Jaundiced Newborn

DEFINITION

• The skin and whites of the eyes have turned yellow

• Onset 2 to 3 days of age
• Peaks day 4 to 5, then improves
• Disappears 1 to 2 weeks of age

• Due to inadequate intake of breastmilk
• Pattern similar to physiological type
• Also, causes poor weight gain

• Due to substance in breastmilk which blocks destruction of bilirubin
• Onset 4 to 7 days of age
• Lasts 3 to 10 weeks
• Not harmful

• Onset during first 24 hours of life
• Can reach harmful levels

WHEN TO CALL YOUR DOCTOR

HOME CARE ADVICE FOR MILD JAUNDICE

1. Reassurance:
   • Some jaundice is present in 50% of newborns.
   • It is temporary and usually harmless.
   • The first place for jaundice to appear is in the whites of the eyes (sclera).
   • Jaundice that only involves the face and eyes is always harmless.
2. Bottlefed: If bottle fed, increase the frequency of feedings. Try for an interval of every 2 to 3 hours during the day.
3. Breastfed: If breastfed, increase the frequency of feedings. Nurse your baby every 1½ to 2½ hours during the day. Don't let your baby sleep more than 4 hours at night without a feeding.
   
4. Increase Stools:
   • If your baby is 5 days or older AND has less than 3 stools/day, carefully insert a lubricated thermometer ½ inch (12 mm) into the anus and gently move it from side to side a few times to stimulate a stool.
   • Reason: increased stools carry more bilirubin out of the body
   • Do this once or twice per day until jaundice improves or stool frequency becomes normal.
5. Expected Course: Physiological jaundice peaks on day 4 or 5 and then gradually disappears over 1-2 weeks.
   
6. Judging Jaundice:
   • Jaundice starts on the face and moves downward. Try to determine where it stops.
   • View your baby unclothed in natural light near a window.
   • Press on the skin with a finger to remove the normal skin tone.
   • Then try to assess if the skin is yellow before the pink color returns.
   • Move down the body, doing the same. Try to assess where the yellow color stops.
   • Jaundice that only involves the face and eyes is always harmless. As it involves the chest, the level is going up. If it involves the abdomen, arms or legs, the bilirubin level needs to be checked.
7. Call Your Doctor If:
   • Jaundice becomes worse
   • Legs becomes yellow
   • Feeding poorly or weak suck
   • Baby starts to act sick or abnormal
   • Jaundice not gone by day 14

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.