Yellow discoloration of the skin and the whites of the eyes in a newborn baby
- Present from or shortly after birth
- Genetics as a risk factor depends on the cause
- Gender and lifestyle are not significant factors
More than half of all newborn babies develop slight yellowing of the skin in the first week of life, giving them a tanned appearance. This condition is known as neonatal jaundice. In most cases, neonatal jaundice is normal, lasts only a few days, and does not indicate a serious underlying illness.
Neonatal jaundice is caused by high levels of a yellowish-green pigment in the blood known as bilirubin, which is a breakdown product of red blood cells. The liver, which removes bilirubin from the blood, may not function properly in a newborn baby for several days. As a result, the level of bilirubin rises as fetal blood cells are broken down. Breast-feeding may make neonatal jaundice worse, but it can be continued without harming the baby.
Neonatal jaundice may be more severe if it is caused by an underlying condition, for example if the mother and baby have incompatible blood groups because of Rhesus (Rh) incompatibility. Incompatibility of ABO blood groups is also a common cause of jaundice, as is G6PD deficiency (an inherited enzyme deficiency). Rare conditions that may produce jaundice include congenital infections and biliary atresia, in which a baby is born with underdeveloped bile ducts (the tubes that drain bile from the liver).
What are the symptoms?
In most full-term babies with neonatal jaundice, the skin and the whites of the eyes appear yellow, but there are no other symptoms. However, if bilirubin levels rise, symptoms may include:
Reluctance to feed.
Severe, abnormal jaundice may lead to impaired hearing or brain damage. If the bile ducts are underdeveloped due to biliary atresia, there is a risk of fatal liver damage unless the condition is treated.
What might be done?
Your baby will probably have a blood test to measure the level of bilirubin and exclude underlying disorders. If biliary atresia is suspected, imaging tests such as ultrasound scanning and MRI of the liver may be performed. A liver biopsy, in which a small sample of liver tissue is removed for examination, usually confirms the diagnosis.
Most babies with mild jaundice do not require treatment. However, if the level of bilirubin in the blood is high, phototherapy may be necessary, whatever the cause of the jaundice. In phototherapy, bilirubin is converted into a harmless substance that can be excreted. Treatment of Rh incompatibility may involve exchange transfusion, in which a large proportion of the baby’s blood is replaced. Biliary atresia is corrected by surgery in the first weeks of the baby’s life to prevent liver damage.
Neonatal jaundice does not usually have long-term effects and tends to disappear during the first week of life, or slightly later if the baby is breast-fed. Babies who have had severe jaundice will have a hearing test (see Hearing tests in children) and will be monitored for the first few months of life.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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