Jaundice in Newborns

Jaundice in Newborns: A Complete Guide for Parents

The appearance of a yellowish tint to the skin and the whites of the eyes in a newborn is a phenomenon that can greatly frighten new parents. However, in most cases, the so‑called physiological jaundice is completely normal, temporary, and safe, occurring in 60‑80% of full‑term infants. Understanding its causes and being able to distinguish normal from pathological is the key to your peace of mind.

Why do babies "turn yellow"? The magic of bilirubin

Jaundice is caused by an increase in the level of bilirubin in the blood. Bilirubin is a yellow pigment formed as a natural result of the breakdown of red blood cells (erythrocytes). In an adult, this bilirubin is processed by the liver and eliminated from the body. In newborns this process has its own specifics:

• Excess red blood cells. In the mother's womb the baby lives in relative hypoxia, so to transport oxygen efficiently it has many more red blood cells with a special fetal hemoglobin. After birth, when the infant begins to breathe on its own, these "extra" red blood cells are rapidly destroyed, releasing a large amount of bilirubin.
• Immature liver. The newborn’s liver is not yet fully mature and cannot process and eliminate the excess bilirubin as efficiently as an adult liver.

As a result, unprocessed bilirubin accumulates in the blood and "paints" the skin and mucous membranes yellow. Usually jaundice appears on day 2‑3 of life, peaks on day 4‑5, and resolves on its own within 2‑3 weeks. More details about this condition can be read in the article "Jaundice in Newborns: Normal and Pathological".

The role of feeding in fighting jaundice

The best remedy for physiological jaundice is frequent and effective feeding. Bilirubin is eliminated primarily through stool. The more often the baby eats, the more active the intestines work, and the faster bilirubin is expelled. That’s why it is so important to establish breastfeeding on demand from the first days.

When does jaundice require a doctor’s attention?

Although physiological jaundice is normal, there are pathological conditions that require medical intervention. Contact a doctor if:

• Jaundice appears within the first 24 hours of life.
• The bilirubin level is very high or rises rapidly.
• Yellowing spreads to the palms and soles.
• The baby becomes excessively sleepy (lethargy) and feeds poorly.
• Jaundice persists longer than 3‑4 weeks.

In such cases the doctor may prescribe phototherapy — treatment with a special lamp whose light helps convert bilirubin into a non‑toxic form that is easily eliminated.