Newborn jaundice - discharge
Your baby has newborn jaundice. This common condition is caused by high levels of bilirubin in the blood. Your child’s skin and sclera (whites of their eyes) will look yellow.
Some newborns need to be treated before they leave the hospital. Others may need to go back to the hospital when they are a few days old. Treatment in the hospital usually lasts 1 to 2 days. Your child needs treatment when their bilirubin level is too high or rising too quickly.
To help break down the bilirubin, your child will be placed under bright lights (phototherapy) in a warm enclosed bed. They will wear only a diaper and special eye shades. Your baby may have an intravenous (IV) line to give them fluids.
Rarely, your baby may need treatment called a double volume blood exchange transfusion. This is used when the baby’s bilirubin level is very high.
Unless there are other problems, your child will be able to feed (by breast or bottle) normally. Your child should feed every 2 to 2 ½ hours (10 to 12 times a day).
The doctor may stop phototherapy and send your child home when their bilirubin level is low enough to be safe. The doctor will need to check your child's bilirubin level in the doctor’s office, 24 hours after therapy stops, to make sure the level is not rising again.
Possible side effects of phototherapy are watery diarrhea, dehydration, and skin rash that will go away once the therapy stops.
What to Expect at Home
If your child did not have jaundice at birth but now has it, you should take them to the doctor when they are 3 days old. Bilirubin levels are generally the highest when a newborn is 3 to 5 days old.
If the bilirubin level is not too high or not rising quickly, you can do phototherapy at home with a fiberoptic blanket, which has tiny bright lights in it. You may also use a bed that shines light up from the mattress. A nurse will come to your home to teach you how to use the blanket or bed and to check on your child.
The nurse will return daily to check your child's:
- Weight
- Intake of breast milk or formula
- Number of wet and poopy (stool) diapers
- Skin, to see how far down (head to toe) the yellow color goes
- Bilirubin level
You must keep the light therapy on your child’s skin and feed your child every 2 to 3 hours (10 to 12 times a day). Feeding prevents dehydration and helps bilirubin leave the body.
Therapy will continue until your baby’s bilirubin level lowers enough to be safe. Your baby’s doctor will want to check the level again in 2 to 3 days.
If you are having trouble breastfeeding, contact a breastfeeding nurse specialist.
When to Call the Doctor
Call your baby’s doctor if your baby is:
- Lethargic (hard to wake up), less responsive, or fussy
- Refusing the bottle or breast more than 2 feedings in a row
- Having problems breastfeeding, losing weight, or has watery diarrhea
- Turning yellow - eyes, belly, arms, or legs
- Turning more yellow (jaundice is getting worse)
- Has yellow color that goes away, but then comes back after treatment stops
- Has yellow color that lasts for more than 2 to 3 weeks
- You have concerns
Alternate Names
Jaundice of the newborn - discharge; Neonatal hyperbilirubinemia - discharge; Breastfeeding jaundice - discharge; Physiologic jaundice - discharge
References
Moerschel SK, Cianciaruso LB, Tracy LR. A Practical Approach to Neonatal Jaundice. American Family Physician. May 2008;77(9).
Update Date: 1/23/2011
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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