What causes jaundice in newborns?
Jaundice is a common condition among newborns that causes yellowing of the skin and eyes. Nearly 60% of full-term infants and as many as 80% of preterm infants develop jaundice. Also referred to as hyperbilirubinemia, this condition occurs when bilirubin, a byproduct of red blood cells, builds up in a newborn’s bloodstream faster than the liver can break it down and pass it through bowel movements. Before birth, the mother’s liver processes the bilirubin for her baby but after birth, it takes a few days for a baby’s liver to process the bilirubin on its own.
With frequent breastfeeding, an infant’s body can usually rid itself of the excess bilirubin but in some cases, additional treatments may be needed to keep the condition from progressing.
Does breastfeeding affect jaundice?
According to the American Academy of Pediatrics (AAP), jaundice is more common in breastfed versus formula-fed babies, however, this occurs most often in newborns who are not getting enough breast milk because their mother’s milk supply comes in late or there are breastfeeding obstacles such as the baby not properly latching.
To help you produce more breast milk and keep your baby’s bilirubin level down after birth, both the AAP and Academy of Breastfeeding Medicine (ABM) recommend breastfeeding your newborn at least 8 to 12 times a day.
Treating jaundice
The treatment for jaundice in breastfeeding babies varies with the cause and severity of the condition. Typically, it involves some combination of phototherapy (light therapy) and infant feeding management (breastfeeding support or, less commonly, supplementation.) Phototherapy is often given in the hospital setting, but for low-risk infants whose bilirubin levels are monitored, it can be done at home.
With appropriate treatment, jaundice usually resolves within 7–10 days, but it can persist for weeks. If the cause is not easily identified, a thorough medical evaluation may be necessary. Taking your baby for routine medical check-ups during the early days and weeks will ensure that jaundice or other common conditions are quickly identified and appropriately treated. Jaundice which appears after your baby leaves the hospital, or in between check-ups, should be reported to your baby’s doctor right away.
The ABM recommends these steps to prevent excessive weight loss, ensure adequate weight gain, and minimize the risk for jaundice:
- Initiate breastfeeding as soon as possible after birth, ideally within the first hour—even for mothers who deliver by cesarean section.
- Breastfeed exclusively. Make sure your baby gets enough to eat by breastfeeding at least 8–12 times every 24 hours. Although babies may only receive about 1 teaspoonful per feeding during the first 24 hours, these feedings also act as natural signals or triggers in the mother's body to make more milk.
- Avoid supplements unless medically indicated. If supplements are needed, a mother’s expressed milk is the first choice, followed by donor milk, then infant formula. Water and glucose water should not be given. And if you must supplement, be sure to pump so that your milk supply is not negatively affected
- Optimize breastfeeding support by paying attention to position and latch from the very start.
- Encourage skin-to-skin contact (when a mother is awake and alert), which helps with milk supply and makes the mother’s milk easily available to the infant.
- Know early feeding cues. Providers should counsel new parents about early feeding cues, and signs of concern, such as a very sleepy baby, or one who doesn’t show signs of hunger. providers should counsel new parents. Infants should be fed at the initial signs of hunger, rather than when they reach the point of crying, a late hunger sign.
- Identify those at-risk for jaundice such as late preterm babies, those whose siblings had jaundice, those whose mothers have certain medical conditions (such as diabetes, Rh sensitization); and ensure follow-up care. Infants who are discharged from the hospital within 72 hours of birth should be seen by a health care provider within 2 days of being at home.
