Jaundice is a common and usually harmless condition that affects newborn infants, causing yellowing of the skin and the whites of the eyes. The medical term for jaundice in newborns is neonatal jaundice.
Other symptoms of neonatal jaundice may include:
- Yellowing of the palms of the hands or the soles of the feet
- Dark yellow urine, whereas a newborn’s urine should normally be colorless
- Pale-colored stools, which should normally be yellow or orange
Symptoms of jaundice typically appear two to three days after birth and gradually improve on their own over time, usually resolving by the time the infant reaches approximately two weeks of age.
When to Seek Medical Advice
Newborns are routinely examined for signs of jaundice within the first 72 hours after birth as part of the standard neonatal physical examination. If signs of jaundice appear after this examination, the midwife or physician should be informed as soon as possible to obtain appropriate guidance.
Jaundice is not usually a cause for concern; however, it is essential to determine whether the infant requires treatment.
If a jaundiced newborn is being monitored at home, medical advice should be sought immediately if the symptoms worsen rapidly or if the infant refuses to feed.
Causes of Neonatal Jaundice
Jaundice occurs due to a buildup of bilirubin in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells.
Neonatal jaundice is common because newborns have a higher concentration of red blood cells, which are broken down and replaced more frequently. In addition, a newborn’s liver is not yet fully mature, limiting its ability to remove bilirubin efficiently from the bloodstream.
As the infant grows and the liver becomes more effective—typically by around two weeks of age—bilirubin levels decrease naturally, and jaundice resolves without causing harm in most cases.
In a small number of cases, jaundice may indicate an underlying medical condition. In such instances, jaundice usually appears very soon after birth, often within the first 24 hours.
Prevalence of Neonatal Jaundice
Jaundice is one of the most common conditions affecting newborns. It is estimated to occur in approximately 60% of full-term infants and up to 80% of preterm infants (those born before 37 weeks of gestation). However, only about 5% of newborns develop bilirubin levels high enough to require medical treatment.
Treatment of Neonatal Jaundice
Most cases of neonatal jaundice do not require treatment, as symptoms typically resolve within 10 to 14 days, although they may persist longer in a small number of infants.
Treatment is generally reserved for cases in which test results show significantly elevated bilirubin levels, due to a small risk that bilirubin may cross into the brain and cause damage.
Two main treatment options may be used in the hospital to rapidly reduce bilirubin levels:
- Phototherapy: A special type of light is directed onto the infant’s skin, altering the structure of bilirubin and making it easier for the liver to break it down.
- Exchange transfusion: A type of blood transfusion in which a small amount of the infant’s blood is replaced with an equal amount of compatible donor blood.
Most infants respond well to treatment and are able to leave the hospital within a few days.
Complications
If an infant with severely elevated bilirubin levels is left untreated, there is a risk of permanent brain damage. This serious condition is known as kernicterus.
