What it is, why it happens and how to treat it at home
Have you ever noticed how newborn babies often have a really healthy glowing tan? It’s as if they went on holiday to the south of France without you before they arrived. This glowing tan is often a sign of jaundice and whilst jaundice in adults is a sign of ill-health, in newborn babies it is very normal.
Ok. Are you ready for the science?
Cast your mind back to those school day science lessons. While the dreary teacher drones on in the background, you doodle love hearts and flowers in your notebook. (Just me? Oh well, never mind.)
Your teacher probably mentioned that the air that we breathe is made up of lots of gases. Oxygen is the essential one that we all need to provide energy for all our cells and organs. Air has about 21% oxygen in it. This is a perfect amount for our bodies to function well.
So, pregnant women breathe that 21% oxygen and the oxygen is absorbed by their bloodstream which then delivers the oxygen to all their organs. Because of that, by the time the blood reaches the placenta, it has about 16% oxygen in it. The placenta is where the oxygen in the mother’s blood gets passed over to the baby for him or her to use to power their own cells and organs.
Babies handle this lower level of oxygen really well because they have unique red blood cells with fetal haemoglobin molecules. Don’t worry, I’m not going to start an in-depth atom by atom description of haemoglobin. All you need to know is that fetal haemoglobin molecules are extra sticky when it comes to oxygen. That means that although there is only 16% oxygen passing over to the baby, the baby picks up all of it. They can make it work just as well as we do with our 21%.
What happens once a baby is born
As babies are born, they begin to breathe the air around them. They can use the 21% oxygen in that normal air, rather than relying on the oxygen in the bloodstream of their mum. This means they don’t need that extra sticky type of haemoglobin molecule. Because of that, their body starts to change from using fetal haemoglobin to creating adult haemoglobin molecules.
Being excellent at recycling from the start, their bodies break down the fetal haemoglobin into its various parts like iron and lots of proteins. Most of these parts are reused by the baby to create adult haemoglobin molecules. However, there is one part which is not reused, the yellow pigment called Bilirubin.
Bilirubin is the cause of babies’ yellow skin. As the baby doesn’t need it, it gets rid of it. Some of the bilirubin will come out in the baby’s nappy. You may have noticed the transition in colour of your baby’s poo from sticky black tar, through various mixes of brown and green and on to a chicken korma or mustard-like colour. You can take this change as a very good sign that your baby is feeding well and adapting perfectly to life outside the womb.
The tan on your baby’s face, torso, and even limbs is caused by extra bilirubin that hasn’t exited via their nappy. You can tell if it is jaundice by pressing lightly on their nose. As you release the pressure the skin underneath will show the yellow more clearly.
As I’ve already said, jaundice is a normal reaction to being born, so in the majority of babies, it is nothing to be worried about. However, sometimes bilirubin levels can rise to such an extent that they can cause the baby problems.
When jaundice is a problem
Babies who are struggling to get rid of the bilirubin levels in their body can start to seem extra sleepy or lethargic. They often aren’t pooing or still have dark poos rather than yellow ones. They may not seem all that interested in eating and you may have trouble waking them up enough to feed.
If your baby has any of these symptoms, please contact your midwife or GP as soon as possible
Very few babies need extra treatment to help them reduce their bilirubin levels. The usual treatment is phototherapy, where they get to lie under a mattress which gives out UV light. You may have seen photos of this or noticed babies on the TV having this treatment. They are surrounded by a blue light source and often wear cute little sunglasses! The UV light helps to break down the bilirubin lying under the skin. Once it is broken down, the baby can poo it out.
Treating Jaundice at home
The good news is that just two minor alterations in your baby’s routine can reduce the risk of him or her needing hospital treatment.
First of all, make sure your baby is feeding regularly. As they feed, their body will move the bilirubin out of their system with the waste products. You’ll see it in the nappy!
Secondly, keep your baby in bright rooms during daylight hours. Natural daylight contains UV light, so you have your own free source of phototherapy! If you set the baby’s cot, pram or Moses basket next to a window, the daylight will help break down the bilirubin under the baby’s skin. Please don’t think that it needs to be direct sunlight as too much direct sunlight may cause the baby to overheat. We also live in the UK, where actual sunlight isn’t always available! Don’t worry, just keeping little one near the window will make a difference.
The key is to avoid putting your baby in a dark inner corner of the room far from the windows. You also don’t need to expose lots of the baby’s skin to the daylight. Their face will be enough surface area if it is cold, although if it is warm you can certainly take off their baby grow. Leave them with their vest on and arms out, but put a blanket over their bodies to keep them cosy.
So there you have it. A simple explanation of newborn jaundice and how to treat it yourself so that you don’t need to go back into hospital.
For more information on Jaundice, you can visit the NHS website here
You can also find information on charities and organisations which can help you with feeding problems on my useful links page.