My newborn baby is getting yellow! What's going on?
It's not infrequent that newborn babies develop a yellowish coloration of the eyes white area as well the skin and even when it may be frightening, it's something normal affecting almost half of all newborns.
Called neonatal jaundice; such yellowish coloration is the result of high blood bilirubin levels due to the fetal hemoglobin breakdown, being replaced by adult hemoglobin and certain grade of liver immaturity, being unable to process bilirubin at a proper rate, leading to its accumulation on the blood stream.
Neonatal jaundice is a benign condition usually appearing within the first 24 hours after bird and lasting no more than 7 days; being resolved without complications.
However if bilirubin levels raise over 18 mg/dl there are risks of neurological complications such as cerebral palsy, seizures or kernicterus, then the health team will check baby's bilirubin levels on a regular basis just to be sure everything is going good.
The usual treatment for neonatal jaundice is phototherapy because light changes the bilirubin molecular structure towards a water-soluble form, easier to metabolize and eliminate.
Phototherapy is usually performed on an hospital basis and consists of baby's skin exposure as much as possible to an specific wave length blue light. UV radiation is not involved on this treatment, so there's no risk of burns.
Generally, phototherapy is held until jaundice resolution, that means no clinical detectable yellowish coloration on the body and bilirubin blood levels below 2 mg/dl.
In severe cases, when there are high complication risks, it might be necessary to practice a exchange transfusion; that mean the replacement of the whole blood volume in order to remove fast all fetal hemoglobin. This is not a complications free procedure but must be considered almost always if bilirubin levels raise over 25 mg/dl; however each case must be individualized taking into account the baby's general health status as well the age.
If jaundice does not respond to regular treatments or lasts more than 7 seven days, it's necessary to discard other causes of jaundice and the health team will need to perform further tests in order to identify the cause and start proper treatment shortly.
For those newborns who don't develop neonatal jaundice, it's a good idea to perform "prophylactic" sun baths once a day. You only need to expose your baby's skin to the sun (wearing only the diaper) between 5 and 10 minutes when the sun light is not so intense, that could be between 9:00 am and 10:30 am, or 3:00 pm and 4:30 pm.
The idea is to help the baby to metabolize bilirubin (even when there's not jaundice) but without the risk of sunburns.
As always, if you notice something wrong with your newborn baby or have any concern, never hesitate to contact your pediatrician to get profesional advise.