24 May, 2021
Yellow Babies - Physiological Jaundice
What is Jaundice?
Jaundice is the yellowing of the skin, eyes and mucus membranes (like inside the mouth).
In the womb, foetuses get their nutrition and oxygen supply via the umbilical cord. These goodies are transported around the body in the blood to nourish all the cells, tissues and organs. To do this, foetus have more red blood cells.
After birth, not requiring that many red blood cells, they start to break down red blood cells. These are broken into smaller molecules like bilirubin. Bilirubin can build up in the tissues, like under the skin, which causes a yellow appearance.
Overtime, the bilirubin is broken down and eliminated in the poo causing the yellowing to disappear.
This is a normal and healthy process.
Sometimes jaundice can be due to something more serious. This will be picked up in the first 24 hours by your birthing team.
How Common is Jaundice in Newborns?
Very common. In fact around 50-60% of term babies and 80% of prem babies will have jaundice in the first week (Neonatal Jaundice, 2013).
Jaundice is more common and prolonged in breastfeeding infants. In fact, it's got it's own name - "breastmilk jaundice". It occurs in two thirds of breastfed babies persisting for several weeks, even up to 3 months. Continuing to breastfeed your baby is actually really helpful so it's not a reason to stop feeding. More on that below.
Testing for Jaundice in Newborns
Testing is generally pretty simple. Your midwife or nurse will look at your baby's skin, eyes and inside their mouth to look for signs of yellowing. It's so simple you might not notice it's been checked.
A little machine (called a bilirubinometer) may be placed on the skin, like the forehead or chest, which sends out light waves (Bilirubinometer, 2011). This helps read how much bilirubin is in the bloodstream without doing a blood test.
Sometimes a blood test may be required to look further into the bilirubin levels. This will just be a pinprick test to collect a few drops of blood.
Helping your newborn with Jaundice
- Frequent Feeding: Early and frequent feeds is the usual treatment. Babies should be nursed 8-12 times in the first few days. This helps the liver to break down and eliminate bilirubin in the poo while preventing dehydration.
- Phototherapy: Some babies with jaundice will require light therapy, called phototherapy. This is usually done in the hospital crib. Not all babies need phototherapy.
- Indirect Sunlight: Spending time with the baby in a light-filled room with big windows may be beneficial.
- Massage: Adding baby massage can be beneficial when used alongside other therapies, like frequent feeding and light therapy (Abdellatif et al., 2020).
Signs to Watch Out For
Jaundice that starts in the first 24 hours after birth will be investigated further to find the cause of it. This will be assessed by your birth team.
If your baby experiences the following, please seek medical assessment right away ("Clinical Practice Guidelines : Jaundice in early infancy", 2020):
- Pale poo
- Dark urine
- Significant bruising
- Most newborns will have some yellowing of their skin called jaundice.
- Jaundice is more common and longer lasting in breastfed babies.
- Feed frequently and expose to light to help break down the bilirubin (yellowing pigment).
- If your baby is unwell, seek medical assistance.
About the Author
Dr Cassie Atkinson-Quinton - Chiropractor, Sleep Coach, Postpartum Doula (in-training), Perinatal Yoga & Pilates Instructor
There's a lot of change that happens for both parents and babies in the first few months after birth. There's tremendous growth and development for the bubba. Parents need to learn new (or remember and relearn with subsequent kids) how to look after a child. Mother's bodies are healing from pregnancy & birth and the new challenges of breastfeeding.
This is a passion area for Cassie. She helps support her clients through this transition with Chiropractic, Yoga & Pilates, Sleep Coaching and Doula support services.
Similar articles you'll enjoy:
- Abdellatif M, Vuong NL, Tawfik GM, Elfaituri MK, Mansour MI, Zaki MM, Duong PD, El-Qushayri AE, Liang Y, Liu K, Hirayama K. Massage therapy for the treatment of neonatal jaundice: A systematic review and network meta-analysis. Journal of Neonatal Nursing. 2020 Feb 1;26(1):17-24.
- Bilirubinometer [Internet]. World Health Organisation; 2011 [cited 29 January 2021]. Available from: https://www.who.int/medical_devices/innovation/bilirubinometer.pdf
- Childbirth International (2020). Postpartum Doula Training: Physiological Jaundice [Online Course].
- Clinical Practice Guidelines : Jaundice in early infancy [Internet]. RCH.org.au. 2020 [cited 30 January 2021]. Available from: https://www.rch.org.au/clinicalguide/guideline_index/Jaundice_in_early_infancy/
- Jaundice in neonates [Internet]. Safer Care Victoria. 2020 [cited 30 January 2021]. Available from: https://www.bettersafercare.vic.gov.au/clinical-guidance/neonatal/jaundice-in-neonates
- Neonatal Jaundice [Internet]. Nice.org.uk. 2013 [cited 29 January 2021]. Available from: https://www.nice.org.uk/guidance/qs57/documents/neonatal-jaundice-briefing-paper2