Newborn Jaundice

What Is the Difference Between Newborn Jaundice and Childhood Jaundice?

Newborn jaundice occurs several days or weeks after childbirth. In most cases, jaundice is mild and improves on its own. But some causes of newborn jaundice require medical care. All babies with jaundice should see their provider. 

Childhood jaundice, which occurs months or years after the newborn stage, is a sign that your child may have a health condition that needs immediate medical attention. Liver disease is a common cause of childhood jaundice (also known as pediatric jaundice). 

What Causes Jaundice in Babies?

Excess bilirubin in a baby’s blood causes jaundice. Bilirubin is a yellow-orange color that forms when your baby’s body breaks down old red blood cells. Your baby’s liver processes bilirubin in bile, a digestive fluid that leaves your baby’s body when they poop.

The placenta removes bilirubin from a baby’s body while in the womb. After birth, several factors can cause a buildup of bilirubin and jaundice.

Liver Diseases That Cause Newborn Jaundice

Less commonly, newborn jaundice is a sign of liver disease. Liver conditions that cause jaundice in babies include:

• Biliary atresia
• Cholestasis
• Hepatitis
• Liver failure

What Are the Types of Jaundice in Newborns?

There are different types of jaundice in babies:

• Physiological jaundice: This most common type of newborn jaundice typically appears when a baby is two to five days old. It typically goes away on its own in a couple of weeks as a baby’s digestive system matures and other factors improve.
• Breastfeeding (chestfeeding) jaundice: This newborn jaundice usually appears within seven days after childbirth. It may occur when infants who only breastfeed (or almost exclusively breastfeed) are not getting enough breast milk due to low milk supply or problems latching on to nurse. This issue typically improves when babies drink more. 
• Breast milk (chest milk) jaundice: This newborn jaundice occurs when substances in breast milk affect how a baby’s liver breaks down bilirubin. The amount of breast milk a baby receives isn’t a factor. Breast milk jaundice typically appears when a baby is four to seven days old. Breast milk jaundice is typically mild. Most babies don’t need treatment. However, symptoms can last for up to 12 weeks.

What Are the Risk Factors for Newborn Jaundice?

Any baby can develop jaundice, even those who get infant formula. These factors increase the risk for newborn jaundice:

• Bleeding underneath a baby’s scalp (hematoma), sometimes from a difficult childbirth
• Hemolytic anemia 
• Mismatch of blood types between mother and baby that causes hemolytic disease of the newborn (HDN)
• Infections and illnesses
• Prematurity (childbirth before the 37th week of pregnancy)
• Sickle cell disease
• Twin-to-twin transfusion syndrome (TTTS)

What Are the Signs and Symptoms of Jaundice in Babies? 

Signs of newborn jaundice typically appear soon after childbirth. Your baby may feed poorly or sleep too much. 

A yellow-orange coloring is the most common symptom. This yellow tint may affect the:

• Palms of your baby’s hands and soles of their feet 
• Skin (starting with their face and going down to their chest and lower limbs)
• Skin underneath their fingernails and toenails
• Whites of their eyes (sclera)

How Is Jaundice in Newborns Diagnosed?

Your newborn will get a bilirubin test before leaving the hospital. If your baby is receiving specialized care in the neonatal intensive care unit (NICU) at Lurie Children’s, they may get several bilirubin tests during their stay. After discharge, your baby’s pediatrician will check for signs of jaundice during their well-child visits. 

Tests for newborn jaundice include:

• Bilirubin skin probe: A probe device placed against your baby’s skin measures transcutaneous bilirubin (TcB) levels in their skin. 
• Bilirubin blood test: A healthcare provider pricks your baby’s heel to collect a blood sample. This test shows the total serum bilirubin (TSB) level in blood.

How Is Newborn Jaundice Treated?

Mild physiologic jaundice often goes away on its own as your baby’s liver gets better at removing bilirubin. Depending on the bilirubin level, your pediatrician may recommend certain actions to treat newborn jaundice. Your baby may also receive care from a pediatric liver disease specialist (hepatologist) at Lurie Children’s. 

Increased Feedings

It can take a month or longer for breastfeeding jaundice and breast milk jaundice to improve. However, there’s usually no reason to stop breastfeeding or switch to formula. Increased breastfeeding can improve breast milk supply and cause your baby to poop more, which helps get rid of bilirubin. If your baby receives formula, your doctor may recommend increasing these feedings.

Phototherapy

Total bilirubin levels that are too high or continue to rise can pose a risk of brain damage. Your baby may need phototherapy in the hospital for a couple of days. This light therapy helps break down bilirubin in your baby’s skin. It changes bilirubin into a substance that more easily leaves your baby’s body. 

During phototherapy, your baby:

• Wears a diaper and eye mask
• Lies in a bed (isolette) underneath special blue lights for approximately 30 minutes
• Absorbs light waves while we rotate their body a few times for maximum skin and light exposure  

Exchange (Blood) Transfusion

Newborns who have certain blood (hemolytic) disorders that cause jaundice, such as HDN, as well as those who don’t improve with phototherapy, may need an exchange transfusion. This type of blood transfusion takes place in the hospital. Your baby will stay in the hospital for several days after the transfusion.

An exchange transfusion involves:

• Slowly removing your baby’s blood 
• Replacing your baby’s blood with fresh, warm blood or plasma from a donor stored at our Blood Bank Laboratory

What Is Lurie Children’s Approach to Caring for Babies With Jaundice?

Lurie Children’s provides the highest level of care for newborns with jaundice. Your baby receives care at the top-rated children’s hospital in Illinois, as ranked by U.S. News & World Report. 

Your child benefits from:

• Experts in newborn jaundice care: Your baby’s care team may include doctors who specialize in newborns (neonatologists), pediatrics and liver diseases. Our experts work together to manage newborn jaundice and protect your newborn’s health.
• Dedicated Pediatric Liver Center: Babies with jaundice caused by liver disease receive specialized care and the latest treatments at our dedicated Pediatric Liver Center.  
• Research and clinical trials: Our doctors are active in hepatology research and clinical trials to find new ways to manage newborn jaundice. 

Pediatric Liver Center at Lurie Children’s 

Pediatricians at Lurie Children’s have deep expertise in recognizing signs of newborn jaundice and managing the condition. When needed, our pediatricians partner with our pediatric liver disease specialists to ensure your baby benefits from the most effective treatment. Newborns with jaundice caused by liver diseases receive expert care at the Pediatric Liver Center at Lurie Children’s. We have all the experts your baby needs to get better and thrive. 

Learn more about our Pediatric Liver Center.