Jaundice in newborn babies

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1 Jaundice in newborn babies Information for Parents and Carers Excellent care with compassion

2 Many babies develop jaundice in the first days of life. This leaflet explains why this can happen and what treatment may be needed. What is jaundice? A baby with jaundice will look slightly yellow or suntanned. Sometimes the whites of the eyes or the inside of the mouth or gums also look yellow. If your baby has dark skin, the main sign may be a yellowing in the whites of their eyes or inside their mouth. Jaundice is caused by the build-up in the body tissues of a waste product called bilirubin. Bilirubin is a yellow substance produced during the body s natural and continual cycle of breaking down old red blood cells to replace them with new red cells. The bilirubin is removed from the body in stools and urine. Why do babies become jaundiced? When a baby is born it can take a few days before this cycle becomes fully established so bilirubin may build up and cause jaundice at about 3 days of age. The jaundice is usually mild and requires no treatment. However some babies develop early or more severe jaundice, either because they have a higher than average breakdown of red cells or because they are less able to remove the bilirubin from their bodies. Babies are more at risk if: They have a brother or sister who required treatment for jaundice You have Rhesus antibodies or other red cell antibodies They were born before 38 weeks of pregnancy 2

3 Checking your baby for jaundice Your midwife and doctor will look for signs of jaundice each time they see your baby but it is also important that you check your baby every day for at least the first week of life. A good time to check is when you are changing your baby s nappy or clothes. Try to do these checks in bright natural light. 1. Does your baby s skin look yellow? The yellow colour usually starts on the face and forehead and then spreads to the body, arms and legs. 2. Are the whites of your baby s eyes yellow? 3. Look in your baby s mouth to see if the gums or roof of the mouth are yellow. The best time to do this is when your baby is crying and the mouth is open wide. 4. Gently press your finger tip against your baby s forehead or chest for a few seconds to see if there is a yellow tinge to the skin when you remove your finger. Ask your midwife to show you how to do these checks if you are not sure. What should I do if I think that my baby has jaundice? If your baby is less than 24 hours old contact a midwife urgently. Jaundice at this age could be a sign of another medical problem. If your baby is more than 24 hours old, you should still contact a midwife the same day. It is particularly important that you do this promptly if your baby also seems drowsy and reluctant to feed. You should also tell your midwife, on-call midwife or doctor if your baby, at any time, passes pale, chalky coloured stools or dark urine that stains the nappy. 3

4 How will my baby s jaundice be assessed? To assess the level of your baby s jaundice, a small device called a bilirubinometer may be used. This device measures the levels of bilirubin in skin and fat tissue by being gently pressed against your baby s forehead or chest without puncturing the skin. If the reading suggests that your baby s jaundice may need treatment, a direct measure of the amount of bilirubin in your baby s blood will be required. You will be asked to bring your baby to one of the birth centres or to the Paediatric Assessment Ward at Royal Preston Hospital for a blood sample to be taken. It is usually possible to collect the sample by simply pricking your baby s heel and collecting a few drops of blood to send to the laboratory. How is jaundice treated? Mild jaundice does not normally need any treatment, but your midwife will give you extra advice and support with feeding to make sure that your baby is feeding adequately and effectively. More severe jaundice is usually treated with phototherapy. This involves admission to the Children s Ward where your baby will be nursed in an incubator under one, or more, lamps that shine a special type of light onto the skin. The light alters the structure of the bilirubin so that your baby is better able to pass it out of his/ her body in stools and urine. Eye pads are used to protect your baby s eyes from the light and regular blood tests are taken to monitor the bilirubin levels. The length of time your baby remains in phototherapy will vary from a few hours to a few days depending on how quickly the bilirubin levels fall. You will be able to stay with your baby. Very rarely, bilirubin levels rise so high that an exchange blood transfusion may be advised. This involves replacing the baby s blood with new blood from a donor. Your doctor will discuss all treatment options with you and answer any questions that you have. 4

5 Does jaundice cause any long term problems? Mild jaundice causes no long term problems. Severe jaundice, if untreated, can sometimes result in bilirubin being deposited in brain tissue and there is then a risk that brain development can be affected. This condition is called kernicterus but is very rare. What should I do if my baby s jaundice does not clear up? Jaundice usually fades gradually over a few days but if your baby is still jaundiced at 2 weeks old (or 3 weeks, if born before 37 weeks) you should contact your midwife or doctor. Your baby will be referred to the Children s Clinic to determine whether further investigations are needed. Contact your midwife urgently at any time, if you think your baby s jaundice has become worse, particularly if your baby has become drowsy and reluctant to feed. 5

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8 Sources of further information Lancashire Teaching Hospitals NHS Foundation Trust is not responsible for the content of external internet sites. Please ask if you would like help in understanding this information. This information can be made available in large print and in other languages. Department: Women s Health Division: Maternity Production date: September 2014 Review date: September 2017 LTHTR/Tr/2014October/143 Excellent care with compassion