What is jaundice?
Jaundice is a condition that causes the skin, the whites of the eyes, and sometimes the inside of the mouth to look yellow. It happens when bilirubin builds up in the blood. Bilirubin is a yellow substance that the body makes when it breaks down old red blood cells. Normally, the liver processes bilirubin and passes it into bile. Bilirubin then leaves the body in stool (poop).
Jaundice is a sign that there is too much bilirubin in the body. Treatment for jaundice depends on the cause. It may include monitoring, medicines, treating an underlying condition, or, for some newborns, phototherapy (light therapy).
Jaundice can be caused by many things, including:
- Newborn-related causes: A liver that has not fully developed, premature birth, feeding problems, bruising, or differences between the baby’s and mother’s blood types
- Red blood cell breakdown: Sickle cell disease, thalassemia, G6PD deficiency, or other conditions that cause red blood cells to break down too quickly
- Liver or bile duct problems: Hepatitis, other liver diseases, gallstones, or a blocked bile duct (tube that drains the liver)
- Inherited conditions: Genetic conditions that affect how the liver processes bilirubin or how red blood cells break down
- Medicines and treatments: Chemotherapy, immunotherapy, or other medicines that affect the liver
- Complications of serious illness or treatment: Infections, graft versus host disease after stem cell (bone marrow) transplant, or rarely, a transfusion reaction
Your care team will determine the cause of jaundice before deciding on treatment.
General signs and symptoms of jaundice may include:
- Yellow color of the skin or eyes
- Dark urine (pee)
- Pale or clay-colored stools
- Itchy skin
- Feeling very tired or weak
- Not feeling hungry
- Nausea or vomiting
- Belly pain, especially in the upper right side
- Fever (if an infection is present)
Babies with jaundice may also:
- Be unusually sleepy or hard to wake up
- Have trouble feeding
- Have fewer wet diapers than expected
Your child’s care team will ask about their symptoms and medical history and do a physical exam. Tests may be needed to measure bilirubin and find the cause of jaundice. Your care team may:
- Check your child’s skin and eyes
- Order blood tests to measure bilirubin levels and check liver function
- Use a device for newborns that estimates the bilirubin level through the skin
- Check red blood cell counts and look for signs of blood cell breakdown
- Order imaging tests, such as an ultrasound, if they suspect a blockage in the liver or bile ducts
Your child’s treatment will depend on the cause of jaundice. If an underlying condition causes jaundice, treating that condition may help improve the jaundice. Treatment may include:
- Adjusting or changing medicines
- Blood transfusions
- Phototherapy (light therapy) for some newborns with high bilirubin levels
- In severe newborn jaundice, an exchange transfusion to replace some of the baby’s blood
- Removing a blockage in the bile ducts
- Treating an infection, liver disease, or blood disorder
Jaundice in newborns
Jaundice is common in newborns. Sometimes it is a normal part of the newborn period. Other times, it can be a sign of a health condition. Feeding your baby often can help the body remove bilirubin. Follow your care team’s instructions about how often and how much your baby should eat.
Contact your care team if your baby is not feeding well, has fewer wet diapers than expected, is fussier than usual, or looks more yellow.
Phototherapy for newborn jaundice: Phototherapy uses a special blue light that helps the body remove bilirubin. Some newborns with high bilirubin levels need phototherapy in the hospital or at home.
Phototherapy may use:
- An overhead light
- A fiberoptic blanket (also called a bili blanket)
Your care team will explain how to use the equipment safely.
Do not use sunlight to treat jaundice. Sunlight is not a substitute for prescribed phototherapy. Sunlight can cause overheating or sunburn.
In rare cases, very high bilirubin levels can harm a baby’s brain. Early treatment can help prevent this problem. Call 911 or take your baby to the emergency room if your baby:
- Is arching backward with their neck or body
- Is very hard to wake up
- Has high-pitched crying or crying that will not stop
- Has unusual eye movements
When to call the care team
Contact your care team or seek medical care right away if your child has:
- Yellowing of the skin or eyes that gets worse or does not improve
- Severe belly pain
- A fever or other signs of infection
- Severe sleepiness or trouble waking up
- Trouble eating or drinking
- Dark urine or pale stools
- Signs of dehydration
- Confusion or changes in behavior
- Worsening itching or swelling
Questions to ask your care team
