Neonatal Jaundice

Jaundice is a common condition amongst newborns and is a symptom of a condition called hyperbilirubinaemia. This is an increased level of bilirubin within the bloodstream. Bilirubin is produced during the breakdown of red blood cells. Baby's have extra red blood cells once born. Bilirubin is normally broken down by the liver, and leaves the body in baby's urine and stool. In a healthy term baby this usually peaks around day 5 of life.

Jaundice is shown by the yellowing of the skin and sclera (whites of the eyes). In the first few days of life, a baby may be redder than normal (plethoric).

Other signs can include:

• Being sleepier than normal
• Not having wet nappies
• Not having dirty nappies
• Poor feeding

Babies can be more likely to develop jaundice if they are:

• born preterm
• have an infection
• different blood group to their mother
• difficulty feeding
• difficult delivery, for example where there is some bruising from forceps delivery

Your baby may have their bilirubin level checked by

scanning their skin (transcutaneous) or by a blood test (SBR). Depending on the results your baby may need additional/repeat tests.

Jaundice does not always need treatment, and can be managed through supportive measures and monitoring levels. One of the most important ways to support this is to feed your baby responsively, and look for their hunger cues. Please seek support from your midwife/nurse if you are worried about your  babies feeding.

If your baby needs treatment for jaundice, they may receive phototherapy. This involves placing your baby under a blue light, either in a phototherapy blanket or under an overhead lamp. The light helps to break down bilirubin so that it can leave the body through your baby’s urine and stool.

During phototherapy:

• Your baby will be undressed to allow maximum skin exposure.
• They will wear an eye mask to protect their eyes from the blue light.
• Feeding and hydration are important to help flush out the bilirubin.
• Other treatment will be discussed if required.

A baby can go home if their jaundice levels are within a safe range. They may need repeat tests or monitoring by midwives/health visitors/community children's nurses in the community.

Once home monitor for worsening signs of jaundice and seek help from your midwife/health visitor or GP.

If jaundice persists:

Term babies: after 14 days

Preterm babies: after 21 days

They may be referred for further blood tests. This is called prolonged jaundice and will be discussed with you beforehand.

Image from: Parent club, Learning your baby’s cues, Learning your baby's cues | Parent Club