Infant Jaundice – Diagnosis and Treatment
Diagnosis
Doctors check newborns for jaundice by examining their skin and eyes. If they notice yellowing, they measure bilirubin levels.
They use several methods to do this.
Physical Exam: The doctor checks the skin, especially around the face and chest, for yellow coloring.
Blood Tests: The doctor takes a small blood sample to find out the total serum bilirubin in the babyโs blood.
Skin Scan: A device called a transcutaneous bilirubinometer shines light on the skin to estimate bilirubin just beneath the surface.
If the jaundice appears severe or unusual, doctors may order extra blood or urine tests to look for other health problems.
Further Details
Newborns often have higher bilirubin levels because their bodies break down red blood cells quickly. Some babies show more signs, like yellow skin or eyes, or slow clearing of meconium.
Bruising during birth can increase the risk of higher bilirubin. Early and regular checks help doctors detect and manage jaundice.
Treatment
Doctors decide how to treat jaundice based on the amount of bilirubin in the blood and the babyโs health. Mild jaundice often gets better on its own.
If bilirubin levels rise or the baby shows signs of severe jaundice, doctors provide medical care.
Nutritional Support
Doctors may suggest more frequent feedings or extra nutrition. Extra feeding helps reduce bilirubin by making the baby urinate and pass stool more often. In some cases, doctors give nutritional support to prevent weight loss.
Phototherapy (Light Treatment)
Doctors use phototherapy to treat higher bilirubin levels. Special blue-green light changes bilirubin into a form the body can remove more easily. Babies usually wear only a diaper and eye patches for protection.
Some babies may use light pads or mattresses as extra therapy. Doctors use intensive phototherapy for serious cases or when bilirubin rises quickly.
| Treatment | Purpose | Setting |
|---|---|---|
| Extra Feeding | Lowers bilirubin through more waste removal | Home or hospital |
| Phototherapy | Changes bilirubin for easier removal | Hospital or sometimes home |
| IVIg | Lowers antibodies causing red blood cell breakdown | Hospital |
| Exchange Transfusion | Rapidly reduces bilirubin and antibodies | NICU |
Intravenous Immunoglobulin (IVIg)
Doctors use IVIg for babies with jaundice linked to blood type differences with their mother. IVIg can lower harmful antibodies and may reduce the need for a blood exchange transfusion.
Exchange Transfusion
If other treatments do not work, doctors may perform an exchange transfusion. They remove small amounts of blood and replace it with donor blood to quickly lower bilirubin and antibodies. This procedure takes place in a neonatal intensive care unit.
Self-Care
Parents can help infants with mild jaundice by following good feeding habits. Frequent breast or formula feedings promote more bowel movements, which help clear bilirubin from the body.
Breastfed infants usually need 8 to 12 feedings each day in the first days after birth. Babies fed with formula often need about 1 to 2 ounces (30 to 60 milliliters) every two to three hours in the first week.
Proper milk intake keeps the baby hydrated and lowers the risk of jaundice from not eating enough.
If a baby has trouble latching, loses weight, or looks dehydrated, the doctor may suggest supplemental feedings, such as expressed breast milk or formula.
| Feeding Method | How Often | Amount Per Feeding |
|---|---|---|
| Breastfeeding | 8โ12 times per day | As needed, on demand |
| Formula feeding | Every 2โ3 hours | 1โ2 oz (30โ60 mL) |
Parents can ask a doctor or lactation consultant for help if they have concerns about breastfeeding or milk intake. Regular, adequate feedings are important for managing jaundice at home.
Getting Ready for Your Babyโs Medical Visit
Planning for the Next Checkup
Babies often reach their highest bilirubin levels between the third and seventh days after birth. The doctor should examine the baby during this period.
Many families schedule a follow-up appointment after leaving the hospital. Babies with increased risk factors, such as premature birth or bruising from delivery, may need extra attention.
A family history of jaundice can also increase risk. Other factors include blood type differences, feeding problems, or specific medical guidelines.
Before the appointment:
Parents should bring important information about their baby.
| Information to Bring | Examples |
|---|---|
| Feeding details | How often the baby breast-feeds or takes a bottle |
| Diaper changes | Number of wet and dirty diapers per day |
| Changes in behavior | Signs like sleepiness or difficulty waking for feeds |
| Changes in skin or eye color | If the yellowing has moved beyond the face |
| Temperature patterns | Any fevers or trouble maintaining normal temperature |
| Family history | If another child had severe jaundice |
Clear answers help the healthcare provider make the best plan for the babyโs care.
Sample questions the doctor may ask:
- How well and how often does the baby feed?
- Is the baby formula-fed or breast-fed?
- Are there any changes in stool or urine output?
- Does the baby seem especially sleepy, irritable, or weaker compared to earlier?
- Has the skin color changed or has yellowness spread beyond the face?
- Are there other signs of illness, like an unstable temperature?
Questions parents might want to ask their doctor:
- Is the jaundice severe?
- What is causing the jaundice, and is there a risk of neurotoxicity?
- Are more blood tests needed to check bilirubin or rule out blood type problems?
- Will treatment start right away?
- Are specific guidelines being used for this case?
- Should feeding routines change?
- Will another hospital visit be needed?
- Are written materials available for extra reference?
Tip: Using this checklist can make the visit smoother and help parents feel more confident during the follow-up.
