Tabassum delivered her baby 3 days ago. Today her baby looks yellowish and her paediatrician has told her that the baby has newborn jaundice. Is there anything to worry about?

What is newborn jaundice?

Most babies will have mild newborn or neonatal jaundice. Physiologic jaundice is the most common form of newborn jaundice. Treatment is required when the jaundice is pronounced. Jaundice is a yellow discolouration of the skin and the white part of the eyes. When a finger is pressed gently against the baby’s skin, normal skin will turn white, but jaundiced skin will stay yellow.

Newborn jaundice results from having too much of a substance called bilirubin in the blood. Most babies are born with a high amount of red blood cells. Bilirubin is formed when the body breaks down red blood cells. The liver usually processes and removes the bilirubin from the blood.

Jaundice in babies occurs because their immature livers are not efficient at removing bilirubin from the bloodstream. The type of bilirubin that causes the yellow discolouration of jaundice is called unconjugated bilirubin. This form of bilirubin is not easily removed from the baby's body. The baby's liver changes this unconjugated bilirubin into conjugated bilirubin, which is easier for the baby's body to remove. The immature livers of newborn babies are not able to perform this job very efficiently at first. As the breakdown of red blood cells slows down, and the baby's liver matures, the jaundice rapidly disappears.

Newborn babies will begin to appear jaundiced when they have more than 5 mg/dl of bilirubin in their blood. In an adult, bilirubin levels are considered high when the blood result shows a value of more than 1mg/ dl. On the other hand, it is quite common to see newborn babies with bilirubin levels of 5 to 10 mg/dl. 

It is important to recognise and treat neonatal jaundice. The level of bilirubin may be treated according to the baby’s age. For example, a bilirubin level of 12 mg/dl needs to be treated if the baby is less than 48 hours old but is considered normal when the baby is more than 5 days old.