Jaundice/Kernicterus

Jaundice can develop when red blood cells break down and bilirubin is left. It is normal for some red blood cells to die every day. In the womb, the mother's liver removes bilirubin for the baby, but after birth the baby's liver must remove the bilirubin. In some babies, the liver might not be developed enough to efficiently get rid of bilirubin. When too much bilirubin builds up in a new baby's body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice.

Jaundice usually appears first on the face and then moves to the chest, belly, arms, and legs as bilirubin levels get higher. The whites of the eyes can also look yellow. Jaundice can be harder to see in babies with darker skin color. Your baby's doctor or nurse can test how much bilirubin is in your baby's blood.

About 60% of all babies have jaundice. Some babies are more likely to have severe jaundice and higher bilirubin levels than others. Babies with any of the following risk factors need close monitoring and early jaundice management:

• Sibling: A baby with a brother or sister that had jaundice is more likely to develop jaundice.
  
  
• Bruising: A baby who has bruises at birth is more likely to have jaundice. A bruise forms when blood leaks out of a blood vessel and causes the skin to look black and blue. Then, when the bruise begins to heal, red blood cells die. Bilirubin is made when red blood cells break down. The healing of large bruises may cause high levels of bilirubin, and the baby may become jaundiced.
  
  
• Preterm babies: Babies born before 37 weeks, or 8 ½ months, of pregnancy may become jaundiced because their liver may not be fully developed. The young liver may not be able to get rid of so much bilirubin. If too many red blood cells break down at the same time, the baby can become very yellow or may even look orange.
  
  
• Feeding difficulties: A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to get jaundice.
  
  
• Early jaundice: A baby who is yellow in the first 24 hours of life may get dangerously jaundiced.
  
  
• Heredity A: baby born to an East-Asian or Mediterranean family is at a higher risk of becoming very jaundiced. Also, jaundice is harder to see in babies with darker skin tones. Some families inherit conditions (such as G6PD), and their babies are more likely to become jaundiced.
  
  
• Blood type: Women with an O blood type or Rh negative blood factor might have babies with higher bilirubin levels. A mother with Rh incompatibility should be given Rhogam.