What is jaundice?

More than 80% of newborns show some degree of jaundice during their first week of life. In most cases, it is part of the process of adapting to life outside the womb, but, occasionally, jaundice can be a sign of other health issues that need assessment.

Jaundice is also more common in babies who are born early.

What causes jaundice?

Babies are born with more red blood cells than they will need after birth. As these are broken down, they produce bilirubin, a yellowish pigment that circulates in the blood.

The liver processes bilirubin so that it can be eliminated through the bowel, mainly in the stools. In the first few days, however, the newborn's liver is still adapting and may not be able to process all the bilirubin at the same rate it is produced.

When there is excess bilirubin, it temporarily builds up in the tissues, giving the skin and the whites of the eyes a yellowish or golden tint. This change can be harder to spot in babies with darker skin.

You should seek a professional assessment if your baby:

• Develops jaundice in the first 48 hours of life
• Still has jaundice after three weeks of life
• Has jaundice and was born prematurely or is unwell
• Has yellow-toned palms of the hands or soles of the feet
• Still has black, brown, or green stools after the 5th day
• Shows signs of possible dehydration, such as fewer than five wet nappies a day

You should continue breastfeeding

When your baby has jaundice, it is especially important to ensure they are feeding frequently and effectively. A good milk intake promotes the elimination of stools and, through them, the accumulated bilirubin.

Keep offering the breast frequently and look out for signs that your baby is actually getting milk: you hear swallowing during the feed, more and heavier nappies, weight gain, among others.

If your baby is very sleepy, having difficulty feeding, or if you have concerns about the amount of milk they are getting, seek support to assess the feed and the need for other measures.

Phototherapy

In some situations, phototherapy will be necessary. The duration of treatment is individualised and depends, among other factors, on bilirubin levels and how they develop. Often, phototherapy can be carried out alongside the mother, without the need to separate the baby, allowing you to maintain closeness and breastfeeding.