Jaundice

Yellow or brown tinged skin and eyes are the hallmarks of jaundice (pronounced JAWN-dis). The yellowing is a result of elevated levels of a substance called bilirubin (pronounced BILLY-roo-ben) in the blood. Slightly elevated levels of bilirubin cause the skin to appear yellow while high levels cause the skin to appear brown.

Bilirubin is a natural by-product of red blood cells in the body. As the red blood cells age, they break down. Hemoglobin, the chemical in the cells that carries oxygen, is released from the dying cells, and the substance that remains in the dying cells becomes bilirubin.

Bilirubin is a waste product, and the liver works to remove it, as well as other toxic chemicals and waste, from your blood. The liver takes the bilirubin, processes it, and adds other chemicals to it. It then passes the bilirubin mixture, known as conjugated bilirubin, in the bile and out of your body in your feces. Bilirubin is what gives feces its brown color. Some bilirubin, known as unconjugated bilirubin, does not leave the blood. 

Jaundice is caused when the levels of bilirubin in your system become elevated. It is important to note that jaundice is not a disease. It is a symptom of many diseases such as:

• anemia
• malaria
• viral hepatitis
• cirrhosis of the liver
• blockage of the bile ducts
• pancreas cancer
• Gilbert’s syndrome (an inherited disorder that affects the way bilirubin is processed by the liver)
• Dubin-Johnson syndrome (an inherited disorder that affects the way bilirubin is transported from the liver)
• bilary atresia

Because jaundice is a symptom, the disease causing the jaundice must be treated in order for the yellowing effects of jaundice to disappear.

Jaundice in Newborns

Before birth, most of the bilirubin produced in the fetus is passed into and excreted by the mother’s liver. After birth, the baby must eliminate all of the bilirubin without the mother’s help. It may take the baby several days to adjust to this process and to be able to eliminate the bilirubin faster than or, as fast as, it is being made. Until then, bilirubin builds up in the baby’s blood and the baby may become jaundiced.

Jaundice is common and it occurs in 50 to 70 percent of newborn babies. Some have jaundice at birth and others develop it after the second or third day of life. Breastfed babies are more prone to jaundice; however, it usually does not require a mother to stop breastfeeding. If your baby does develop prolonged jaundice, your pediatrician may ask you to supplement breast milk with formula or have you temporarily stop breastfeeding for a day or two. 

If your newborn has jaundice, don’t be alarmed. It doesn’t cause the baby any discomfort, but consult your pediatrician if:

• the yellow color persists for several days
• the yellow color spreads down your baby’s body
• your baby slows or stops feeding
• your baby’s stool becomes pale (almost white)
• your baby appears lethargic or irritable

In most cases, jaundice in newborns is harmless and will disappear within a few days; however, if bilirubin builds up too much, it may be harmful. High levels of bilirubin -- above 20 mg -- can cause deafness, cerebral palsy, or brain damage. In rare cases, jaundice may indicate that hepatitis is present.

Be sure that your pediatrician is aware of your newborn’s jaundice so that he or she can monitor your baby’s condition.