J is for Jaundice
For many parents, a diagnosis of Newborn Jaundice (otherwise known as hyperbilirubinemia) can be very concerning. Although it may seem scary, almost 50% of all newborns can deal with this condition, making it one of the most common issues in the first few weeks of life. Most cases can be handled at home, with the proper medical care and observation. Importantly, usually breastfeeding does not need to be interrupted and nursing can even assist your newborn in regulating their body.
What is Jaundice?
Jaundice is defined as a higher than normal level of bilirubin, causing yellowing of the skin, the whites of the eyes, gums, and fingernail beds. It's caused by an excess of red blood cells in the newborn's system, which when processed by the liver is excreted as bilirubin. When the bilirubin level is too high and is not being passed with urine, it builds up in your babies body and shows through the yellowing skin tone. For a more detailed explanation, read Dr. Sears' article here.
What are the Risk Factors?
- Premature Birth
- Breastfeeding Difficulties
- Rhesus or ABO Incompatibility
- Bruising during Birth
What are the Symptoms?
- Yellowing of the skin, in infants with darker skin tone it appears in the whites of the eyes, the gums, and the fingernails beds.
- Poor Feeding and/or Latching
- Pale Stools
- Dark Urine
How is Breastfeeding Affected?
Jaundice is more prevalent in premature newborns, due to their development and inability to cope with the excess bilirubin in their system. Premature infants usually have difficulty nursing, and one of the symptoms as we mentioned is drowsiness and even poor feeding habits. This can exacerbate symptoms and lead to severe Jaundice, which may require hospitalization for phototherapy.
Unfortunately, many sources recommend taking a break from breastfeeding to assist in recovery, even though it isn't necessary and can interfere with the new nursing relationship. This is not always applicable to severe cases or cases related to preexisting blood conditions, but is true for most newborns with manageable levels of bilirubin.
Bilirubin levels average 2-3 milligrams higher in breastfed infants than in formula-fed infants (14.8 milligrams versus 12.4 milligrams). The difference is thought to be due to an as-yet unidentified factor in breast milk that promotes increased intestinal absorption of bilirubin, so that it goes back into the bloodstream rather than moving on to the liver. Higher rates of jaundice in breastfed infants may also be related to lower milk intakes in the first days after birth, because of infrequent or inefficient feeding. It is normal for jaundice to last a bit longer in breastfeeding infants, sometimes until the third week after birth. - Dr. Sears
In short, Jaundice usually resolves on it's own within 2-3 weeks of birth. It's neither necessary or beneficial to most infants to be denied nursing for 24-48 hours as some pediatricians still recommend. In order to recover quickly and with minimal intervention, here are the best at home remedies to try before moving on to other solutions.
- Nurse frequently, on demand! Breastmilk will help your baby process the excess bilirubin in their bodies. Your goal should be 8-12 feedings a day. Contact a Lactation Consultant to assist you in getting started on the right foot, as drowsiness can cause some nursing difficulties. Check out this handy guide for Breastfeeding Success!
- Stay hydrated, eat good food, and reduce your stress level. If you are tense, anxious, or tired yourself, breastfeeding will be more difficult.
- If you must supplement with formula, check with your Lactation Consultant for alternatives to bottle feeding to reduce nursing interruption.
- Ask about alternatives to phototherapy, like sunlight treatment and at home phototherapy blankets.
In cases that are not managed, there are serious risks. Make sure to be in contact with your care provider and observe your newborn for any signs of their condition worsening. Symptoms of Jaundice that require medical attention:
- The yellowing of the skin is worsening or not improving at all, extending to the abdomen, arms, and legs
- Your baby is listless, seems sick or is hard to wake
- Lack of weight gain, poor feeding
- High pitched crying
*The information presented in this article isn't meant to replace the advice of your medical care provider. Always consult with your pediatrician about any concerns you have, as well as alternative treatment methods you are interested in.