How to Prevent Jaundice in Newborns

Measuring and Reducing Risk Factors

Take blood tests during pregnancy. Certain blood incompatibilities can cause more blood cells to break down, producing more bilirubin. Mothers with Rh negative blood or O+ blood type should consider having additional blood work taken for their babies since Rh incompatibility and ABO incompatibility are among the highest risk factors. Genetic enzyme deficiencies, like glucose-6-phosphate dehydrogenase deficiency, can also lead to a higher risk of jaundice because they can destroy certain blood cells, creating more bilirubin in the blood stream. In addition to prenatal blood tests, doctors now routinely test the baby for jaundice before the baby leaves the hospital.

Reduce the risk of a preterm birth. Babies born before 38 weeks are at an increased risk of developing jaundice. The liver of a preterm baby is less developed than that of a full-term baby, making it even more difficult for the newborn's liver to eliminate bilirubin. Some preterm risk factors, such as age or multiple births, cannot be changed, but many environmental risks can. Keep up-to-date on your prenatal care. Early and consistent prenatal care will ensure that you and your baby stay as healthy as possible during the pregnancy, which can pinpoint any problems that could lead to premature delivery. Avoid chemical contaminants. Tobacco, alcohol, street drugs, and some medications can increase your chances of delivering early. If you need help quitting, talk to your doctor. Environmental pollutants can also contribute a risk. Stay as calm as possible. Stress is a major factor in early births. Lack of social support, work that is physically or emotionally demanding, and domestic violence, whether physical or emotional, can all contribute to stress and lead to a premature birth. Monitor or reduce your risk of certain infections. Infections such as herpes, syphilis, CMV, and toxoplasmosis can lead to premature births as well as jaundice.

Recognize that breastfed babies are more likely to develop jaundice. However, it is usually easily treated and short lived. Breast milk naturally does not come in until a few days after the baby's delivery. In the first few days of life, breastfed babies eat a pre-milk substance called colostrum, which is very scant in amount but dense in nutrients. Because they do not drink as much as formula-fed babies in the first few days of life, their digestive systems are not emptied as quickly, which causes bilirubin to build up in the system. This is generally not a cause for concern, and experts still recommend breastfeeding. Because breastfed babies often get a mild case of jaundice, it is not unusual for doctors to recommend supplementing them with formula in the early days of life if the baby is at higher risk for jaundice, until the breast milk supply is established.

Treating Jaundice in Newborns

Begin breastfeeding immediately. Nursing immediately after birth can help reduce the risk of developing jaundice and also begin to treat it if the baby already has it. Mothers who begin breastfeeding within the first few hours after birth are more likely to have success than those who wait. Early weight gain can help a baby's development, making it easier for the liver to do its job. Moreover, the colostrum a mother produces early on prompts the baby's digestive system to eliminate waste, which helps to expel excess bilirubin from the intestines. In other words, the sooner your baby begins pooping, the sooner the jaundice will begin to clear up. If you decide to breastfeed your baby, work with a lactation specialist to improve your breastfeeding technique. These professionals can help new mothers learn how to encourage proper latching so that newborns can receive enough milk.

Feed your baby frequently. A steady supply of milk will increase your baby's weight and development, including the development of the liver. This is true for both breastfed and formula fed babies. Ideally, newborns should eat at least eight to 12 times daily for the first several days, especially if they are at risk for developing jaundice. If you nurse, frequent feedings in the first few days of life (at least eight to 12 times a day) will encourage your milk to come in sooner and establish a strong supply.

Expose your baby to light. Ultraviolet light reacts with bilirubin, changing it into a form that does not need to pass through the liver in order to be expelled, thereby eliminating excess bilirubin from the body and reducing the risk of jaundice. Expose a naked or diapered baby to sunlight for no more than five minutes at a time, once or twice a day. Do not exceed this amount, since prolonged sun exposure can cause a baby to burn very easily and create further complications. Ensure that the baby does not become chilled while sunning by raising the temperature in the room and/or laying the baby across your own chest while sunning. Alternatively, try placing the baby's bed near a sunny window with curtains. Curtains and windows filter out many of the UV rays that can cause help problems, allowing your baby to take in sunlight without burning.

Understanding Jaundice

Understand how jaundice develops. Jaundice typically develops on the second or third day of life and generally follows a predictable pattern. In healthy bodies, bilirubin is a normal byproduct that occurs in the blood stream as red blood cells are broken down. The bilirubin travels to the liver, where it is excreted into the bile duct and eventually in your stool. In cases of newborns with jaundice, the liver has not begun to work efficiently yet, so the bilirubin builds up in the liver and the blood instead of traveling to the bile duct. Newborns in hospitals are routinely tested for jaundice. It's very common — about 60% of full term babies will develop jaundice, and even more of those who are born preterm. In a typical scenario, a newborn infant will be tested for bilirubin levels by pricking the baby's heel and squeezing out a small amount of blood. A baby with a bilirubin level of under 5 milligrams per deciliter (mg/dL) is considered normal, while anything over 5 mg/dL is considered an elevated level. Most babies with a low to moderate level of jaundice will not need treatment, and the jaundice will clear up after a week or two. Sometimes, if the level is too high, rises too quickly, or does not go down after two weeks, doctors may prescribe light therapy (a UV therapy which is harmless and enjoyed by most babies). In rare cases, your baby may need a blood transfusion to reduce severe jaundice.

Know the symptoms of jaundice. Most babies born in a hospital will be tested one or more times for their bilirubin levels, but certain symptoms can signal jaundice: A yellow color to the skin and the whites of the eyes. This is the most common feature of jaundice. Sleepiness and difficulty feeding. Sometimes bilirubin levels cause an infant to be drowsy, which can make nursing or bottle feeding the baby difficult. Try undressing the baby to rouse it to eat.

Know when jaundice signals a problem. Jaundice is very common and most often clears up on its own. But in some rare cases, it can cause complications and require treatment. Although jaundice is common among newborns, high levels of untreated bilirubin (what is medically known as "severe hyperbilirubinemia") in the blood can cause bilirubin to pass to the brain, leading to serious complications. Although rare, these complications can lead to permanent brain damage (cerebral palsy, learning problems, or developmental disabilities), improper development of tooth enamel, or hearing loss. Symptoms to watch for include lethargy, a bright yellow color, and yellow feet (especially the soles). Also poor muscle tone, an unusual, high-pitched cry, fever, or irritability may occur. Your doctor may recommend supplementing breastmilk with infant formula if your baby's bilirubin levels continue to rise after a couple of days of life. In most cases, it is not necessary to supplement unless the baby's bilirubin level is 20 mg/dL or higher or if the baby has other risk factors for jaundice such as prematurity or blood disorders or is losing too much weight. Supplementing with formula can make it harder to establish a successful breastfeeding relationship. Talk your doctor about the pros and cons before supplementing.