Jaundice and Bilirubin

• Jaundice means the skin has turned yellow.
• Bilirubin is the pigment that turns the skin yellow.
• Bilirubin comes from the normal breakdown of old red blood cells.
• The liver normally gets rid of bilirubin. But, at birth, the liver may be immature.
• Half of babies have some jaundice. Usually it is mild.
• The level of bilirubin that is harmful is around 20. Reaching a level this high is rare.
• High levels need to be treated with bili-lights. That's why your doctor checks your baby's bilirubin levels until it becomes low.

Causes of Jaundice in Newborns

Physiological Jaundice (50% of newborns)

• Onset 2 to 3 days of age
• Peaks day 4 to 5, then improves
• Disappears 1 to 2 weeks of age

Breastfeeding or Malnutrition Jaundice (5 to 10% of newborns)

• Due to inadequate intake of breastmilk
• Onset pattern similar to physiological type
• Also, causes poor weight gain
• Needs close follow-up and weight checks

Breastmilk Jaundice (10% of newborns)

• Due to substance in breastmilk which blocks removal of bilirubin
• Breastmilk intake and weight gain are normal
• Onset 4 to 7 days of age
• Lasts 3 to 12 weeks
• Not harmful

Rh and ABO Blood Group Incompatibility (Serious, but Rare)

• Onset during first 24 hours of life
• Can reach harmful levels

Liver Disease (Serious, but Rare)

• The main clue is light gray or pale yellow stools
• The jaundice doesn't go away
• Causes include liver infection (hepatitis) and liver blockage (biliary atresia)