Why Is My Baby’s Skin So Yellow: Jaundice In the Newborn

Jaundice is a yellow discoloration of your infant’s skin.

What is newborn Jaundice or Hyperbilirubinemia?

Jaundice, technically known as hyperbilirubinemia (which means too much bilirubin), is a yellow discoloration of your infant’s skin, It’s caused by the accumulation of a waste product called bilirubin. Bilirubin comes from the normal and natural breakdown of the hemoglobin in our red blood cells and has a yellow/green color. After birth, most bilirubin is excreted in our stools, giving them a green/yellow color. Babies cannot “poop” in the womb and the infant’s bilirubin is transported through the placenta to mom, who then excretes it. After birth, all infants have a short-term increase in bilirubin as the baby takes over processing their own bilirubin in their liver before excreting it in their stools. However, in some babies, the liver can’t keep pace.

Why do we follow bilirubin levels? Is it harmful?

In general, the small increases in bilirubin seen after birth are benign (harmless) and will decrease over time as the infant begins feeding and stooling more. However, extremely high levels can cause deafness or a serious condition called kernicterus, which damages the brain. Because treatment is so easy and kernicterus is so terrible, we are very cautious in our approach to hyperbilirubinemia.

What are the situations that can lead to hyperbilirubinemia?

Some babies are just prone to higher bilirubin levels and have family members who needed treatment when they were newborns. Premature, Asian, breastfeeding, and bruised infants also tend to have higher bilirubin levels and are prone to requiring treatment. A difficult birth, some blood disorders, and infection can also lead to higher bilirubin levels that require treatment.

What are the symptoms of hyperbilirubinemia?

Infants have a yellowing of their skin and the whites of their eyes (conjunctiva), are lethargic, and have difficulty feeding. Hyperbilirubinemia can happen to babies of all races, but the skin discoloration can be less obvious in babies with darker skin, so we take extra care to monitor them.

How is hyperbilirubinemia diagnosed?

We do a blood test of infants who are born with clinically significant yellowing of the skin or eyes and those who are 24 hours old. This level is plotted against time on graphs which predict the infant’s risk for serious hyperbilirubinemia. In general, high and quickly rising bilirubin levels are more harmful than low and slowly rising levels. These graphs help your baby’s doctor manage your baby’s bilirubin for further testing or treatment. These graphs can be seen on the app bilitool.org.

How is hyperbilirubinemia treated?

Almost all infants requiring treatment will only need phototherapy. We place infants under a special blue light. This light changes the structure of the bilirubin as it passes through tiny blood vessels just under the skin. The changes make it possible for some of the bilirubin to be removed by the baby’s kidneys and excreted in the urine. In this way, phototherapy lightens the load on the liver and helps your baby’s body “catch up” on getting rid of excess bilirubin. Best results are obtained with more skin exposure to the light, but allowing an infant to breast- or bottle- feed every few hours does not decrease the light’s effectiveness. As bilirubin levels decrease and the baby gets older, we can stop light therapy. However, we keep tracking bilirubin levels for a time because sometimes the bilirubin level increases significantly when phototherapy ends and we have to restart treatment.

What is our goal?

First and foremost, we want to protect your baby’s health! We strive to make your birth experience at St. Mary’s Hospital as joyful as possible as a new life is brought into your family. We strive to include you in our team, which is dedicated to providing unsurpassed medical treatment with compassionate and individualized care.

Learn more about St. Mary’s Family Birth Center in Athens.

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