Jaundice

What is jaundice? 

Jaundice is a condition that makes the skin and eyes look yellow. Normally, the body breaks older red blood cells into a yellow fluid called bilirubin. The liver helps take the bilirubin out of the blood. It becomes part of a fluid called bile. This bile helps people break down their food.  

In some newborns, their liver can’t do this process very well yet. Too much bilirubin builds up, and their skin and eyes look yellow (jaundice). Jaundice usually goes away in 2-3 weeks after eating as their liver develops and they start feeding. 

Other things can cause jaundice such as: 

• Problems with breastfeeding (not eating enough) 
• Premature birth (born too early) 
• The mother and the baby have different blood types that work against each other 
• Infections that hurt the liver (getting a virus such as hepatitis A) 
• Diseases that harm the liver or red blood cells (some cancers or sickle cell disease) 
• Some kinds of medications (like too much acetaminophen) 
• Problems with your child’s immune system acting against their own body (autoimmunity) 

Jaundice treatment 

The primary treatment for jaundice is putting your baby under a special blue light that breaks down the bilirubin. Your baby might lie under an overhead light or under a blanket that shines this light on their skin (fiberoptic or bili blanket). Your care team will show you how to use the light or blanket.  The special blue light helps break down the bilirubin. 

If the jaundice is not severe, your care team may ask you to put your baby by a window so that they can get indirect (filtered)  sunlight.  The indirect sunlight helps break down bilirubin. Talk to your care team before putting your baby in the sunlight and follow their instructions. 

Be sure to check your baby’s body temperature during any kind of light therapy. Check to see your child regularly to see if they are too hot or too cold.  Follow your care team’s instructions.  They will tell you how to do treatments safely and about other treatments your baby needs. 

Overhead light therapy  

Your doctor may order overhead light therapy. Your child may get light therapy in the hospital, or you may have to do it at home. If you give light therapy at home, your doctor will tell you how to do it. This may include steps such as: 

1. Undress your child but leave their diaper on.  
2. Your child must wear eye patches during light therapy to protect their eyes.  
3. Make sure the light is at the correct length away from your child that their doctor told you. Read the instructions. Call your doctor if you have any questions. 
4. If the light does not give off enough heat, change the temperature in the room to keep your child warm. Lights give off different amounts of heat. Do not let your child get too cold or too hot.  
5. Measure how much light your child is getting during treatment. The device may have an indicator that tells how much light your child receives. There might even be a screen that tells you. Ask your care team how to do this. It’s important to make sure your child is getting the right amount of light, but not too much. Take measurements every 8 hours or whenever you change the position of the light. 

Follow your doctor’s instructions. 

Eye protection during light therapy is important. Follow these tips to protect your child’s eyes: 

• Before you put eye patches on your child, make sure they have closed their eyes.  
• If they need light therapy for more than 4 hours a day, take the patches off for 5 or 10 minutes.   Do this every 4 hours.  
• Check to see if your child’s eyes look red or irritated or if fluid or mucus is coming from them. If you notice this, call your doctor’s office. 
• You can take the patches off and make eye contact with your baby. This time together helps you bond with your baby. 

Fiberoptic (bili) blanket  

Your child might need a blanket that shines a light on their skin. You might hear this called a fiberoptic blanket or “bili blanket". The blanket is inside a cover or vest. You can wrap the blanket around your child or lay them on it. Follow these steps: 

1. Put the blanket into the cover or vest. Make sure that the clear side of the blanket is underneath the soft side of the cover. Your child will lie on the soft side, with the light shining on them through the cover or vest. 
2. Plug in the cable securely. Put this end of the blanket with the cable at your child’s feet. 
3. Lay the covered blanket on your child’s crib mattress or another flat surface. Place your baby on the blanket, with the tip of the blanket at their shoulders. 
4. Your child can wear diapers. They can also wear clothes over some blankets. Ask your doctor any questions about what your child can wear. 
5. Put eye patches on your child if they are lying on their side facing downward toward the blanket. Before you put eye patches on your child, make sure they have closed their eyes.  They do not need eye patches if they are lying on their back, facing away from the blanket. 
6. The blanket has a control that shows the brightness of the light. Adjust this before giving light therapy to your child. Your provider will instruct you on which settings  to use for the light therapy. 
7. Measure how much light your child is getting during treatment. The blanket has a way of measuring the amount of light your child is getting. There might even be a screen that tells you. Ask your care team where to find it and how to do this. It’s important to make sure your child is getting the right amount of light, but not too much. Measure every 8 hours or as often as the nurse tells you.