Born Too Early /
Premature Baby Care /
Health Complications /
What it is, and when you need to worry
By Candace Campbell, DNPs, MSN-HCSM, RN
Newborn jaundice is a normal occurrence. All babies have it to some degree. To understand how jaundice develops, let’s scroll back a bit.
How jaundice begins
Imagine you’re a baby, floating happily in the safety of your mother’s womb. Since your lungs aren’t active during this zero gravity experience, oxygen is circulated via a special form of hemoglobin that attaches to your red blood cells (RBCs). It gets delivered out to your body through your blood superhighway.
At birth, your lungs inflate, and you take your first breath. Since breathing is a much more efficient way of delivering oxygen, brain central sends a message to your liver (the recycling plant) to start breaking down excess red blood cells.
As the red blood cells start to break down, they produce a substance called bilirubin. Jaundice occurs when bilirubin builds up faster than the liver can pass it through the intestines and out from the body. Sometimes, the newborn liver can get overwhelmed by the work (think traffic jam.)
Bilirubin will make your newborn’s skin or the whites of his eyes look yellowish. It usually peaks at day 5 of life and then clears the body by the end of the first week.
What if it gets worse?
The resulting back-up of bilirubin in the blood can be potentially dangerous for one reason: it can cross the blood-brain barrier and cause severe, permanent mental delays.
A blood test can measure the amount of bilirubin circulating in your newborn’s body. High levels, usually 25mg or more, can lead to deafness, cerebral palsy or even brain damage.
At lower levels, jaundice may mean your baby has an infection or a thyroid problem, say experts the Mayo Clinic. It’s for this reason that experts at the American Academy of Pediatrics advise all newborns be screened for jaundice during the first few days of life.
Lights, action: Phototherapy!
If your baby’s blood levels of bilirubin are determined to be in the high-risk range, the most common treatment is to give her phototherapy under a light specifically designed to break down bilirubin. This may take a few days to accomplish.
Some abnormal blood problems or blood incompatibilities
Too many red blood cells (common in multiples, small and premature infants)
Certain missing enzymes
Rubella, syphilis, cystic fibrosis
Other inherited disorders
Candace Campbell, DNPs, MSN-HCSM, RN, is adjunct faculty at the University of San Francisco, and a practicing NICU nurse. She is also a filmmaker, author, blogger and expert advisor to Healthy Mom&Baby.