How to tell if your newborn has jaundice

Sometimes newborn babies may develop a yellow colouring of the skin, eyes, tongue and palms. This is called jaundice. Newborn jaundice occurs when a baby has high levels of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can be removed from the body in the stool. Usually, the high levels of bilirubin make your baby’s skin and whites of the eyes look yellow.

It is important to remember that, generally, a baby’s bilirubin level is most often a bit higher after birth. During pregnancy, the placenta removes bilirubin from the baby’s body. After birth, the baby’s liver starts doing this job. Sometimes, it can take a while for the baby’s liver to fully take on this task effectively, hence the generally higher bilirubin levels.

It has been observed that most newborn babies have some yellowing of the skin, called “physiological jaundice.” It is harmless, and usually is worst when the baby is two to four days old. It goes away within two weeks and doesn’t usually cause a problem. If the newborn is breastfed, two types of jaundice may occur, and both are usually harmless. These are breastfeeding jaundice and breast milk jaundice.

Severe harmful jaundice can occur in a baby with abnormal blood cell shapes or a blood type mismatch between the mother and the baby; or baby develops a large bleeding underneath the scalp (cephalohematoma) especially following difficult delivery; or a small-for-gestational-age baby or some twins with higher than normal levels of red blood cells; or infection; and/or lack of certain important enzymes.

Jaundice may also occur in situations which make it harder for the baby’s body to remove bilirubin due to certain medications; congenital infections, such as rubella and syphilis; liver disease; low oxygen level; infections; and many different genetic or inherited disorders. Jaundice has also been observed more frequently in premature than in full-term babies.