By Michelle Kelly, MD
As printed in Around Town Publishing, February 2007
Jaundice is the yellow-orange pigmentation you may see in your newborn baby. It occurs from the deposition of bilirubin in the skin and mucous membranes (eyes & mouth). Bilirubin is naturally released from blood cells in the body and broken down by the liver. Since all newborn livers are not yet efficient with this process, a little bit of jaundice occurs in almost all infants. Major factors that increase the degree of jaundice include prematurity, illness, poor feeding, and blood type differences between Mom and baby. Jaundice is a concern because the bilirubin that gets deposited in the skin can also accumulate in the brain, a condition that can cause neurologic damage. Fortunately, very high levels of bilirubin need to be reached before such a situation ensues.
Due to the vigilance of nursery staff and pediatricians, the incidence of bilirubin-induced neurologic damage is quite rare in the USA. That is why your baby’s nurse or pediatrician will often check a bilirubin level on your infant during your hospital stay. This can be achieved with a light meter if the condition appears mild or with a blood draw if the jaundice seems more significant. Most levels of jaundice can be treated simply with frequent feeding and indirect sunlight while more pronounced levels of jaundice will require phototherapy. This refers to the administration of blue light to your infant, a process that causes the breakdown and subsequent excretion of bilirubin into the urine. Phototherapy can usually be arranged for home unless your infant’s bilirubin level is extremely high. Bilirubin levels are checked at regular intervals and phototherapy is discontinued once the levels are in the normal range.