How to treat jaundice in newborns?
Family Health, Women's Care
St. Joseph’s/Candler Neonatal Intensive Care Unit nurse explains this common condition
It’s a very common occurrence in newborns but it doesn’t make it any less scary – jaundice. The good news is there are available treatments whether you are still in the hospital or at home.
Jaundice is typically a short-term condition that is most commonly associated with yellowing of the skin and eyes. It develops in more than half of all newborns, with premature babies more likely to have jaundice.
When babies are born, their body automatically makes extra red blood cells in order to have extra oxygen at birth, explains Lisa Loadholt, nurse resource coordinator in the Neonatal Intensive Care Unit at The Mary Telfair Women’s Hospital at Candler Hospital. When the body no longer needs those extra blood cells, the liver tries to excrete the byproduct, which can cause yellowing of the skin, eyes or tissue. As the liver matures, the jaundice should go away.
“Jaundice is very, very common,” Loadholt says. “Usually with newborn babies you see it on the second or third day of life. The premature babies, however, can be sooner, usually within 24 hours.”
How do you treat jaundice?
As all bodies – babies to adults – break down cells, hemoglobin is changed into bilirubin, a yellowish pigment that is made during the normal breakdown of red blood cells. Bilirubin passes through the liver and is eventually excreted out of the body. A high amount of bilirubin left in the body can lead to jaundice or signal a problem with the liver.
After delivering your baby, your team of nurses and doctors will continually look for signs of jaundice. The yellow tint to the skin can often be seen by gently pressing the baby’s forehead or chest and watching for color to return.
To determine how to treat jaundice in babies, your doctor will check the bilirubin level through a simple blood test. Doctors will use these levels plus hours of age of the baby to determine treatment, Loadholt says. Because it’s so common and typically goes away quickly on its own, your baby may just need monitoring. Other babies may need phototherapy, which can be done at the hospital or at home, depending on your baby’s health and age.
Phototherapy is special lights that are placed above the baby’s crib, or isolette for our preemies, that give off certain intensities of light. This light helps the baby’s liver break down and remove the bilirubin from your baby’s blood.
During treatment, baby will only have on a diaper and wear special goggles to protect the eyes, Loadholt says. How long phototherapy lasts depends on the bilirubin levels day to day.
Another option is called a bili blanket, which also is a type of phototherapy, but this time using a blanket with a pad of woven fibers that transfer light to the baby. Bili blankets may be used in the hospital setting or there are home care agencies that help with bili blankets to purchase or rent to use at home.
This is ideal for moms who want to breastfeed, Loadholt says. Your healthcare team may want you to supplement with formula, however, if the baby’s bili levels are elevated.
Cause for caution but not fear
“It can be scary for parents when the baby is underneath the light,” Loadholt says. “There is a scary appearance to it, but once we explain to them the importance of getting the therapy now versus waiting and those levels going up, it helps them realize the baby will have better outcomes.”
As mentioned, jaundice typically goes away on its own or after a certain amount of phototherapy sessions. However, if left untreated, jaundice can lead to kernicterus, which is a type of brain damage caused by high levels of bilirubin in the blood.
“That’s what we want to prevent. That’s why monitoring and assessing the baby continuously is so important so those babies don’t reach high, high levels,” Loadholt says.
If your baby is treated for jaundice at the hospital, your pediatrician should be able to follow up on their bilirubin level at their first appointment, Loadholt says. If your baby did not experience jaundice the few days after birth, you may still want to monitor for yellowing of the eyes and skin tone for the next several days and immediately report anything unusual to your doctor.