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Newborn jaundice - discharge

Jaundice of the newborn - discharge; Neonatal hyperbilirubinemia - discharge; Breastfeeding jaundice - discharge; Physiologic jaundice - discharge

Your baby has been treated in the hospital for newborn jaundice. This article tells you what you need to know when your baby comes home.

When Your Child Was in the Hospital

Your baby has newborn jaundice. This common condition is caused by high levels of bilirubin in the blood. Your child's skin and sclera (whites of their eyes) will look yellow.

Some newborns need to be treated before they leave the hospital. Others may need to go back to the hospital when they are a few days old. Treatment in the hospital most often lasts 1 to 2 days. Your child needs treatment when their bilirubin level is too high or rising too quickly.

To help break down the bilirubin, your child will be placed under bright lights (phototherapy) in a warm, enclosed bed. The infant will wear only a diaper and special eye shades. Your baby may have an intravenous (IV) line to give them fluids.

Rarely, your baby may need treatment called a double volume blood exchange transfusion. This is used when the baby's bilirubin level is very high.

Unless there are other problems, your child will be able to feed (by breast or bottle) normally. Your child should feed every 2 to 2 ½ hours (10 to 12 times a day).

The health care provider may stop phototherapy and send your child home when their bilirubin level is low enough to be safe. Your child's bilirubin level will need to be checked in the provider's office, 24 hours after therapy stops, to make sure the level is not rising again.

Possible side effects of phototherapy are watery diarrhea, dehydration, and skin rash that will go away once the therapy stops.

What to Expect at Home

If your child did not have jaundice at birth but now has it, you should call your provider. Bilirubin levels are generally the highest when a newborn is 3 to 5 days old.

If the bilirubin level is not too high or not rising quickly, you can do phototherapy at home with a fiber optic blanket, which has tiny bright lights in it. You may also use a bed that shines light up from the mattress. A nurse will come to your home to teach you how to use the blanket or bed and to check on your child.

The nurse will return daily to check your child's:

  • Weight
  • Intake of breast milk or formula
  • Number of wet and poopy (stool) diapers
  • Skin, to see how far down (head to toe) the yellow color goes
  • Bilirubin level

You must keep the light therapy on your child's skin and feed your child every 2 to 3 hours (10 to 12 times a day). Feeding prevents dehydration and helps bilirubin leave the body.

Therapy will continue until your baby's bilirubin level lowers enough to be safe. Your baby's provider will want to check the level again in 2 to 3 days.

If you are having trouble breastfeeding, contact a breastfeeding nurse specialist.

When to Call the Doctor

Contact your baby's health care provider if the infant:

  • Has a yellow color that goes away, but then returns after treatment stop
  • Has a yellow color that lasts for more than 2 to 3 weeks

Also contact your baby's provider if you have concerns, if the jaundice is getting worse, or the baby:

  • Is lethargic (hard to wake up), less responsive, or fussy
  • Refuses the bottle or breast for more than 2 feedings in a row
  • Is losing weight
  • Has watery diarrhea

References

Kaplan M, Wong RJ, Burgis JC, Sibley E, Stevenson DK. Neonatal jaundice and liver diseases. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 91.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Digestive system disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 123.

Rozance PJ, Wright CJ. The neonate. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 23.

  • Newborn jaundice

    Newborn jaundice

    Animation

  •  

    Newborn jaundice - Animation

    Are your newborn baby's skin or eyes yellow? Is she extremely tired and doesn't want to eat? Your baby may have jaundice. Newborn jaundice happens when your baby has high levels of bilirubin in her blood. This yellow pigment is created in the body during the normal recycling of old red blood cells. The liver helps break bilirubin down so it can be removed from the body in the stool. Before a baby is born, the placenta removes the bilirubin from your baby so it can be processed by your liver. Right after birth, the baby's own liver takes over the job, but it can take time. Most babies have some jaundice. It usually appears between the second and third day after birth. Often babies get a screening test in the first 24 hours of life to predict if they are likely to develop jaundice. Your baby's doctor will also watch for signs of jaundice at the hospital, and during follow-up visits after your baby goes home. If your baby seems to have jaundice, the doctor will test the bilirubin levels in her blood. So, how do you treat newborn jaundice? Jaundice usually goes away on its own, so treatment is usually not necessary. If your baby's bilirubin level is too high or rising too quickly, however, she may need treatment. You'll need to keep the baby well hydrated with breast milk or formula. Feeding up to 12 times a day will encourage frequent bowel movements, which help to remove the bilirubin. If your baby needs treatment in the hospital, she may be placed under special blue lights that help break down bilirubin in the baby's skin. This treatment is called phototherapy. If your baby's bilirubin level isn't rising too quickly, you can also do phototherapy at home with a fiberoptic blanket that contains tiny bright lights. For most babies, it takes about a week or two for jaundice to go away. Very high levels of bilirubin, however, can damage a baby's brain. The good news is that this condition, called kernicterus, is almost always diagnosed long before bilirubin levels become high enough to cause damage, and phototherapy treatment will usually make it go away.

  • Exchange transfusion - series

    Exchange transfusion - series

    Presentation

  • Infant jaundice

    Infant jaundice - illustration

    Jaundice is a yellow discoloring of the skin, mucous membranes, and eyes, caused by too much bilirubin (a breakdown product of hemoglobin made by the liver) in the blood. Jaundice is a condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat (the layer of fat just beneath the skin), causing a yellowish appearance of the skin and the whites of the eyes.

    Infant jaundice

    illustration

  • Newborn jaundice

    Newborn jaundice

    Animation

  •  

    Newborn jaundice - Animation

    Are your newborn baby's skin or eyes yellow? Is she extremely tired and doesn't want to eat? Your baby may have jaundice. Newborn jaundice happens when your baby has high levels of bilirubin in her blood. This yellow pigment is created in the body during the normal recycling of old red blood cells. The liver helps break bilirubin down so it can be removed from the body in the stool. Before a baby is born, the placenta removes the bilirubin from your baby so it can be processed by your liver. Right after birth, the baby's own liver takes over the job, but it can take time. Most babies have some jaundice. It usually appears between the second and third day after birth. Often babies get a screening test in the first 24 hours of life to predict if they are likely to develop jaundice. Your baby's doctor will also watch for signs of jaundice at the hospital, and during follow-up visits after your baby goes home. If your baby seems to have jaundice, the doctor will test the bilirubin levels in her blood. So, how do you treat newborn jaundice? Jaundice usually goes away on its own, so treatment is usually not necessary. If your baby's bilirubin level is too high or rising too quickly, however, she may need treatment. You'll need to keep the baby well hydrated with breast milk or formula. Feeding up to 12 times a day will encourage frequent bowel movements, which help to remove the bilirubin. If your baby needs treatment in the hospital, she may be placed under special blue lights that help break down bilirubin in the baby's skin. This treatment is called phototherapy. If your baby's bilirubin level isn't rising too quickly, you can also do phototherapy at home with a fiberoptic blanket that contains tiny bright lights. For most babies, it takes about a week or two for jaundice to go away. Very high levels of bilirubin, however, can damage a baby's brain. The good news is that this condition, called kernicterus, is almost always diagnosed long before bilirubin levels become high enough to cause damage, and phototherapy treatment will usually make it go away.

  • Exchange transfusion - series

    Presentation

  • Infant jaundice

    Infant jaundice - illustration

    Jaundice is a yellow discoloring of the skin, mucous membranes, and eyes, caused by too much bilirubin (a breakdown product of hemoglobin made by the liver) in the blood. Jaundice is a condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat (the layer of fat just beneath the skin), causing a yellowish appearance of the skin and the whites of the eyes.

    Infant jaundice

    illustration


Review Date: 1/24/2023

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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