by Nadine Odo

Created on: July 30, 2008

What is jaundice, and is my baby going to be okay? It's common for a new mother to be told that her little baby has jaundice, and understandable for this news to make her a bit anxious. Over half of all full-term and up to 80% of premature babies have jaundice (neonatal jaundice) within the first few days of life. This occurs when there is too much bilirubin in the blood and results in a yellowish tint to the skin, whites of the eyes, and mucus membranes (in the mouth). If the bilirubin level is very high, the coloration may be brownish.

Causes of Jaundice

Bilirubin is produced when the hemoglobin in red blood cells breaks down. In newborns, jaundice is usually caused by the breakdown of the type of hemoglobin fetuses have (fetal hemoglobin) as it is being replaced by adult hemoglobin. This rapid breakdown of fetal hemoglobin together with the inability of a newborn's immature liver to remove high levels of bilirubin from his system cause jaundice. This is a normal process, and bilirubin levels generally return to normal after a few weeks.

Once in a while, however, an infant is jaundiced right away, not a few days after birth. If this is the case, the cause may be more worrisome, including severe bruising, a blood infection, or an incompatibility between the mother's blood and that of her baby.

Breast-milk or breast feeding jaundice is another possible, though rare, cause. The hypothesis is that something in breast milk reduces the ability of the liver to eliminate bilirubin. With this type of jaundice, bilirubin levels rise and peak in about two weeks, remain elevated for about a week, then revert to normal over several weeks or months. If a baby has breast-milk jaundice, there may be an underlying problem (eg, biliary atresia) which may be a cause for concern.

Incidentally, in older children and adults, there are a variety of reasons for jaundice which would be of concern, including hepatitis, cirrhosis, pancreatic cancer, and sickle cell anemia.

Treating Jaundice

Neonatal (also known as physiologic) jaundice and breast-milk jaundice usually do not cause problems. But, if the bilirubin level is high or if it is elevated over a long period of time, there is a possibility that the baby will have neurologic damage. Phototherapy and, if further treatment is necessary, exchange transfusion, will be started. In an exchange transfusion, the baby's blood is replaced by blood from a healthy blood donor.

There are a few rare instances when jaundice is a cause for concern. Most of the time, however, jaundice is just something that usually happens with newborn babies. Almost always, mom can rest assured that her baby will be fine.

References: clevelandclinic.org, medicinenet.com, mayoclinic.com

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