Understanding Newborn Jaundice
Has your infant’s skin turned slightly yellow? Here’s what you need to know: If you notice a yellowish tinge in your newborn’s skin or eyes within a few hours or days after birth, it’s natural to feel concerned. However, this condition, called jaundice, is common and usually not harmful. It affects about 50% of full-term babies and up to 80% of premature babies in their first week of life. Rest assured, it typically resolves on its own.
What Is Newborn Jaundice?
Newborn jaundice is a common condition that often affects pre-term babies (born before 38 weeks) and some breastfed infants. It generally appears on the second or third day after birth. Jaundice occurs when there’s an excess of bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells break down. While the liver normally processes and eliminates bilirubin, a newborn’s liver might not be fully developed, leading to a temporary buildup.
During pregnancy, the placenta helps remove bilirubin from the baby’s blood. After birth, the baby’s liver takes over. Newborns produce more bilirubin than adults due to higher red blood cell turnover. By 1 to 2 weeks of age, most babies’ livers are efficient enough to handle bilirubin, and jaundice naturally resolves.
Types of Newborn Jaundice
- Physiological Jaundice:
- The most common type, appearing between days 2 and 4 after birth.
- Typically harmless and clears up within two weeks as the liver matures.
- Breastmilk Jaundice:
- Occurs in healthy breastfed babies, usually starting in the second week.
- Peaks around weeks two or three and may take over a month to resolve.
- Substances in breast milk can affect how bilirubin is processed.
- Breastfeeding Jaundice:
- Linked to insufficient milk intake, often due to poor latch or delayed milk production.
- Improved breastfeeding or supplementing with formula usually resolves this.
- Blood Group Incompatibility Jaundice:
- Happens when the mother’s antibodies attack the baby’s red blood cells due to incompatible blood types.
- This typically appears within the first 24 hours after birth.
Severe jaundice can result from:
- Blood infections (sepsis)
- Bruising from a difficult delivery
- Premature birth or low birth weight
- Liver conditions or metabolic diseases
- Specific enzyme deficiencies (e.g., G6PD deficiency, common in Singapore)
- Blood group incompatibilities (ABO or Rhesus factor)
Signs and Symptoms of Jaundice
Early signs:
- Yellowish skin and eyes, starting with the face and progressing to the chest, stomach, and legs.
- Skin appears yellow when gently pressed.
Severe symptoms:
- Increasing yellow discoloration
- Deepening yellow tone
- Fever above 38°C
- Poor feeding or appetite
- Lethargy or unusual sleepiness
- High-pitched crying
- Unusual arching of the back
Diagnosing Jaundice
In the hospital, jaundice is often detected using a skin device (transcutaneous bilirubinometer). A blood test from a heel prick confirms bilirubin levels. Doctors consider the baby’s age and bilirubin levels to decide the best course of action.
| Serum Bilirubin Levels | Baby's Age |
| Above 10 mg | Less than 24 hours |
| Above 15 mg | 24-48 hours |
| Above 18 mg | 49-72 hours |
| Above 20 mg | Older than 72 hours |
Treatment for Jaundice
Most newborn jaundice cases resolve without treatment. However, for higher bilirubin levels, the following may be recommended:
1. Feeding:
- Frequent breastfeeding or formula supplementation helps the baby pass bilirubin through stools.
- Ensure proper latching and milk intake with help from a lactation consultant.
2. Phototherapy:
- Exposing the baby to ultraviolet light under medical supervision breaks down bilirubin in the skin.
- The baby is placed under a UV light source with eyes protected by a mask.
- Avoid direct sunlight exposure, as it can harm your baby.
3. Blood Transfusion:
- For severe jaundice caused by blood type incompatibility or other medical conditions, a blood transfusion may be needed.
- This replaces the baby’s blood with fresh blood to remove excess bilirubin.
When to See a Doctor
In rare cases, untreated jaundice can lead to kernicterus (brain damage) and lifelong complications. Seek immediate medical attention if your baby:
- Becomes more yellow
- Shows extreme lethargy or crankiness
- Refuses to feed
- Develops a high-pitched cry
- Arches their back unusually
Can Jaundice Be Prevented?
While jaundice is common and hard to prevent entirely, you can reduce risks by:
- Managing gestational diabetes during pregnancy.
- Monitoring your baby’s milk intake and ensuring proper hydration.
- Seeking timely medical care for any risk factors like infections or blood group incompatibilities.
- Starting phototherapy promptly if needed.
If you suspect your baby has jaundice, consult our paediatricians immediately.
At Thomson Paediatric Centre, our dedicated paediatricians are experienced in treating a wide range of infant and child medical conditions, including jaundice. Book your appointment today!