2 days after my son’s birth, I noticed that he wasn’t feeding much or latching properly. I thought maybe he wasn’t getting properly fed, so I switched to formula milk to help him gain enough nutrition and hydration his tiny body needs. But it didn’t work; after 4 days, I started noticing his skin has a yellowish tinge and his eyes are prominently yellow.
He also lost weight rather than gaining any. This was quite concerning and alarming for me, so I immediately referred to my pediatrician and found out my baby had jaundice.
Before I go into the details, let me tell you, “it’s not the end of the world,” it’s not a disease. It’s just a physiological reaction to your baby’s body.
So what actually happens when my baby gets jaundice?
Your baby’s body is born sterile; they haven’t used their digestive system before, they haven’t processed breast milk before, and it takes some time for their digestive system to get working.
In the meantime, they’re born with all this blood in their body; these red blood cells are obviously important as they carry oxygen to tissues, give nourishment to the brain, help pump the heart and lungs, and other organs of the body to figure properly.
Red blood cells get old, they break down, and new ones are built. So red blood cells are constantly turning over, and new ones are created to adequately bring oxygen to the tissues. The old red blood cell byproduct turns into bilirubin, and those little particles in the blood need to be filtered through the liver and excreted through your baby’s poop.
Newborn babies who haven’t really been feeding much haven’t worked through and gotten the digestive system working super well. They are at risk for those byproducts of bilirubin to accumulate in their bodies, and because they are not excreting, it doesn’t work that well. So it may leave some extra bilirubin in their blood, causing jaundice.
To all the new parents out there “Expect your baby to have a little bit of jaundice, it’s normal!”
Delayed cord clamping
Jaundice in a newborn can be attributed to delayed cord clamping. When the cord pulsates, it actually brings more blood into the baby’s body which is admittedly good. Once we weigh the risks and benefits, it’s actually better for the baby to get that extra blood.
Still, there is an increased risk of jaundice because when you give more blood, more RBCs will die off and leave byproduct of bilirubin, which eventually turns skin to yellow indicating jaundice. You can also look for jaundice in the whites of the eye.
So if you are like, oh my baby looks reasonably yellowish, that’s a risk indicated. Consult your doctor ASAP!
Factors that cause jaundice
Jaundice is suspected in babies who are:
- Born before 35 weeks of gestation, referred to as a premature baby.
- Born to mother with type O blood group.
- Having trouble latching or bottle feeding.
Breastfeeding Jaundice or Starvation Jaundice
Breastfeeding Jaundice links to the baby not receiving enough milk to be excreted out of the digestive system, and this causes bilirubin to be reabsorbed into the intestines. Consequently, the bilirubin level keeps elevated, causing jaundice.
The baby receives too little breast milk from breastfeeding due to difficulty latching or delay in breast milk production, leading to low nutrition and reduced excretion. If your baby’s poop is dark brown and hard, this means his system is working to eliminate extra bilirubin, but your baby isn’t well hydrated to excrete it completely from the body.
During the first week, the mother and baby are learning how to breastfeed properly, the timing, and the duration of the baby’s feeding schedule. It can be easily treated by increasing the number of feeding per day from 10 to 12 times, ideally every 2hrs.
While it takes time to produce enough milk, you can switch your baby to formula milk to keep your baby’s calorie intake and hydration at an optimal level.
Breast milk jaundice
This usually occurs within the first week; studies have shown that breast milk jaundice is linked to the presence of certain substances in mothers’ milk that keep the level of bilirubin in infants elevated.
You can switch your child to formula milk for a week or use it intermittently with breastmilk to keep bilirubin at an optimal level. Always consult your doctor before switching to formula milk.
What do you do if your baby has jaundice?
Once you suspect that your baby might be affected by jaundice, consult your pediatrician and get your baby monitored. Your baby could have a yellow tinge but a low level of bilirubin, or there might be a slight tinge but a high level of bilirubin.
The only way to get to know is through a blood test, your doctor can then diagnose if the baby is suffering from acute phase jaundice or chronic.
Another thing you could do is that keep your baby well hydrated, feed after every 2 or 3 hours to get the digestive system working. Bilirubin is excreted through poop, and more feedings will result in more diaper changes, so the goal is to get the digestive system working.
Formula milk or breast milk?
The goal is to keep your baby’s tummy full and formula milk is a good choice if your baby is suffering from breast milk jaundice.
Whether you choose to breastfeed, exclusively pump, only formula feed (or a combination of it all), the goal is feeding, keeping your baby well hydrated, and get that digestive system to work.
Studies have shown that jaundice is seen mostly in breast milk babies because of the presence of various enzymes that prevent the degradation of bilirubin in the baby’s liver.
Contrary to it, babies on formula are less likely to develop jaundice, and if it is suspected, it resolves faster than a breastfed baby.
How can I get rid of bilirubin from my baby’s body?
The treatment for infant jaundice focuses on 3 things…
- Observation and lab tests to detect bilirubin levels
- Feeding and pooping, the poop you’ll notice with jaundice will be dark brown and hard, but with a proper feeding schedule of every 2hrs, the poop will eventually turn yellow as if your baby’s abnormal skin pigment is also being removed with excretion.
- Phototherapy continues until the bilirubin level returns to normal.
What factor causes jaundice in breastfed baby?
Jaundice in a newborn baby is caused by an increased level of bilirubin in the baby’s blood. An elevated bilirubin level could be linked to breast milk jaundice, breastfeeding jaundice, neonatal physiological jaundice, and pathological jaundice (it is a serious type of jaundice and occurs within 24 hours of birth and needs immediate blood transfusion).
What are the symptoms of jaundice in newborn babies?
- Your baby may look pale and sick.
- May not feed well or latch properly.
- Sleep more than usual.
- Skin and eyes appear yellowish tinged.
Should I continue breastfeeding if my child has jaundice?
Yes! Absolutely you should frequently breastfeed your child after every 2 hours. Ideally, you should start breastfeeding in the first hour of birth.
- Try to breastfeed 10 to 12 times a day to get your baby’s digestive to get working promptly.
- Notice in what position your baby is comfortable while breastfeeding and try to stick to that position; it helps your baby latch properly.
- Also, look for initial signs of hunger in your baby and feed right away, do not wait for your baby to cry, this behavior exhausts him, and your baby will be low on energy.
How long does it take for jaundice to go away in newborns?
Jaundice in newborns clears within 2 to 3 weeks of birth. Studies have shown that breastfed babies may take a bit longer than formula milk babies.
The reason could be the presence of certain enzymes or proteins present in breast milk that may prevent liver-free bilirubin in the system.
What happens if jaundice is left untreated?
Excess bilirubin is toxic for your baby’s brain. If your baby’s jaundice gets worse, there is a fair chance of bilirubin passing the blood-brain barrier and entering into the brain, causing a condition called acute bilirubin encephalopathy. It can further lead to…
- Difficult walking
- Excess high pitch crying
- Poor latching and feeding
- Posterior arching of neck and body
Another condition linked to chronic jaundice is Kernicterus, which is a syndrome that develops if Acute encephalopathy causes permanent damage to the brain, it may further result in…
- Athetoid Cerebral Palsy (brain damage)
- Upward gaze
- Impaired hearing
- Abnormal development of tooth enamel
What should I eat if my baby has jaundice?
If your baby needs supplements to treat jaundice, mothers’ milk should be the first choice; use it as a medium to administer supplements. If breastmilk isn’t available, then donor milk or formula milk should be your go-to choice. However, avoid supplements such as water and glucose.
What is the safest level of bilirubin in infant jaundice?
The bilirubin level below 20 milligrams is safest for infant jaundice; however, you should frequently get your baby monitored to know the bilirubin levels.
If you suspect your baby has jaundice, call or visit your doctor and ask for a consultation. Your doctor will run some tests to diagnose it. If your baby has been affected with jaundice, take it seriously and be under the supervision of your pediatrician.
Seeing your baby having difficulty in feeding and getting used to a new environment is worrisome and painful, but don’t take it over to your head; your baby will get fit and healthy eventually as jaundice resolves within 2 to 3 weeks.
Learn that your baby’s body is just started working to its fullest, it will take time, and it will be treated. Manage feeding routine to keep bilirubin level low and stick to follow up a treatment plan as instructed by your pediatrician.