Newborn Jaundice is NORMAL!!

One of the most frustrating things I dealt with in my career as a lactation consultant is newborn jaundice. 

First let me tell you the physiology of newborn jaundice:

Babies are born with a high number of red blood cells.  This number is needed when the baby is in utero, but not after birth.  So…the red blood cells start to break down immedicately after the birth.  Inside the red blood cells is something called bilirubin which is yellow in color.  Usually bilirubin is excrested through the liver, but a baby’s liver does not start to function well until at least the third day after birth – and longer than that with preterm infants.  When the bilirubin is rejected by the liver, it goes back into the baby’s system and ends up under the skin – causing the yellow tinge that we call jauddice.  It starts at the top of the head and goes down, thus we see the whites of the eyes get a little yellow or the tip of the nose.

Why the big concern among physicians about jaundice – well, about 75 years ago, babies would get very jaundice and once in a blue moon, a bilirubin level would go so high that it would cause brain damage.  This has happened once in 100 years where I live.

Now we know that bilirubin is excreted through the bowel in newborns – the more they poop, the sooner the bilirubin leverl will go down.  Breast milk has a natural laxative – so the best idea is to keep breast feeding -right??  No, says many doctors – stop breast feeding and give the baby water or formula – which will not work!!  I have also heard physician tell new moms to put baby in front of the window as unltravilet light breaks down the bilitubin in the skin – unless you livce in a house that has very old windows, this will not work.  New windows have ultraviolet protection – so they block the rays that would help.

Physicians seem to look at the bilirubin number and not the baby.  Poor parents have to take their newborn to the lab for a poke in the heel and pooir baby is put through that pain.  Parents feel their baby is sick and worry, of course.  There have been studies done that report that parents who go throught this process of testing take their babies to the doctor twice as often in the first year because they label them as sick children.  Sad…

OK, my thoughts on this…..look at the baby and not the number.  If the baby is alert, eating, pooping and content – things are ok.  If the baby is lethargic, not pooping or eating and the soles of his feel and the palms of his hands are very yellow – a trip to the doctor is needed.

Do not stop breastfeeding!!  Do not give formla without a very good reason.  Do not pump and measure your milk – as I have written about before, this is not effective or accurate.

Now, one more thing, there is something very rare called breastmilk jaundice.  I am not going to write about it now – maybe later.  But it is rare, RARE and not in the category of normal newborn jaundice.

Let me know if you have questions…….