Health Library

Jaundice

What Are the Types of Jaundice?

There are several types of jaundice:

• Breastfeeding jaundice happens in the first three to five days of life when the baby is not taking enough breast milk or a low breast milk supply, with excessive weight loss.
• Breast milk jaundice syndrome happens with hyperbilirubinemia in infants with adequate milk intake and weight gain. It can last up to three months, and this type of jaundice is normal and is not associated with direct or conjugated hyperbilirubinemia.
• Jaundice from the breakdown of red blood cells due to hemolytic disease (Rh disease), having too many red blood cells or bleeding.
• Jaundice related to poor liver function due to infection or other factors.

Why Is Jaundice a Concern?

Although low levels of bilirubin are not usually a concern, high levels of bilirubin can build up in the brain and may cause seizures and brain damage. This is a condition called kernicterus.

What are the Symptoms of Jaundice?

Call your baby’s doctor if you notice these symptoms:

• Your baby’s skin turns more yellow beginning on the face and moving down to abdomen, arms or legs.
• The whites of your baby’s eyes are yellow.
• Your baby is hard to wake up, fussy, or not nursing or taking formula well.
• Poor feeding, fussiness or sleepiness.

Breastfeeding and Jaundice

• Breast milk (human milk) is the ideal food for your baby. Jaundice is more common in babies who are breast-fed than babies who are formula-fed.
• The amount of breast milk baby gets increases each day.
• If you are breastfeeding, breastfeed your baby as soon as the baby shows signs of hunger, and wake up the baby if it has been longer than three to four hours since the last feeding.
• Breastfeed your baby eight to 12 times a day for the first few weeks. This will help you produce enough milk and will help keep the baby’s bilirubin level down.
• Record your baby’s feedings and output in a log and show it to your pediatrician on follow-up.
• If you are having trouble breastfeeding, ask your baby’s doctor or nurse or a lactation specialist to help.
• It is important to continue breastfeeding and/or feeding breast milk or formula (if breast milk is not available). Giving your baby water is not recommended.

How Do You Test for Hyperbilirubinemia / Jaundice?

• Blood tests
• Direct and indirect bilirubin levels show if the bilirubin is bound with other substances so the bilirubin can be removed by the liver (direct) or is circulating in the blood and unable to be removed (indirect)
• Red blood cell counts
• Blood type and testing for Rh incompatibility (Coombs test)
• Transcutaneous bili-meter measures the levels in the skin

How is Jaundice Treated?

Specific treatment will be determined by your baby's doctor based on:

• Your baby's gestational age, overall health and medical history
• Extent of the disease

Treatment may include:

• Phototherapy (light therapy): Jaundice and increased bilirubin levels usually decrease when the baby is placed under special blue lights. Phototherapy takes several hours to begin working and is used throughout the day and night. The baby’s eyes are protected, and their temperature is monitored during treatment.
• Fiberoptic blanket: Another form of phototherapy is a fiberoptic blanket placed under the baby. This can be used alone or in combination with phototherapy.
• Exchange transfusion: This replaces the baby’s blood with fresh blood to help lower the levels of bilirubin.
• Treatment of underlying conditions: Treating any underlying cause of hyperbilirubinemia, such as infection.