Jaundice is a condition experienced to some degree by most newborns due an immature liver's inability to filter bilirubin. The byproduct of broken down red blood cells, increased bilirubin is common in newborn babies and generally does not require treatment. Symptoms of jaundice are easily recognized and all newborns are evaluated for jaundice by their pediatricians during their first days of life.
Yellow Skin and Eyes
The most common symptom of jaundice is yellowing of the skin as well as the whites of the eyes. As bilirubin accumulates in the blood, instead of being eliminated in the stool, a yellowish tint appears on the skin and eyes. According to the Mayo Clinic, skin yellowing is detected by pressing a finger to the baby's forehead or nose. Skin is examined after the finger is quickly removed. Normally the skin would appear as simply lighter than normal. When jaundice is present, the skin will appear yellow when pressed. The yellow tint may begin on the head and face, and then move gradually down the body. Dark complexions can make detecting a yellow hue more difficult than a lighter complexion.
Sleepiness
Newborns with jaundice, particularly those with higher bilirubin levels, are often sleepy and difficult to fully awaken. Newborns already sleep 16 or more hours a day. Those with jaundice may have trouble waking up to eat, and must be woken by parents. According to the American Pregnancy Association, sleeping through a feeding can worsen jaundice, as the lack of food will result in decreased bowel movements. Parents may need to undress the baby, rub the bottom of his feet or turn on bright lights to help wake a baby in order to have a successful feeding.
Elevated Bilirubin Levels
When bilirubin isn't excreted in the stool, it builds up in the blood. This accumulation is known as hyperbilirubinemia and causes skin to appear yellow. Some pediatricians routinely check bilirubin levels on all newborns, while others employ the wait and see approach. The American Academy of Family Physicians defines hyperbilirubinemia as a bilirubin level above 5mg/dL. Dr. Alan Greene reports that a level of 5mg/dL causes the face to turn yellow, a level of 15mg/dL yellows the abdomen as well, and 20mg/dL even turns the soles of the feet yellow. Treatment is determined by the bilirubin level as well as the number of days since birth.
