Newborn Jaundice Explained
Jaundice is a common condition that affects 60% to 80% of newborn babies. It results from a buildup of a substance in the blood called bilirubin, a pigment which yellows the baby’s skin and the whites of their eyes. Although jaundice is usually harmless, more severe cases can cause permanent brain damage when left untreated.
Treatment for jaundice typically involves light therapy to help the body break down and remove bilirubin from the blood. In more extreme cases, babies may require a complete blood changeover—known as an exchange transfusion—to reduce bilirubin levels as quickly as possible.
What Is Newborn Jaundice?
Jaundice causes a newborn baby’s skin to turn slightly yellow due to high levels of bilirubin in the blood. It’s common and treatable, causing no serious medical complications for the vast majority of babies. Symptoms usually show up within 2-3 days of birth and tend to resolve before the baby is two weeks old.
However, 1 in 20 babies requires immediate medical treatment for their jaundice. Without treatment, severe jaundice can cause serious complications including cerebral palsy, deafness or a form of permanent brain damage known as kernicterus.
Babies should be examined for jaundice by medical professionals within 24 hours of birth. Immediate treatment must be administered if the jaundice is severe. Failure to address signs of newborn jaundice in a timely manner can be considered medical negligence.
What Causes Newborn Jaundice?
When red blood cells break down as part of their natural lifespan, they create bilirubin. Normally, the liver processes this yellowish, toxic substance and the body excretes it with other waste. When red blood cells break down too quickly or the liver is not working properly, bilirubin can build up and cause the skin to turn yellow.
For most babies, jaundice is caused by normal newborn conditions:
- Newborn livers are still developing and cannot yet keep up with bilirubin production.
- Blood cells reproduce and break down at a faster rate in newborns than in adults.
Newborn Jaundice Risk Factors
Newborns have a greater chance of jaundice if several risk factors are present, including:
- Severe Bruising During Birth: Bruises sustained by a baby during a complicated delivery can cause blood cells to break down at a higher rate.
- Blood Type Differences: When a mother’s blood type is different from her baby’s, she may develop antibodies that attack the fetus’s blood cells.
- Breast Feeding: Babies who have difficulties feeding or can’t get enough nutrition through breast milk are significantly more likely to have jaundice.
- Premature Birth: The livers of babies born before 38 weeks of pregnancy cannot process bilirubin as efficiently as those of full-term babies. Premature babies may also be eating too little to assist the excretion of bilirubin from the body.
Babies may also have pre-existing conditions or underlying disorders that cause jaundice, including:
- A blood disease such as sickle cell anemia
- Infections like syphilis, rubella or sepsis
- Low oxygen
- Bleeding under the scalp caused during delivery by complications with vacuum extractions or forceps
- Liver diseases such as hepatitis
- Genetic disorders
These conditions can cause jaundice to show up earlier and be particularly severe. Without immediate treatment, bilirubin can enter the brain and serious complications can occur.
Newborn Jaundice Symptoms
Signs of jaundice typically show up within 2-3 days of birth. The baby’s skin, and possibly the palms and soles of their feet, will be tinted yellow. Babies with jaundice also have dark yellow urine and pale-colored stools.
Untreated jaundice may reveal more severe symptoms including:
- Arching the neck and body backward
- Difficulty feeding
- Difficulty waking up
- Crying at a high pitch
If a child has any of these symptoms, they must receive immediate treatment. A child with dangerously high levels of bilirubin may begin to show signs of brain damage.
Signs of advanced jaundice and brain damage include:
- Involuntary movements
- Hearing loss
- Gazing upwards
- Poorly developed tooth enamel
Examining for Newborn Jaundice
Most hospitals have policies to check a baby for jaundice before discharging the mother. Medical staff should examine the baby for signs of jaundice every 8-12 hours during the first 72 hours of life.
If a baby shows signs of jaundice, the doctor will test bilirubin levels using a noninvasive handheld device touched to the baby’s skin—they should not rely on a visual inspection alone to determine the severity of jaundice. If bilirubin levels are abnormally high, the doctor will conduct a blood test.
The baby will receive immediate treatment if the levels of bilirubin in the blood are higher than 25 milligrams.
Newborn Jaundice Treatment
There are a few treatment options for children with jaundice, depending on the severity of the condition. With normal newborn jaundice, doctors will ensure that the mother is feeding the baby often to help remove bilirubin from the body.
Light therapy, or phototherapy, is the primary treatment for jaundice when bilirubin levels are higher than they should be.
Phototherapy involves placing the baby under a special blue-green light. This light changes the structure of bilirubin, which helps the body remove it faster. During treatment, medical staff will protect the baby’s eyes and monitor their temperature and hydration levels.
Bilirubin levels are monitored closely throughout phototherapy treatment and tested:
- Every 4-6 hours during treatment
- Every 6-12 hours once bilirubin levels begin to drop
- Again 12-18 hours after treatment is stopped
When jaundice is very severe, babies may need a complete blood changeover to lower bilirubin levels as fast as possible. In this case, their bilirubin levels will be checked every two hours following the transfusion.
If jaundice is caused by a difference in the blood types of mother and baby, the doctor will do an intravenous immunoglobulin treatment. This reduces the blood levels of antibodies that are causing blood cells to break down too quickly.
Newborn Jaundice Prognosis
Most newborn jaundice goes away on its own within 1 to 2 weeks and has no lasting medical effects on the child.
However, severe jaundice must be addressed quickly to prevent serious medical complications. Prompt treatment can provide children with a full recovery even in dangerous cases. However, without treatment children may suffer from a permanent disability that can impact the rest of their lives.
Jaundice should be recognized and diagnosed by medical staff before bilirubin levels get high enough to cause brain damage. Failure to address the signs of jaundice and administer treatment promptly can be considered medical negligence.
Financial Compensation for Newborn Jaundice
Medical malpractice may result in jaundice escalating into a severe medical complication. Brain damage is an extremely unfortunate but realistic outcome when severe jaundice is left untreated.
If your child’s brain damage resulted from untreated newborn jaundice, you may be eligible to file a claim for financial compensation. This can be a huge help for parents with children requiring lifelong treatment and therapy for their medical condition.
Work with an attorney experienced in birth injury cases. Contact the Birth Injury Justice Center today at 800-914-1562 for your free medical case review.