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How is newborn jaundice diagnosed?
Before leaving the hospital with your newborn, you can ask the doctor or nurse about a jaundice bilirubin test.
A doctor or nurse may check the baby's bilirubin using a light meter that is placed on the baby's head. This results in a transcutaneous bilirubin (TcB) level. If it is high, a blood test will likely be ordered.
The best way to accurately measure bilirubin is with a small blood sample from the baby's heel. This results in a total serum bilirubin (TSB) level. If the level is high, based upon the baby's age in hours and other risk factors, treatment will likely follow. Repeat blood samples will also likely be taken to ensure that the TSB decreases with the prescribed treatment.
Bilirubin levels are usually the highest when the baby is 3 to 5 days old. At a minimum, babies should be checked for jaundice every 8 to 12 hours in the first 48 hours of life and again before 5 days of age.
What is the treatment for newborn jaundice?
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No baby should develop brain damage from untreated jaundice.
When being treated for high bilirubin levels, the baby will be undressed and put under special lights. The lights will not hurt the baby. This can be done in the hospital or even at home. The baby's milk intake may also need to be increased. In some cases, if the baby has very high bilirubin levels, the doctor will do a blood exchange transfusion. Jaundice is generally treated before brain damage is a concern.
Putting the baby in sunlight is not recommended as a safe way of treating jaundice.
What are the risk factors for newborn jaundice?
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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:
Babies born before 37 weeks, or 8.5 months, of pregnancy might have jaundice because their liver is not fully developed. The young liver might not be able to get rid of so much bilirubin.
Babies with Darker Skin Color
Jaundice may be missed or not recognized in a baby with darker skin color. Checking the gums and inner lips may detect jaundice. If there is any doubt, a bilirubin test should be done.
East Asian or Mediterranean Descent
A baby born to an East Asian or Mediterranean family is at a higher risk of becoming jaundiced. Also, some families inherit conditions (such as G6PD deficiency), and their babies are more likely to get jaundice.
A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to get jaundice.
Sibling with Jaundice
A baby with a sister or brother that had jaundice is more likely to develop jaundice.
A baby with bruises at birth is more likely to get jaundice. A bruise forms when blood leaks out of a blood vessel and causes the skin to look black and blue. The healing of large bruises can cause high levels of bilirubin and your baby might get jaundice.
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.
Don't Wait, Act Early!
Medically Reviewed by a Doctor on 6/27/2013
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