Related concepts:

Bilirubin, Breast milk jaundice, Breastfeeding jaundice, Hyperbilirubinemia, Kernicterus, Neonatal Jaundice, Pathologic jaundice, Physiologic jaundice.

Introduction to jaundice:

Jaundice is common in new babies and is usually not a problem. Nevertheless, jaundice can be a sign of a serious disease and occasionally jaundice can cause lasting nerve damage. Parents need to know when to worry and when to relax.

What is jaundice?

Jaundice is a yellow color observed in the skin or in the eyes. The yellow pigment is a byproduct of old red blood cells that is called bilirubin. If you’ve ever had a bruise, you may have observed that the damaged red blood cells in the skin went through a series of color changes as the skin healed. When you saw yellow in the bruise, you were seeing bilirubin.

Most of the time, about one percent of our red blood cells retire every day, to be replaced by the same number of fresh, young red blood cells. The old ones are processed in the liver as they are disposed of. Much of the bilirubin leaves the body in the stool.

If there are too many red blood cells retiring for the liver to handle, yellow pigment builds up in the body. When there is enough to be visible, jaundice results.

The jaundice can be caused by too many red blood cells retiring, by the liver being unable to perform its job efficiently, or by a combination of the two. Dehydration or decreased stooling can accelerate the build-up of bilirubin concentrations and make jaundice get worse quickly.

Who gets jaundice?

Most babies have some jaundice during the first week of life. The ordeal of birth can send many red blood cells to an early retirement (especially if a vacuum is used!), and babies’ livers are often unprepared for the load. Before Mom’s milk comes in and stooling begins in earnest, bilirubin accumulates more easily.

Jaundice is even more common in premature babies.

Physiologic jaundice is the name for the normal type of jaundice commonly seen in healthy babies.

Pathologic jaundice is the name given when the jaundice is a risk to the baby, either because of its degree or its cause. Pathologic jaundice arises for many reasons, including blood incompatibilities, blood diseases, genetic syndromes, liver diseases, infections, medications, or physiologic jaundice exaggerated for some reason (such as dehydration, prematurity, or a difficult delivery).

Two types of jaundice are related to breastfeeding. They are called breastfeeding jaundice and breast milk jaundice.

What are the symptoms of jaundice?

Jaundice often becomes visible on the face when the bilirubin level is about 5 mg/dL. It can be seen from the head down to the belly when the bilirubin is about 15 mg/dL, and all the way to the soles of the feet at about 20 mg/dL.

Physiologic jaundice in a term baby usually first appears when a baby is two or three days old. The jaundice peaks by day 4 and usually does not continue below the belly. The rate of bilirubin rises less than 5 mg/dL per day.