What is Jaundice?Postpartum
Earlier in the summer, Beyoncé’s twins were reported being ‘under the lights’ for a ‘minor issue’ for eight days after their birth. This issue was routine treatment for jaundice with phototherapy. For many new parents seeing your newborn rival Homer Simpson's skin color can be alarming! But try not to worry too much. Jaundice, or hyperbiliruinemia, is caused by bilirubin, the by-product of the breakdown of red blood cells, in baby’s blood. Because a newborn's liver is immature at first, the skin helps your baby process the excess bilirubin. Jaundice typically occurs in about 60% of full-term babies and 80% of premature infants. It’s pretty normal!
Mild jaundice, sometimes called physiological jaundice, is considered harmless and usually resolves in time. This is the most common type of jaundice in newborns. It typically appears on the second or third day after birth, peaks, and then goes away, disappearing before the end of the second week. Your baby will not be yellow forever and their skin will return to it’s perfect newborn glow.
Jaundice can also be the result of certain blood incompatibilities between mom and baby, such as a Rhesus Factor variance, or an ABO incompatibility. Sometimes jaundice is associated with infection, bruising on the baby’s head from an instrument delivery, or, like the Carter's twins, prematurity.
If significant jaundice occurs, a physician or midwife will order a test of baby's blood, obtained by a heel stick, to measure your baby's bilirubin level. If the bilirubin level is high, your baby may be treated with phototherapy, or light therapy. With phototherapy, your baby wears special eye patches, they look like little sunglasses, over their eyes and is placed under ultraviolet lights that help to break down the bilirubin in the skin. A newer form of phototherapy utilizes a plastic body wrap and fiberoptic lights, called a biliblanket, and many hospitals have them.
Very rarely, jaundice occurs with breastfeeding. With ‘breastmilk’ jaundice, bilirubin levels begin to rise after the third day of age and usually peak somewhere between the 7th to 10th day. Diagnosis is made by ruling out all other possible causes. You may be the first to notice this type of jaundice in your baby. If so, notify your baby's care provider or your public health nurse. This type of jaundice will resolve on it's own in time.
Most babies who have jaundice may be a little sleepy and hard to wake for feedings. It is essential that you stimulate your baby enough to eat well, as bowel movements also help to remove bilirubin. Sometimes everyone must get a little creative to keep baby awake long enough to get in a good nursing session. Don’t hesitate to ask for a breast pump, instructions on how to self express colostrum, use of a syringe for supplementing, or even giving a bottle of breastmilk or formula to top off your baby’s feeds. The most important thing is your baby’s speedy recovery.
Jaundice can be scary for new parents but take comfort in knowing that in most newborns, jaundice is extremely treatable and highly managed by your healthcare team. Try not to stress!
We encourage you to learn more about our "What in the World" series. Please see our A to Z index for a whole host of pregnancy, postpartum, and parenting information and terminology.
Loree Siermachesky works as a multi-certified labour and postpartum doula, certified Lamaze childbirth educator, certified breastfeeding counselor, certified placenta encapsulation specialist and a certified car seat technician in Medicine Hat and Lethbridge. She has had the honour of attending over 1400 births in the last 20 years. She is well-known and greatly respected by the medical providers in Medicine Hat, Lethbridge, Brooks, Taber, and Calgary. She cares deeply for this profession and even more for her clientele, honoring them in whatever method of birth they choose, or helping them transition to new parenthood as they wish.