JAUNDICE – EXPLANATION

History: symptoms now, PMH, FH

Do ICE. What do you know about jaundice?! Have you got any worries at the moment?! What
do you expect to gain out of this consultation!?

WHAT IS JAUNDICE?!
● Jaundice is a very common condition where the skin and whites of the eyes become
yellow.
● Jaundice is actually caused by an excess of a waste product that builds up in the blood.
● It is not a painful condition and it is not a harmful condition either but if it carries on for
longer than 2 weeks then it may indicate some sort of problem with the baby’s liver.
Normal:
● So in the blood you have red blood cells which carry oxygen and when these red cells
are broken down they release a waste product called bilirubin. Your liver works to
remove the waste product (bilirubin) and reduce the amount of it by passing it through
the gut so it can pass through in the stool.
ABnormal:
● But in new born babies the red blood cells are broken down so fast that the liver can’t
initially handle it – so more bilirubin naturally builds up in the blood.
● If you have too many red blood cells that get broken down, you get more bilirubin in the
blood. Bilirubin itself is a yellow substance and so your baby appears yellow if there is
too much in the blood.

There are a couple of reasons for this:

1) Newborn babies have more RBCs than adults
2) Bilirubin is broken down much slower in babies than adults

SO WHAT CAN HAPPEN?!

● There are a couple of different types and causes of jaundice based on the time in which
they present: “so if your baby develops jaundice from ... to ...”
○ First 24hrs = abnormal but we will pick up on this and the baby will need medical
attention.
○ 24hrs to 14 days = this is usually called physiological jaundice which we would
not be concerned about as it is quite common and is harmless – usually resolving
in 2 weeks. But we will still monitor the baby throughout just in case.
○ 14 days + = this is usually called prolonged jaundice and we will usually pick up
on this. If the baby is still jaundiced after the first 2 weeks and we have not
picked up on it – seek medical attention.
○ You should also seek medical attention if jaundice develops at a later stage or if
their stools are chalky white.

HOW CAN I CHECK!?!

● It is very easy!
 ● Gently press on the tip of the baby’s nose or the forehead. If the skin turns white – there
is no jaundice.
● If the skin turns yellow – this may indicate jaundice.
● Drs will do blood tests to check levels of bilirubin.
HOW WILL YOU TREAT IT?!
● Treatment usually isn’t needed if the baby develops jaundice in the first week. Your GP
will monitor your baby by doing blood tests and the jaundice usually disappears after 2
weeks.
● We would advise you to keep breast feeding regularly. If the jaundice doesn’t improve
we can treat it.
● The first way is through phototherapy which involves shining a light onto your baby –
○ the light changes the molecule from a fat soluble substance to a water soluble
substance which is easily excreted by the liver.
○ This will remove bilirubin from the blood.
○ The aim of this is to expose as much light onto the baby’s skin as possible.
○ We will give them protective eyewear to prevent eye damage.
○ Some mothers will find it distressing as they just want to bond particularly in the
early few days.
○ Phototherapy is stopped for 30 minutes every few hours for feeding.
○ The amount of bilirubin in the blood is tested every 4‐6 hrs.
● In more complex cases the treatment can be something called exchange transfusion
where we replace the full volume of blood twice.
Do ICE, CHUNK N CHECK ETC ETC.