Jaundice in preemies and full term babies

Have you ever seen a baby in a NICU or hospital nursery wearing only a diaper, lying under bright lights? The baby is receiving light therapy, due to a condition called jaundice.

Jaundice happens when your baby’s liver isn’t working properly or isn’t fully developed. It can happen to babies born prematurely or full term. Often healthy babies have some jaundice soon after birth. When a baby has jaundice, a yellowish color usually first appears on his face. It then may spread to his chest, belly, arms, legs and white parts of his eyes.

What exactly is jaundice?

Jaundice is the build-up of bilirubin in the blood. Bilirubin is a yellowish substance that is formed when red blood cells break down – a natural process in our bodies. It is the liver’s job to break down the bilirubin so it can be excreted from the body. But if the liver is not working properly, it will not be able to remove the bilirubin, which then causes jaundice.

Is it common?

Newborn babies often get jaundice – in fact, about 60% of full-term babies get it. It can take a few days for a baby’s liver to become fully functional and do its job of getting rid of bilirubin. Usually, it is mild and goes away with treatment.

About 80% of preemies develop jaundice within a few days of birth. Babies born prematurely, before 37 weeks of pregnancy, are more likely than full term babies to develop jaundice because their livers aren’t fully developed or functional yet. It can take a week or more for a preemie’s liver to become fully functional. Usually, with treatment, most babies are fine. In rare cases, very high bilirubin levels can cause brain damage, so this is why treatment is usually started early.

A more severe form of jaundice can be caused by other factors such as Rh disease, liver problems, an infection or a genetic condition.

Treatments for jaundice

Phototherapy is a very safe treatment where bright lights called bililights are placed over your baby’s incubator. Your baby’s eyes are protected with eye shields. The lights help to reduce the amount of bilirubin in your baby’s blood.

If your baby does not respond to the bililights, he may need additional treatment such as intravenous immunoglobulin (IVIg) where your baby gets immunoglobulin (a blood protein) placed directly into his vein. Finally, another treatment includes receiving a blood exchange (which replaces your baby’s blood with fresh blood in small amounts), but this is hardly ever necessary because phototherapy and IVIg have such good results.

Know what to look for

Jaundice can occur even once your baby is home from the hospital. The best way to see jaundice is in good light, like in daylight or under fluorescent lights. Jaundice can be harder to see in babies with darker skin.

Call your baby’s health care provider right away if your baby:

  • Looks yellow, orange or greenish-yellow
  • Is hard to wake up or won’t sleep at all
  • Has trouble breastfeeding or sucking from a bottle
  • Is very fussy
  • Has too few wet or dirty diapers

Go straight to the hospital or call 911 if your baby:

  • Won’t stop crying or has a high pitched cry
  • Arches backward
  • Has a still, limp or floppy body
  • Has strange eye movements

Bottom line

The good news is that jaundice is usually nothing to worry about. So try to relax as your baby takes a bath under the lights, knowing this is temporary. See our article for more detailed info.

Did your baby need phototherapy? How did it go? Please share your story.