Dear Doctors: When my nephew was born, he had neonatal jaundice. It went away after a few weeks, and he seemed fine. The same thing happened when I had my daughter. Why do babies get jaundice? Is it dangerous?
Dear Reader: Neonatal jaundice is a common condition in which a baby’s skin and eyes take on a yellowish tint within the first few days of birth.
It occurs in up to two-thirds of healthy newborns and, in most cases, does not indicate a health problem.
The reason jaundice causes a change to skin color is a buildup in the blood of bilirubin, a yellowish natural byproduct of the breakdown of aging red blood cells.
As blood circulates through the liver, the bilirubin it contains is filtered out. The liver breaks down the captured bilirubin into a form the body can get rid of. These final compounds are sent to the small intestine, where, after being further dismantled by bacteria, they exit the body via the stool.
While the baby is still in the womb, bilirubin is removed from the blood via the placenta. After birth, that job falls to the baby’s organs. A newborn’s liver can take a bit of time to begin to function efficiently. Newborns have greater numbers of red cells than adults or older children do, and the cells have a shorter life cycle. These factors can easily lead to a buildup of bilirubin.
It can take up to two weeks for the baby’s liver to become effective at filtering bilirubin from the blood.
Neonatal jaundice begins in the face, then the chest, belly and legs. In babies with darker skin, this change in color is sometimes easier to discern on the palms and soles.
With most babies, neonatal jaundice will go away on its own. It’s just a matter of waiting for the infant’s liver to catch up to the amount of bilirubin that needs to be removed.
In very rare cases, the condition can signal a more serious problem.
When bilirubin levels become high, babies can experience changes in behavior that can include becoming fussy, feeding poorly, developing floppy limbs and being unusually sleepy. If a problem is suspected, a blood test can help with diagnosis.
Treatment can vary, from addressing potential dehydration with increased liquid intake to a range of medical interventions.
So it’s important to have a health care provider monitor the neonatal jaundice.
Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.
