Jaundice, while incredibly common, can be a scary sight — and potentially serious medical diagnosis — on a new baby. If you’ve never heard of jaundice, it’s the yellow discoloration in a newborn child’s eyes and skin. It occurs when an infant’s blood contains an excess of bilirubin, a normal pigment that’s made when red blood cells break down in the body.
Most jaundice cases are mild and can clear up on their own, but some require treatment. Unfortunately, severe cases of jaundice can lead to brain damage, or acute bilirubin encephalopathy, because bilirubin is toxic to the brain. Additionally, acquired cerebral palsy is sometimes caused by jaundice. Some babies even die from jaundice. Your doctor team should be able to treat jaundice quickly and effectively, but when they don’t, you may have a legal basis for compensation for your medical bills.
Below, we’ll go over some of the basics of jaundice, including how it’s caused and treated, how dangerous it can be, and how to get help if your baby suffered because she wasn’t treated for jaundice soon enough.
Why do babies get jaundice after birth?
Jaundice is caused by excess bilirubin in the blood. A baby’s liver usually filters this out of the blood but sometimes the organ can’t keep up when baby hasn’t developed enough. Premature babies — those born before 38 weeks gestation — are especially at risk for jaundice, though sometimes jaundice is caused by an underlying disease or condition. About 60% of full-term babies develop jaundice.
Jaundice also doesn’t appear right after birth when you may still be at the hospital. Typically, the symptoms of jaundice you’ll notice most are the yellow tint to the skin or whites of the eyes between two to four days after birth, but babies also may exhibit seizures, unusually high-pitched crying, lethargy, fever, or difficulty suckling or swallowing.
To check your baby for jaundice, examine her in good lighting, preferably natural daylight. You’ll want to press gently on her forehead or nose and look for signs of color change like when you would for sunburn on yourself. If the skin looks yellow around the area where you pressed when you remove your finger, she likely has jaundice.
Jaundice is often treatable on its own, but you should seek medical attention right away if you see these signs.
What level of bilirubin causes jaundice?
When bilirubin levels are too high, it can pass into the brain and cause brain damage, referred to as acute bilirubin encephalopathy or “kernicterus.” A blood test is done by your doctor or nurse to measure the level of bilirubin in baby’s body. A special device also can measure bilirubin in the skin. Based on her age, baby’s results will be plotted on a graph to determine when treatment may be appropriate and a follow-up visit will be scheduled. You should know this information before leaving the hospital, even if you leave before your baby is in the typical age range to exhibit signs of jaundice.
It’s most common for a premature baby to have jaundice; because she may feed less and have fewer bowel movements, it’s more difficult for her to remove bilirubin through stool. While an immature liver isn’t unusual for a newborn, jaundice can be caused by an underlying condition.
According to the Mayo Clinic, other disorders causing jaundice can include:
- Internal bleeding (hemorrhage)
- An infection in baby’s blood (sepsis) or other viral or bacterial infections
- Incompatibility between mother’s blood and baby’s blood
- Abnormality of baby’s red blood cells that causes them to break
- Enzyme deficiency
Risk factors for severe jaundice other than premature birth are:
A lot of bruising during birth. The level of bilirubin may increase from the breakdown of red blood cells. Both vacuum extraction and forceps delivery may cause bruising on baby’s head, in addition to causing serious trauma.
Different blood type than the mother. Babies get antibodies through mom’s placenta, but if her blood type is different than babies, it could cause blood cells to break down more quickly. Women with O blood type or Rh negative blood factor might have babies with higher bilirubin levels.
Breast-fed babies are at a higher risk for developing jaundice. Doctors still recommended to breastfeed because of its many benefits, but it can be easy for baby to become dehydrated or take in too few of calories. Make sure to consult with your doctor, nurse, or lactation coach if you’re having difficulty nursing. It’s especially crucial to pay attention to any significant weight loss in a baby within the first few days after birth. (See also: The Vitamins Baby Needs)
Babies with darker skin color, of a certain descent, or those with siblings who had jaundice are at risk. It can be easier to miss the signs of jaundice on a baby who has darker skin; checking the gums or inner lips may help detect jaundice. Additionally, babies from East Asian or Mediterranean families as well as those who inherit certain conditions, such as a G6PD deficiency, are more likely to get jaundice. And watch out for siblings — if baby has an older brother or sister who had jaundice when they were a newborn, she should be tested.
Is jaundice dangerous?
In short, yes. While most cases of jaundice, as stated above, are mild and typically resolve on their own without treatment, you’ll want to keep your doctor team in the loop. Newborns should be examined for jaundice during routine medical checks and about every 8 to 12 hours while you’re in the hospital. Make sure to schedule a follow-up appointment if you and baby are discharged from the hospital earlier than 72 hours after birth.
Luckily, treatment is available, ranging from light therapy to an intravenous transfusion of an immunoglobulin to reduce antibodies from the mother, if mom and baby have different blood types. Sometimes an exchange transfusion is needed, with baby taken to the neonatal intensive care unit, to reduce the level of bilirubin.
Steps you can take at home if your baby has mild jaundice include more frequent feedings or supplementing with formula, if you’re breastfeeding. Jaundice can occur in 1 in 10 babies who breastfeed, according to the Centers for Disease Control and Prevention (CDC). The more bowel movements a baby has, the easier it will be to get rid of the excess bilirubin. Per guidelines from the American Academy of Pediatrics (AAP), to reduce the onset of severe jaundice, breast-fed babies should have 8 to 12 feedings per day while formula-fed babies should consume 1 to 2 ounces every two to three hours for the first week after birth. The AAP also recommends against the routine supplementation of water or sugar water (dextrose) for breastfed infants who are not dehydrated.
For more information about jaundice as well as recommendations for treatment both in and out of the hospital, visit the CDC’s main page about jaundice and kernicterus. It includes guidelines for health professionals and links to free materials, such as fact sheets and brochures, as well as resources for families.
What should I do if my baby’s jaundice wasn’t treated?
If your doctor didn’t treat your baby’s jaundice effectively and it led to brain damage, you have legal options. You’ll want to determine when the law will find a doctor responsible, and what elements you’ll need to prove your case. You didn’t ask for this to happen to your child — or the costs that come with it. Consulting with an experienced birth injury attorney will help you get the compensation you deserve.
At Safe Birth Project, we’re here to help. Contact us today for a free case evaluation.
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