the first few weeks. This will not only aid in bonding but will help with breastfeeding as well.
    • Breastfeed soon after birth and very frequently in the first few days.  By your baby demanding milk frequently, your body will produce more breast milk. The more breast milk your baby gets, the more easily he or she will break down the bilirubin that is causing the jaundice. Babies excrete bilirubin in bowel movements. The more they eat, the more they will pass bowel movements.
    • Encourage your baby to breastfeed 8 to 12 times or more in a 24 hour period in the first week. Some babies are sleepy when jaundiced. You may need to wake your baby to breastfeed if he or she does not show signs of wanting to eat in the first several days until the jaundice decreases.
    • Learn ways to remove more milk from your breasts. Hand expression while breastfeeding can be very helpful. See our “Breast Massage and Hand Expression Video” for more details. We can also help you during a lactation consult appointment in our office. If your infant is sleepy from jaundice, feeding additional expressed breast milk will help.
    • Remember, this is usually a normal process that will go away on its own. We will assist you if there is anything additional your child may need.
  2. When Should I Call?
    We are always happy to discuss any questions or concerns you may have along the way. We recommend a phone call and usually an office visit with one of our lactation consults if:

    • Your baby is not breastfeeding at least 8 to 12 times in a 24 hour period in the first week of life.
    • Your baby looks more jaundiced or is too sleepy to feed
    • Your baby is not having the expected number of wet or soiled diapers. Generally, we expect:
      • On Day 2 of life: at least 2 wet diapers and at least 3 tarry stools
      • On Day 3: at least 3 wet diapers and at least 3 greenish brown stools
      • On Day 4 to 5:  at least 4 -6 wet diapers and at least 3 mustard yellow stools.