Q&A: What exactly is jaundice?

Normal physiologic jaundice is a common condition in newborns that occurs when bilirubin is not excreted quickly enough from the baby's body. Jaundice is what occurs when the skin and or sclera (white part) of the eyes take on a yellow tinge.

What Causes Jaundice?
Babies are born with extra red blood cells. As these extra blood cells are broken down, one of the byproducts of this process is bilirubin. Bilirubin is yellow and will usually be excreted through stool and urine.

The liver helps to remove toxins from the bloodstream; due to the immaturity of the baby's liver, bilirubin can sometimes rise. Why? When the baby was in utero, the mother's liver kept up with the breakdown of the bilirubin for excretion. After delivery, the baby's immature liver can sometimes have problems keeping up with demand. This back-up of the bilirubin can cause it to increase levels in the blood stream. With these higher levels it can sometimes give the skin a yellowish tinge.

Who Gets Jaundice?
Breastfed babies tend to have higher bilirubin levels than formula-fed infants. Many times this condition is looked at as something abnormal or problematic, when research actually shows that bilirubin can act as an antioxidant and can be beneficial.

According to Dr. Sylvain Doré, PhD, of Johns Hopkins School of Medicine, "When women breastfeed, the babies have higher levels of bilirubin and are healthier. Babies with higher bilirubin levels are more disease-resistant," she says. "Bilirubin also protects against retinopathy in premature babies."

High bilirubin levels can pose problems when it is abnormal pathological jaundice (resulting from a blood incompatibility between baby and mom) or if bilirubin levels rise too high in a normal physiologic jaundice and baby becomes lethargic and won't eat.

Jaundice Symptoms
If your doctor notices that the baby appears to look yellow, a blood test may be ordered to check the baby's level of bilirubin. This is done by doing a heel stick and taking a small amount of blood. The levels will then be looked at to see if the amount of bilirubin in your baby is normal according to her age.

If you think your baby's skin looks yellow or the baby is not feeding well, call the doctor's office right away.

Jaundice Treatment
Generally, the goal is to increase the frequency of feedings to increase stools. If the bilirubin level is too high, the doctor may recommend phototherapy. Phototherapy is a process that helps a baby break down bilirubin more quickly. The baby is placed under special fluorescent-type lights between feedings.