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Jaundice in babies

Jaundice in brief:

Jaundice is very common in newborn babies.  About 90% of newborn babies will become jaundiced two or three days after birth.  Jaundice reaches its peak at about four days of life and then gradually disappears in most babies by the time they are two weeks old.  Jaundice does not necessarily mean your baby is ill. 

Sometimes jaundice continues after the baby is 14 days old in a full-term baby and 21 days in a premature baby.  If the baby is breast fed then quite frequently parents are reassured that it is breast milk jaundice, which is harmless, and will go away with time.  It is important, however, that this diagnosis is made by testing.  The vast majority of babies will have breast milk jaundice but a very few will have liver disease jaundice - or even both.  In these babies it is vital that the following is carried out:

• The colour of the stools and urine are checked -
 The urine of a newly born baby should be colourless.
 The stools of a breast fed baby should be green / daffodil yellow colour.
 The stools of a bottle fed baby should be green / English mustard colour

If the urine is yellow and / or the stools pale this can indicate liver disease and you should report this to your midwife, health visitor or doctor.

• A split bilirubin blood test  -
This measures the ratios of the conjugated and unconjugated bilirubin levels in the blood.  If the conjugated fraction is greater than 20% of the total bilirubin the baby should be referred to a specialist paediatric liver unit for investigation as this indicates that the cause is a liver disease.

Some babies who are breast fed may have jaundice which continues but the blood levels are perfectly normal except for the raised total bilirubin.  In these cases the stool and urine colour are normal.  A diagnosis of breast milk jaundice is often given.  Breast milk jaundice is harmless and will gradually disappear.  In a small number of cases it can take a few months to disappear totally.

Breast milk jaundice is common.  It is important that if jaundice persists a split bilirubin test is carried out so a diagnosis of breast milk jaundice is made based on fact rather than assumption.

My baby has breast milk jaundice, what should happen now?
CLDF's experience is that most parents want to be reassured that the baby's bilirubin level is returning to normal.  Initially, it is suggested that the serum bilirubin level is measured weekly until the bilirubin level returns to normal.  In cases where the jaundice takes a long time to diminish, the jaundice level can be tested further apart, providing the trend is that the bilirubin level is reducing.

If you have a query about baby jaundice please contact us.  Call 0121 212 3839 or email info@childliverdisease.org