Yellow Babies? What’s Up With That??

Yellow babies are babies with jaundice. Jaundice occurs when a baby has too much bilirubin. As bilirubin builds up inside the baby’s body, the baby’s skin and even the whites of his or her eyes may turn yellow. A new mother may notice her baby’s skin is yellow in color around two or three days after the birth.

Yellow babies are common, as jaundice affects around 60% of full term newborns. Babies born early are even more likely to get jaundice as are babies who are sick. Most of the time, yellow babies are healthy and the jaundice goes away after a week or so.

Unless the level of bilirubin is very high, the yellow color is normal and the baby will be just fine. Some yellow babies will need treatment. The main treatment for jaundice is phototherapy (light therapy), in which the baby is placed under bright lights.

Yellow Babies: How It Happens

Our bodies are making and breaking down red blood cells all the time. This happens in babies, too. The hemoglobin in red blood cells, for instance, is broken down into different waste chemicals. One of those chemicals is bilirubin.

Before the baby is born, the placenta carries the bilirubin out of the baby’s body and into the mother’s blood. The mother’s body handles the more difficult task of filtering this waste product and getting rid of it. But after the baby is born, the newborn’s liver must suddenly take on this task. The baby’s liver may not be quite mature enough to handle all that tough work.

As a result, it takes more time to flush out the waste, and the bilirubin levels build up in the baby’s body. That is what causes the yellowing of the skin and eyes. In fact, all babies have a higher than usual bilirubin level for some days after birth. In a normal healthy baby, this is not cause for concern, and there may not be any noticeable change in color. Even where there is yellowing of the skin/eyes, the level of bilirubin may not be high enough to worry about.

If the baby has a lot of bruising, from a rough birth, for instance, there may be a high number of damaged red blood cells. These blood cells need to be broken down in order to clear the way for new red blood cells. As the blood cells are broken down, the baby’s bilirubin levels can climb.

Yellow Babies And Breastfeeding

Some yellow babies, around 5% of them, are breastfed babies. These babies can have a mild jaundice that is persistent, and takes a few weeks to clear up. It is thought that a protein in breast milk may cause bilirubin levels to remain high, though not so high as to harm the baby.  Also, a mother’s milk takes a few days come in. During this time, the baby may not be getting enough calories and fluid to flush out the bilirubin as quickly as usual. This too, can cause bilirubin levels to stay high, though not high enough for concern.

Other Causes Of Jaundice

Premature babies and babies sick for one reason or another, for instance, infection, may also have higher than usual levels of bilirubin. Yellow babies may also be the result of babies with different blood groups than their mothers. The level of bilirubin is less important than the general health of the baby. A healthy, fully mature baby with a higher level of bilirubin may do just fine, while an early or ill baby may develop further health issues.

In addition to the yellow coloring of their skin and sometimes eyes, yellow babies may seem sleepier than usual and they may not want to feed much. Getting babies to feed often and long is important. Lots of liquid nutrition can often do the trick of bringing down the bilirubin levels with no need for any other treatment.

The bilirubin levels have to rise quite high to cause damage. But unchecked, very high bilirubin levels can affect the parts of the brain that control vision, hearing and movement (kernicterus).

Now that babies are sent home a day or two after birth, mothers need to be on the watch for jaundice. The yellowing first appears on the baby’s face and head. If the level of bilirubin rises, the yellowing will then show on the baby’s body. At very high levels, there will be yellowing on the baby’s palms and on the soles of his or her feet.

If you’re not sure your newborn baby is yellow, there’s an easy way to tell. Simply press the tip of your finger (gently!) on the tip of the baby’s nose or forehead. Watch as you lift your fingertip away. If the baby’s skin looks white, the baby is fine. If the skin appears yellow, call your baby’s doctor.

If the doctor agrees your baby may be jaundiced, a blood test will be done to see the level of bilirubin in the baby’s body. The doctor will decide whether the baby needs treatment depending on the level of bilirubin and the baby’s health. If the baby is full term and healthy, the doctor may decide to keep a watch on the baby and the baby’s bilirubin levels.

Most yellow babies won’t need treatment. Their livers will mature and learn to break up the bilirubin so it can be broken down and flushed out of the system through the gut. But in the event that the baby’s bilirubin levels continue to climb, phototherapy is an effective treatment.

In jaundice, some bilirubin is just beneath the skin. In response to light, the bilirubin can turn into a different chemical that is easier to clear out of the baby’s body. A baby may need phototherapy for a number of days. This type of therapy works well and is quite safe.

During phototherapy, the nude baby is placed in a bassinette under lights. The baby’s eyes are covered so the light won’t be uncomfortable. Nursing or feeding often is to be encouraged during this time. If you’re breastfeeding, aim to feed the baby between 8 and 12 times a day for several days.

Yellow babies will receive blood tests daily to measure bilirubin levels. This will tell the doctor when the baby can stop phototherapy, assuming the baby responds well and levels of bilirubin are falling. If bilirubin levels become very high, the baby may need a blood transfusion, perhaps from the mother. This almost never happens.

Doctors used to recommend that yellow babies spend time in the sun. Today, this is no longer done. Sun exposure can burn the baby’s delicate skin and the sun may overheat the baby. Phototherapy is much safer, more controlled.

Did you have a newborn with jaundice? What was your first thought when you saw the baby becoming yellow?

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Varda Meyers Epstein is a mother of 12, communications writer, and education blogger at the Kars4Kids blog.