Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Some Colorful Information about Jaundice
Parents have been quite colorful recently with their many questions about their newborn babies having jaundice. Let me provide a few thoughts on this topic.
Jaundice is the yellow color that can develop in newborn babies during their first days after birth. It is due to a chemical called bilirubin that can build up in your baby’s blood. Why is bilirubin a problem? Because in large amounts, it not only colors the skin yellow, but can get into the brain and at extremely high levels cause brain damage.
Normally our livers break bilirubin down before it reaches high levels, but sometimes a baby’s liver may not be able to do this efficiently until a baby is a bit older. The yellow color called jaundice occurs as a warning sign that bilirubin levels are getting high, but usually are not yet high enough to affect the brain.
A blood test can assess your baby’s bilirubin level, but a simple, often helpful, test is to press your fingertip on the tip of your baby’s nose and forehead. If the skin turns white regardless of race, this suggests that the level of jaundice is mild or not worrisome – but if it stays a yellowish color, or you are simply concerned about the yellowish color of your baby’s skin, then it is important to contact your baby’s doctor to have a blood test done to measure the bilirubin level.
Recent guidelines from the American Academy of Pediatrics outline several key recommendations for how to prevent bilirubin levels from getting too high. Babies who appear to have skin bruising due to routine birth trauma during delivery, have some difficulty getting started on breastfeeding, are born premature, have a family history of jaundice or look yellow before leaving the hospital in the first 24-48 hours of life require a blood test to determine their levels and to make sure there is no problem.
If a high level is detected, breastfeeding should usually continue to keep the baby hydrated while a baby is placed under ultraviolet lights or what we call phototherapy for a few days. This type of light breaks down the bilirubin and usually prevents it from getting into the brain. If the jaundice lasts despite phototherapy or appears after your baby is several weeks of age, please check with your child’s doctor to make sure that other treatments beyond phototherapy are not in order.
Hopefully tips like this will do more than just “skin” the surface when it comes to watching for jaundice in your baby, so it can be detected and safely treated as soon as possible.
Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at www.FletcherAllen.org/firstwithkids.