JAUNDICE

Jaundice refers to a yellow tint of the skin usually due to liver immaturity in newborns or due to liver disease in older children. In these conditions, a bile pigment called bilirubin accumulates in the blood stream and is deposited in the skin. 

Bilirubin is the breakdown product of hemoglobin which is contained in red blood cells of the body that carries oxygen to the body. It is the liver’s job to rid the body of this bilirubin (broken down hemoglobin). 

Newborn Jaundice:

The liver of a newborn infant may not be mature enough to efficiently rid the body of all the bilirubin that it routinely makes as it recycles old red bloods cells containing hemoglobin. Hence, bilirubin accumulates and the child can become jaundiced. Accumulated bilirubin in the skin has a yellow color.

Usually by five to seven days of life, an infant’s liver is mature enough to take care of the bilirubin load that the liver creates. 

Most newborn babies usually develop some degree of newborn jaundice, which is a little more pronounced in breast fed babies. We do blood tests to check infants who develop jaundice on the arms, legs and feet during the first 2 to 7 days of life. We also do blood tests to check infants whose jaundice lasts more than ten days in breast fed babies.

Babies who develop significant jaundice (yellow color of the skin) should have a blood test to check their bilirubin level with 24 hours of becoming jaundiced (developing a yellow tint to the skin and the whites of the eyes). Prolonged unmanaged jaundice can do significant damage to the brain. So, make sure and get this problem checked within 24 hours of noting it.

The problem that significant jaundice presents is that it can cause brain damage in infants if the bilirubin level is too high. Low to moderate levels of bilirubin do no harm and will eventually go down as the liver matures.

The bilirubin level is checked in our office with a blood test. You must make an appointment at our office to get this test done. If your child becomes jaundiced on a Saturday afternoon after our clinic is closed, call the online after hours call number listed in the front of this handbook and have our on call physician arrange a test at Baptist Health Medical Center in Little Rock. You should not let more than 24 hours pass in a child with jaundice without checking the level.

Jaundice in an older child:

Jaundice that develops after the newborn period can be due to liver disease. All such children who develop jaundice should have a routine office visit to check this.

Sometimes, children who eat a lot of yellow vegetables (carrots and squash) develop a yellow tint to their skin, but not in the whites of the eyes. This is known as carotinemia and is not true jaundice. It is harmless and requires no treatment. We generally advise children who have carotinemia to eat less yellow vegetables.