Bilirubin is a yellowish substance that is a byproduct when red blood cells are broken down. Red blood cells are always being broken down and replaced by the body. Bilirubin is normally broken down by the liver. Jaundice occurs when bilirubin builds up faster than the liver can break it down and eliminate it from the body. Newborns have more red blood cells than adults and they begin transitioning from fetal red blood cells which have a unique hemoblogin to regular red blood cells after birth.
How common is jaundice in a newborn?
It is pretty common, 60-84% of newborns born at term will experience some level of jaundice in the first week of life. It even has a name, physiologic jaundice because it is considered normal.
How will I know if my baby has jaundice?
The newborn will start to get a yellowish tinge to the skin. It starts at the top of baby’s head and travels down the body through the torso. The whites of baby’s eyes may also start to take on a yellowish tinge. Jaundice usually peaks between 2-5 days after birth, and lasts 1-2 weeks.
Can jaundice become a problem?
Yes, in a small amount of cases, jaundice can be a problem. Jaundice can be a sign of blood type incompatibility, whether due to rH factors, or blood type. If bilirubin levels get high enough, brain damage can occur. Thankfully, jaundice induced brain damage is rare.
What can I do to minimize jaundice?
Bilirubin is eliminated through the digestive system. The single most helpful thing you can do to minimize jaundice is to nurse baby frequently. I prefer that baby is nursed every two hours. Light therapy can also be helpful since sunlight breaks down bilirubin. Place baby where natural sunlight will shine with just a diaper on, or completely naked. Do this for 45-60 minutes 3 times a day. You could also consider having baby under a SAD (seasonal affective disorder) light if there isn’t a lot of direct sunlight in your home.
New perspectives and understanding of jaundice
In the past, blood serum levels of bilirubin were used to determine whether treatments were necessary, regardless of the age of the newborn. As the understanding of the normal trajectory of newborn jaundice has expanded, blood serum levels of bilirubin based on how old the newborn is should be used to determine if treatment is needed. Results from recent studies show that jaundice may be beneficial to the newborn, acting as an antioxidant and preventing illness from Group B Strep. As a midwife, I find it reassuring that the research is showing increasing evidence that physiological processes after birth may not be harmful but actually serve a beneficial purpose.