Neonatal jaundice

Overview

During the first few days of life, the skin and whites of the eyes of almost 60% of healthy newborns take on a yellowish hue. Brown urine and pale stools can also occur. Neonatal jaundice (icterus) is a mostly harmless adjustment disorder affecting the liver. More rarely, it can also be an indicator of a serious disease (metabolic disorder, liver problem, etc.).

Symptoms

• Primarily during the first week of life
• Yellowish discolouration of skin and whites of the eyes
• Brown urine
• Pale stools

Complications if bilirubin levels in the blood continue to increase

• Yellowish discolouration doesn't improve after 14 days
• Yellowish discolouration seems to increase (whole body)
• In rare cases
  • Sucking weakness
  • Apathy
  • Greenish vomit
  • Fever, shrill crying
  • Difficulty breathing, seizures

Causes and treatment

Causes

• Normal adjustment process
  • Background: high number of red blood cells with a short lifespan
  • Must be broken down in the liver after birth
  • Haemoglobin is converted into bilirubin
  • Liver is not yet able to break down these large volumes of bilirubin sufficiently
  • Yellowing due to deposit of bilirubin in the skin
• Blood type incompatibility between mother and child
• Premature baby
• Narrowing/malformation of the bile duct
• Metabolic disorders
• Infections/inflammations (e.g. of liver)
• Medication, malnutrition
• Underactive thyroid

Further treatment by your doctor / in hospital

Possible tests:

• Pregnancy check-ups
• Standard: neonatal screening (search for metabolic disorders)
• Blood test (bilirubin concentration, liver function, etc.)
• Light signals to measure yellowness

Possible therapies

• Phototherapy (blue light) to treat the skin
• Exchange transfusion (blood transfusion; seldom)
• Treatment of the underlying disease

What can I do myself?

• Ensure sufficient daylight (no direct sun exposure)
• Breastfeed often (if experiencing problems: obtain breastfeeding advice/contact midwife
• Watch child carefully

When to see a doctor?

• Skin colour changes > 14 days or yellow discolouration affects the whole body
• Sucking problems and greenish vomit
• Newborns with fever
• Dark brown urine
• Growing drowsiness and weakness
• Breathing problems, child can “turn blue”
• Feeling that something isn't right

Further information

Swiss Society of Paediatrics (Schweizerische Gesellschaft für Pädiatrie)
www.swiss-paediatrics.org

Schweizerischer Hebammenverband (Swiss Federation of Midwives)
www.hebamme.ch

Synonyms

neonatal jaundice, neonatal icterus, infant jaundice, newborn jaundice