Baby Jaundice - Information for Parents

Introduction
Jaundice affects nine out of ten babies in the first
few days of life. This leaflet explains all about
baby jaundice and, most importantly, what you
should do if your baby continues to be jaundiced
two weeks after birth if born at term, or three
weeks after birth if born pre-term i.e. before 37
weeks completed gestation.
Every year a few babies are born with liver
disease and continued jaundice can be an early
sign. It is vital that liver disease is detected and
treated as early as possible.
Is my baby alright?
For many parents, the joy over the arrival of their
baby is mixed with the worry that he or she may
not be completely healthy. It is always upsetting
for parents to be told that there is something
wrong with their baby, however small the problem
may turn out to be. The purpose of this leaflet is
to tell you about one of the most common
problems seen in newly born babies - BABY
JAUNDICE. This is often called ‘neonatal
jaundice’ by doctors, midwives and health visitors.
It is usually a minor problem and rarely causes
serious concern.
What is jaundice?
Jaundice is the name given to a yellow
appearance of the skin and the whites of the
eyes. Jaundice is common and occurs in about
nine out of ten newborn babies. It usually
develops in the second or third day of life and
reaches its peak around the fourth day. It
gradually disappears in most babies by the time
they are ten days old. Jaundice can occur within
the first 24 hours after birth, but this is rare. If this
happens, it is important that a Neonatologist or
Paediatrician (doctors who specialise in the care
of babies and children) sees your baby. Normally
this is not a problem as you will still be in hospital.
If your baby is at home, it is important that your
midwife, doctor or health visitor is informed.
What causes baby jaundice?
When your baby is in the womb, the waste
products are removed through the placenta. Once
your baby is born, their own body has to do this.
It can take some days, or even weeks, for a baby
to be able to remove its waste products properly.
Therefore, in the early days of your baby’s life
some waste products may build up in their body.
One waste product is called BILIRUBIN. This
causes the yellow colour seen in the skin in
jaundice if there is too much bilirubin in the body.
What is Bilirubin?
The body continuously makes new red blood cells
and breaks down old ones. Bilirubin is produced
when the old red blood cells are broken down. In
an adult, the red blood cells last for about 120
days, but in a newborn baby, they last for a
shorter time. Newborn babies also have a higher
than normal number of red blood cells.
Why do so many babies become
jaundiced?
Because newborn babies have a greater number
of red blood cells, which are also breaking down
more quickly, more bilirubin is released into the
blood. The liver is responsible for removing
bilirubin from the blood, but a newborn baby’s
liver takes some days to start to do this properly.
Therefore, in the first few days of life, bilirubin
builds up in the baby’s blood and nine out of ten
babies will become jaundiced.
Is there any treatment for baby
jaundice?
Most babies need no treatment for baby jaundice
and the jaundice normally disappears by the time
your baby is 10 days old. However, a small
number of babies do need some treatment,
depending on how much bilirubin there is in the
blood. The bilirubin level can easily be checked
with a small blood sample. The usual treatment
for baby jaundice is known as PHOTOTHERAPY.
This will mean that your baby is placed naked,
except for some eye pads, in a cot under a
special light. This light breaks down the bilirubin.
You will be encouraged to feed your baby, so that
the baby produces plenty of urine. Phototherapy
can usually be stopped within a few days.
Can baby jaundice harm my baby?
Jaundice is not usually dangerous for babies. If
there is any doubt, a small sample of blood will be
taken to make certain that there is no risk for your
baby. Very high levels of bilirubin can damage the
brain. Phototherapy is therefore always started
well before any dangerous level is reached.
Why may some babies remain
jaundiced?
Baby jaundice normally clears ten days after birth.
However, sometimes it lasts longer. There can be
a number of reasons why jaundice continues:
1. Your baby may have been born early i.e.
prematurely and it may take a little longer for
the liver to work properly.
2. Your baby may have a condition in which the
blood cells break down more quickly than is
normal for babies. This is often discovered
very soon after the baby is born, or even
during pregnancy, and further treatment may
be necessary.
3. Jaundice may continue occasionally in babies
who are entirely well and breast fed. Breast
feeding may safely continue and the jaundice
will fade with time.
4. Your baby may have some infection or other
illness.
5. You may have a condition which makes your
baby more likely to have jaundice.
6. Your baby may have a thyroid gland that is
not functioning properly. This is tested as part
of a blood test that is carried out on all babies
between 5 and 8 days old, referred to as the
Newborn Blood Spot.
7. Rarely, your baby may have a problem with
its liver.
What should be done if the
jaundice does not disappear?
Jaundice should normally have disappeared by
the time your baby is 10 days old. If your baby is
still jaundiced at the age of two weeks if born at
term, or three weeks if pre-term, it is important
that your baby is seen and examined by the
doctor, midwife or your health visitor who will refer
your baby for investigation. In our area, these
investigations will normally be carried out at
Antrim Area Hospital.
There are several important questions you should
ask yourself:
1. Is my baby feeding well?
2. Does my baby seem happy?
3. Is my baby’s urine yellow?
Normally a baby’s urine is virtually colourless.
4. Are my baby’s stools (‘pooh’) pale or clay
coloured?
Normally a baby’s stools are yellow or green.
Being able to answer these questions will be
helpful to your doctor, midwife or health visitor.
Is time important?
Time is important. Prolonged jaundice can be a
sign of liver disease. Whilst liver disease in
babies is rare, it is important that it is detected
quickly and, where appropriate, treatment given.
If liver disease is the cause, a paediatrician will
need to carry out more investigations to find out
which liver disease is affecting your baby, so that
your baby can be given the best treatment.
Naturally all this takes time. Weeks can be
important. The earlier treatment is given, the
better, as it is likely that less damage will have
been done to your baby’s liver.
Remember, liver disease is rare. But for those
babies that are affected, it can be very serious.
The golden rule is if your baby is still jaundiced
aged two weeks if born at term, or three weeks if
pre-term, investigations are required.
If you have a child with liver disease, need more
leaflets or need further help, please contact the
Children’s Liver Disease Foundation at the
address given overleaf.
Children’s Liver Disease Foundation
36 Great Charles Street
Birmingham B3 3JY
Tel: 0121 212 3839
Fax: 0121 212 4300
Website: www.childliverdisease.org
Email: info@childliverdisease.org
Reg Charity No 1067331
If you have any further questions, please do not
hesitate to ask a member of staff.
This leaflet has been adapted from Children’s Liver Disease
Foundation.
email: info@northerntrust.hscni.net
This document is available, on request,
in accessible formats, including Braille, cd,
audio cassette and minority languages.
Baby Jaundice
Information for parents
NT/WCS//03/09/5600 1k CCD