Why is my newborn baby’s skin yellow?

A newborn baby should have rosy skin, and if there is any skin discoloration, you are right to be worried. You definitely want to contact your pediatrician to see what’s going on. In most cases, your newborn has a common condition called jaundice.

Up to 60 percent of full-term newborns, and 80 percent of premature infants have jaundice. In a majority of cases, jaundice goes away on its own and it’s not dangerous. However, in cases of severe jaundice, your baby will need to get treated to avoid the potential risk of brain damage.

What is Jaundice?

Jaundice is a common health problem in newborns that causes their skin and the whites of their eyes to look yellow. It is caused by high levels of a yellow pigment called bilirubin in the infant’s bloodstream. When there is too much bilirubin (a condition called hyperbilirubinemia), the pigment accumulates in the skin and causes the skin to turn yellow. Jaundice isn’t a disease, but a symptom that your child has high levels of bilirubin in the blood.

In most cases, jaundice isn’t a serious and it will go away on its own, without the help of any treatment. Jaundice isn’t painful to your baby, but occasionally, serious complications can occur if bilirubin levels are too high. Jaundice can be a symptom that a baby is at risk for developing severe hyperbilirubinemia – a condition that can be toxic to the infants’ nervous system and cause brain damage if left untreated.

Healthy babies may start to display signs of jaundice – yellow skin and yellow in the white of their eyes – between 2 and 4 days old. These healthy babies often get better on their own, and the jaundice disappears within one or two weeks without causing any problems.

If your baby displays any signs of jaundice, contact your doctor. Your newborn may need a blood test in order to see how much bilirubin is in the blood, and if your baby needs treatment.

What Causes Jaundice?

Babies develop jaundice when their body has more bilirubin that it can eliminate. Bilirubin is made when red blood cells break down. This yellow pigment is naturally processed by the liver, and leaves your baby’s body via urine and bowel movements. If there is too much bilirubin being produced, and the newborn’s body cannot get rid of it fast enough, so this pigment will become elevated and your baby will get jaundice.

When you were pregnant, the placenta removed bilirubin from your baby and your liver processed it. After birth, your newborn’s liver must take over, but it can take time before it can function at the same speed as your adult liver. For this reason, newborns can have higher levels of bilirubin.

In addition, in the first weeks after birth, your baby is producing two to three times more bilirubin than an adult does. As a result, jaundice is more common. Nearly all newborns have “physiologic jaundice,” in which they have mildly elevated levels of bilirubin. This condition develops between 72 and 96 hours after birth, and it disappears within two weeks. Babies who were prematurely may require more time to recover from their jaundice.

Jaundice and Breastfeeding

There is also a link between breastfeeding and jaundice. Because breast milk is more easily digested than formula, breastfed newborns are at higher risk of becoming dehydrated when their feedings are spaced too far apart. This dehydration can make it harder for your baby to get rid of bilirubin and other wastes in her body.

Jaundice is common when there is breastfeeding failure – the mother doesn’t have an adequate milk supply, babies don’t have good latch, etc. To prevent breast milk jaundice, you need to feed often and ensure your baby has a good suck (latch). You can prevent jaundice by making sure that your newborn gets plenty of breastmilk or formula.

Symptoms of Jaundice in Babies

In Caucasian babies, jaundice is easier to spot. When your infant has a darker skin color, it may be difficult to recognize the yellowing of the skin. But if your child’s skin changes color or shade, you should contact the pediatrician or child’s doctor.

Jaundice is first noticeable in the face and the white of the eyes. The yellow discoloration will continue down to your baby’s chest, tummy, arms, and finally her legs. You can also check for jaundice by pressing your finger on your newborn’s forehead or nose. When you release, your baby’s skin will appear yellow.

Signs of severe jaundice include the following:

• The yellow discoloration is getting worse. It’s becoming a deeper yellow.
• You have a difficult time waking up your baby.
• Your newborn has a shrill cry.
• He or she is irritable and hard to console.
• Your infant arches his neck or body backwards.

If you notice any of the above signs, you need to call the pediatrician right away. Severe cases of jaundice need to be treated to prevent brain damage.

In the United States, all babies are checked for signs of jaundice before they leave the hospital. The American Academy of Pediatrics recommends that newborns are checked by a pediatrician or healthcare provider again when they are 3 to 5 days old, because this is when the levels of bilirubin are highest.

How is Jaundice Treated?

In mild cases of jaundice, your newborn doesn’t require treatment. If a blood test detects high levels of bilirubin, your baby will need to be treated.

Premature babies with jaundice are often treated, because they are at increased risk for developing hyperbilirubinemia.

The most common treatment for jaundice in newborns is phototherapy (light therapy).

During phototherapy, newborns are exposed to a special blue light, which breaks down bilirubin so that it’s easier for the babies’ body to eliminate it. Phototherapy is usually performed in a hospital, but for healthy babies who are at low risk for any complications, sometimes phototherapy can take place at home.

This light therapy is successful for most babies. When phototherapy fails, and the baby continues to have high bilirubin levels, she may be treated with a special blood transfusion called an exchange transfusion. Because exchange transfusions can pose a risk for infection and other complications, it’s performed in a newborn intensive care unit and only recommended after phototherapy has failed.

But remember – that jaundice is typically easily treated. It is rarely dangerous. 

Newborn Jaundice Increases Risk for Autism 

With the rates of autism increasing every year, there has been recent interest in the link between jaundice and autism.

A 2010 study, published in an issue of the medical journal Pediatrics, which examined close to 734,000 children born between 1994 and 2004, found that babies with jaundice were 67 percent more likely to be diagnosed with autism in the future.

The autism and jaundice link didn’t just apply to premature babies (which researchers already know are at higher risk for autism), but full-term babies with jaundice as well.

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