Ask Dr Sears: Newborn Jaundice

Ask Dr. Sears: Newborn Jaundice
By Dr. William Sears, Parenting

William Sears, M.D.

Q. Our 6-day-old son has a slight case of jaundice. Is there anything we can do at home to get rid of it, besides exposure to sunlight? I have heard about using some kind of special lamp as treatment. What is the truth behind this?

A. Nearly all newborn babies get a touch of jaundice, or a yellow tinge to the skin. Some babies get more jaundice than others. Jaundice is caused by the buildup of yellow pigment, or bilirubin, in the skin. Normally, when worn-out blood cells are broken down by the body, the bilirubin is released and disposed of by the body's master filter -- the liver. However, a newborn's immature liver can't dispose of all the extra bilirubin, so the excess settles in the skin, causing jaundice. As soon as your baby's liver becomes more mature, it will be able to dispose of the excess bilirubin, and the jaundice will disappear.

Jaundice is only a problem if there is an underlying medical reason for it, such as extreme prematurity or a blood grouping incompatibility. Premature infants usually have higher levels of bilirubin because their livers are even less mature than those of other infants. Also, if mothers and babies have different blood types, more blood cells are broken down, so the bilirubin is higher. In both these cases, the high bilirubin levels can lead to severe jaundice, which can interfere with the development of the brain. However, doctors normally monitor bilirubin levels to keep them from getting that high.

Since your baby has "a slight case of jaundice," he likely has the usual type of newborn jaundice, called physiologic jaundice, which is temporary and harmless. You don't need to worry that the bilirubin has gotten harmfully high. Here are some things to help bring the usual levels of bilirubin down:Home phototherapy. What you've heard about at-home lamp therapy is correct: If your baby's bilirubin level is going up instead of down, your doctor may want to prescribe home phototherapy, an alternative to keeping newborns in the hospital for jaundice treatment.

Home phototherapy requires you to put your baby under a special sun lamp and is only done when bilirubin levels are unusually high. Another, newer form of treatment is to wrap baby in a bili-blanket, a device that removes bilirubin. This is the easiest way to do home therapy in mild cases of jaundice that require treatment.

Expose your baby to sunlight. If the jaundice is slight, you may not have to institute any treatment at all. Your doctor may, however, advise you to put your skin-exposed baby next to a closed window and let the rays of sunlight shine on him for around fifteen minutes, four times a day. Sunlight dissolves the bilirubin in the skin so that it can be excreted in your baby's urine.

Feed your baby frequently. The more fluid -- breastmilk or formula -- you get into your baby, the easier it is for his body to flush out the excess bilirubin.

Feed your baby at least every two to three hours during the day and when he awakens at night.

Be sure your doctor explains to you the concept of physiologic, or "non-worry," jaundice. Oftentimes, the worry level of new parents is higher than the bilirubin level of the baby. It's important to avoid needless worry, since it can interfere with your ability to make milk and to get to know your newborn.