Many normal, healthy infants develop a yellowish tinge to their skin in the first days of life. This condition, called "physiologic jaundice", is a sign that the blood contains an excess of bilirubin, a chemical formed during the normal breakdown of old red blood cells. Everyone's blood contains small amounts of bilirubin, but newborns tend to have higher levels because they have extra red blood cells at birth and their immature livers have trouble processing the additional bilirubin that exists.
As bilirubin levels rise above normal, the jaundice will appear first on the face, then on the chest and abdomen, and finally on the legs. Typically, after worsening for a few days the jaundice will subside without treatment. If the bilirubin level is extremely high and does not decline, there's risk to the nervous system. Your doctor will order blood tests to determine the cause and may recommend treatment with phototherapy.
As newborns are going home soon after birth, the parent must be involved with observations about the degree of jaundice. The amount of jaundice (yellow color) is best judged by viewing your baby unclothed in natural light by a window. Check for yellow skin by pressing on it with your finger, then assessing the underlying color before the pink color returns.
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- Jaundice is noticed during the first 48 hours of life.
- The jaundice involves the arms or legs.
- Your baby develops a fever over 100° F rectally.
- Your baby also starts to look or act sick.
DURING REGULAR HOURS if:
- The color gets deeper after day 7.
- The jaundice is not gone by day 14.
- Your baby is not gaining weight well.
- You are concerned about the amount of jaundice.