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Jaundice is a fairly common condition in newborns. It involves the yellow discoloration of the skin due to the buildup of a substance called bilirubin in the blood. Everyone produces bilirubin, which is cleared from the blood by the liver. In a newborn, however, the liver is still developing and unable to clear bilirubin efficiently, leading to a buildup. As a result, many newborns get jaundice. Most cases are transient and harmless.
Jaundice usually appears within two days of birth. It starts on the face, spreads to the chest and stomach and then to the legs. It may also cause yellowing of the whites of the eyes. To check your baby, gently press the tip of your finger on your baby’s skin, blanching it. If the skin appears yellow, she most likely has jaundice. A couple of easy spots to test are the forehead and the tip of the nose. Jaundice may be hard to detect in darkly pigmented skin. If there is any question, do not hesitate to contact your baby’s doctor. The doctor will check your baby for jaundice within the first day of birth. The level of bilirubin can be measured with a simple skin test or blood test. Depending on the situation, the doctor may check for other causes of jaundice. Most cases of jaundice are mild and do not require any treatment. Severe jaundice, however, is associated with brain damage if left untreated. Treatments include phototherapy, in which the baby’s skin is exposed to special lights. In some cases blood exchange may be necessary to clear the bilirubin from a baby’s bloodstream. Any child can get jaundice. It occurs across all races and ethnicities. The risk of developing a problem from jaundice is increased in babies born before 38 weeks, and in babies who are dehydrated or not getting enough calories as a result of inadequate breastfeeding. The risk is also higher if an older sibling had problems with jaundice. Formula-fed babies born after 40 weeks are unlikely to have a problem with jaundice. Notify your baby’s doctor immediately if your newborn appears jaundiced. If you are breastfeeding your baby, be sure to do so 8-12 times a day for the first few days, to prevent dehydration and low caloric intake. Be sure to contact the hospital, lactation consultant or your doctor for assistance with breastfeeding if needed. After leaving the hospital, be sure your baby is seen again by a doctor or nurse within a few days. Contact the doctor immediately if the jaundice appears to be deepening or spreading, or if your baby has fever, fussiness, weight loss, difficulty feeding or if there is trouble waking the baby up. Most jaundice goes away within two to three weeks or sooner in formula-fed babies. See the doctor if your baby is jaundiced for longer than three weeks. With the proper precautions, serious health effects from jaundice are preventable. Dr. Richelle K. Marracino is a family practice physician at the UC Riverside Campus Health Center. Information: 951.827.3031. |
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