Neonatal Jaundice

December 24, 2018
Janelle Thomas MSN, RN
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What Is Neonatal Jaundice?

The most common condition that requires medical attention and hospital readmissions in newborns is Neonatal jaundice – sometimes referred to as infant jaundice. It is the yellow discoloration of a newborn baby’s skin and eyes. Neonatal jaundice is a condition, especially in babies born before 38 weeks gestation.

Neonatal Jaundice Symptoms

The main signs and symptoms of neonatal jaundice are yellowing of the skin and the whites of the eyes. This typically occurs between the second and fourth day after birth.

You can check for neonatal jaundice by gently pressing on your baby’s nose or forehead. If the skin looks yellow where you pressed, it’s possible that your baby has a mild form of jaundice.

What causes jaundice in babies?

Neonatal jaundice is caused by excess bilirubin, which is a yellow pigment of red blood cells. Oftentimes, a newborn baby’s liver is not mature enough to rid the body of the bilirubin in the bloodstream, leading to neonatal jaundice. This is most common in preterm babies, especially babies who are born before 35 weeks.

In some babies, an underlying condition or disease may cause neonatal jaundice, including:

  • Liver malfunction
  • Enzyme deficiency
  • Abnormality in the red blood cells
  • Incompatibility between the baby’s blood and the mother’s blood
  • Internal bleeding
  • Blood infection
  • Bacterial or viral infection

Types of Neonatal Jaundice

Physiological Jaundice

Physiological Jaundice is sometimes referred to as ‘normal’ jaundice. This is the most common type of jaundice, affecting up to 60 percent of full-term babies in the first week of life. This type of jaundice occurs more than 24 hours after a baby is born.

Non-physiological Jaundice

Non-physiological Jaundice occurs much sooner, with infants developing jaundice less than 24 hours after birth. In these cases, an infant’s levels of bilirubin tend to be much higher than physiological jaundice.

How to Diagnose Jaundice in Newborns

Your doctor will likely diagnose neonatal jaundice on the basis of your baby’s appearance. It is still necessary to measure the level of bilirubin in your baby’s blood to determine the severity of jaundice and the appropriate treatment.

How long does jaundice last in newborns?

Jaundice typically occurs between two and four days after birth. Physiological jaundice typically goes away within one to two weeks but can last longer in some cases. You may notice your baby’s jaundice symptoms peak at five to seven days and then lessen over the following month.

Neonatal Jaundice Risk Factors

Certain factors can put your baby at a greater risk for jaundice, which can include complications. These factors include:

  • The Mother’s Blood Type: Sometimes, if a mother’s blood type is different than her baby’s, the baby can receive antibodies via the placenta. These antibodies can cause an abnormal, rapid breakdown of the red blood cells.
  • Breastfeeding: Babies who are breastfed – in particular, those who have trouble getting enough nutrients via breastfeeding – are at a higher risk for jaundice. This is typical because nursing difficulty can lead to dehydration and low caloric intake, which can contribute to the onset of jaundice. Still, doctors recommend breastfeeding due to its vast benefits.
  • Bruising During Birth: Sometimes newborns can bruise during delivery, which can cause a higher level of bilirubin due to the breakdown of more red blood cells.
  • Premature BirthBabies born before 38 weeks of gestation have a greater risk of jaundice. This is often influenced by lower caloric intake and fewer bowel movements, which result in less bilirubin being eliminated.

Complications of Neonatal Jaundice

Sometimes, high levels of bilirubin can cause severe jaundice. Severe jaundice can lead to serious complications, including:

Acute Bilirubin Encephalopathy

Bilirubin is toxic to the brain cells. Severe jaundice poses a greater risk of bilirubin affecting the brain, but quick treatment can prevent lasting damage. Signs of acute bilirubin encephalopathy include:

  • Fever
  • Trouble waking
  • High-pitched crying
  • Poor feeding or sucking
  • Backward arching of the body


If acute bilirubin encephalopathy causes damage to the brain, a syndrome known as kernicterus can occur. Kernicterus can result in the following:

  • Hearing damage
  • Permanent upward gaze
  • Improper development of tooth enamel
  • Athetoid cerebral palsy causing involuntary movements

How to Prevent Jaundice in Newborns

Jaundice is best prevented by adequate feeding. Infants who are breastfed should have eight to 12 feedings every day during the first days after birth. If you are using a formula for feeding, infants should have one to two ounces of formula every two to three hours during the first week after birth.

Neonatal Jaundice Treatment

If your baby is diagnosed with neonatal jaundice, your doctor will decide the best treatment based on how severe the levels of bilirubin are. Treatment typically includes:

  • Light Therapy: Special lamps that emit light on the blue-green spectrum help change the shape and structure of bilirubin molecules. In doing so, your baby’s body can excrete excess bilirubin via urine and stool. During this treatment, your baby will simply wear a protective eye covering and a diaper.
  • Intravenous Immunoglobulin: Sometimes jaundice occurs due to a difference in blood types between mom and baby. When this is the case, intravenous immunoglobin may be the best option. This treatment transfuses a blood protein called immunoglobin into your baby. The transfusion helps reduce the levels of antibodies, decreasing jaundice.
  • Exchange Transfusions: This treatment is rare but used if your baby doesn’t respond to other types of treatment. This treatment involves withdrawing small amounts of blood from your baby and replacing it with donor blood. This dilutes the bilirubin and maternal antibodies. This procedure is performed in the neonatal intensive care unit.

Contact Care Options for Kids for Pediatric Home Health Care Services in Florida

If you need assistance in caring for your newborn with a medical condition, we are here to help. At Care Options for Kids, we have an entire team of experienced caregivers to ensure the wellbeing of our pediatric patients. Contact us or call us today to learn more.

If you are considering pediatric home health care services in Florida, contact the caring staff at Care Options for Kids. Call today at (888) 592-5855.