Most likely what your infant has is known as jaundice. In most cases, newborn or baby jaundice is a minor symptom that will not hurt or affect your baby's health in anyway. Yellowing of the skin or eyes in a newborn is caused by an increase in the baby's bilirubin, a yellow substance that your infant makes when his or her little body is replacing old red blood cells. When your baby was growing inside of you, the placenta removed all of the bilirubin from the baby's body. After your baby was born, the baby's liver needed to take over this job and sometimes it can take a few days for your baby's liver to master this task. It is very common for a baby's bilirubin to be a bit higher right after birth and is usually nothing to worry about.
Jaundice in a breast-fed baby is also very common, especially if your baby is not nursing well or your milk is slow to come in. Usually it is nothing to be concerned about. Breast milk jaundice may continue to peak until 2-3 weeks of life and then remain at lower levels for a few more months. It is believed that jaundice in a breast fed baby may due to how nutrients in the breast milk affect how bilirubin is broken down.
Even though jaundice or yellow skin in a baby is usually harmless and nothing to worry about, it does not mean that it should not be watched or monitored. Many times, babies with a high bilirubin level or jaundice will respond to light or phototherapy while still in the hospital. If the bilirubin level is trending down, the baby might be discharged to home with instructions to come back and get a repeat bilirubin level in a few days just to make sure the level is still going down.
If your baby's bilirubin level is not going down, your baby's pediatrician may perform additional blood tests to see what may be causing the yellow skin in your baby. Sometimes newborn jaundice can be caused conditions that increase the number of red blood cells that need to be replaced in your baby's body. Some of these conditions are:
- ABO or blood type differences between the mother and baby
- Abnormal or different shapes to the red blood cells
- Excessive bruising caused by delivery or a Cephalohematoma (bleeding under the scalp)
- More red blood cells which is common in smaller babies, twins or multiple babies
- Sepsis or an infection in your newborn
Sometimes, there are other things that make it harder for your baby to filter out all of the extra bilirubin in their body. Certain medications, especially ones that are filtered out through the liver, infections, cystic fibrosis, liver problems, hepatitis, hypoxia or multi-system organ failure, or genetic disorders can lead to a higher level of bilirubin in your baby or kernicterus.
Your child may need additional treatments if the bilirubin level is too high or is rising too quickly. Sometimes, depending on what is causing the jaundice, your baby may require an exchange transfusion of blood to replace your baby's blood with fresh blood or intravenous (IV) immunoglobulin to lower the bilirubin level before it causes permanent brain damage.
High levels of bilirubin or untreated severe jaundice can cause permanent brain damage in a baby. When that happens, it is called kernicterus. If a newborn develops kernicterus they can be left with permanent brain injuries, developmental delays, cerebral palsy, deafness, seizures, or blindness.
If your baby is yellow or jaundiced right after birth, most likely it is normal. Just make sure you follow up on any lab tests that need to be repeated and express any concerns you may have with your child's pediatrician.