Discharge Instructions for Newborn Jaundice
Your baby has been diagnosed with jaundice. This is a short-term condition. Jaundice happens when your baby’s liver is still immature and isn't able to help the body get rid of enough bilirubin. Bilirubin is a substance that is found in the red blood cells. It can build up in the blood after your baby is born. This is part of the normal breakdown of red blood cells. But if bilirubin levels become too high, they can be dangerous to your baby's developing brain and nervous system. That is why it is important to check babies who have signs of jaundice to make sure the bilirubin level does not become unsafe.
An immature liver is normal at this stage of your baby’s growth. Your baby's liver should quickly begin to activate the proteins needed to remove bilirubin from the body. Almost half of all babies show some signs of jaundice, such as yellow skin or eyes. There are other causes for abnormal jaundice in newborns, so your baby's healthcare provider will closely follow your baby's health until the jaundice goes away.
Watch your baby for signs of jaundice returning or getting worse:
Your baby’s skin or the whites of the eyes turn yellow.
If jaundice gets worse, the yellow color will move from the eyes to your baby's face. Then it will move down your baby's body toward the feet.
Breastfeed your baby often, at least 8 to 12 times every 24 hours. (Most babies with jaundice get better after eating for several days because the bilirubin is removed from the body in the stools.)
Talk with your baby's healthcare provider about feedings if you are bottle-feeding your baby.
Arrange to have "bili lights" at home if your baby's healthcare provider recommends it. They can help your baby's body properly break down the bilirubin if the levels are too high.
When to call your baby's healthcare provider
Call your baby's healthcare provider if your baby:
Is not interested in feeding at least 8 to 12 times every 24 hours
Has pale skin
Has pale or grayish stool or bowel movements
Has jaundice that gets worse (yellow color moving toward the feet)
Has jaundice that does not improve by 2 weeks of age
Has a fever
Is fussy or crying a lot
Has fewer wet or soiled diapers per day than expected. As a general rule, newborns who are getting enough milk will be stooling 3 to 4 times a day by their fourth day of life. Their stool should be yellow rather than black, brown, or green by day 5. They will probably also have at least one wet diaper for each day of age in the first week (one the first day, two the second day, and so on).
November 19, 2017
Clinical manifestations of unconjugated hyperbilirubinemia in term and late preterm infants, UpToDate., Maisels, JM. Hyperbilirubinemia in the Newborn Infant > 35 Weeks' Gestation: An Update With Clarifications. Pediatrics (2009); 124(4); pp. s1193-s1198, Pathogenesis and etiology of unconjugated hyperbilirubinemia in the newborn, UpToDate., Patient Information: Jaundice in Babies (The Basics). UptoDate, Treatment of unconjugated hyperbilirubinemia in term and late preterm infants, UpToDate.
Freeborn, Donna, PhD, CNM, FNP,Lee, Kimberly G., MD, MSc, IBCLC