Treating jaundice in newborn babies

You should speak toyour midwife, health visitor or GP if your baby develops jaundice. They'll be able to assess whether treatment is needed.

Treatment is usually only necessary if your baby has high levels of a substance called bilirubin in their blood, so tests need to be carried out to check this. See diagnosing jaundice in babies for more information about the tests used.

Most babies with jaundice don't need treatment because the level of bilirubin in their blood is found to be low. In these cases, thecondition usually gets betterwithin 10 to 14 days and won't cause any harm to your baby.

If treatment is felt to be unnecessary, you should continue to breastfeed or bottle feed your baby regularly, waking them up for feeds if necessary.If your baby'scondition gets worse or doesn't disappear after two weeks, contact your midwife, health visitor or GP.

Prolonged newborn jaundice (lasting longer than two weeks) can occur if your baby was born prematurely orif he or she is solely breastfed. It usually improves without treatment. However, further tests may be recommended if the condition lasts this longto check for any underlying health problems.

If your baby's jaundice doesn't improve over time ortests show high levels of bilirubin in their blood, they may be admitted to hospital and treated with phototherapy or an exchange transfusion.

These treatments are recommendedto reduce the risk of a rare but serious complication of jaundice calledkernicterus, which can cause brain damage.

See complications of jaundice in babies for more information about kernicterus.

Phototherapy

Phototherapy is treatment with light.It is usedin some cases of newborn jaundice tolower the bilirubin levels in your baby's blood through a process called photo-oxidation.

Photo-oxidation adds oxygen to the bilirubin so it dissolves easily in water. This makes it easier for your baby's liver to break down and remove the bilirubin from their blood.

There are two main types of phototherapy.

  • conventional phototherapy where your baby is laid under a halogen or fluorescent lamp with their eyes covered
  • fibreoptic phototherapy where your baby lies on a blanket that incorporates fibreoptic cables; light travels through the fibreoptic cables and shines on to your baby's back

In both methods of phototherapy, the aim is to expose your baby's skin to as much light as possible.

Conventional phototherapy is the treatment tried first in most cases, although fibreoptic phototherapy may be used first if your baby was born prematurely.

These types of phototherapy will usually be stopped for 30 minutes everythree to four hours so you can feed your baby, change their nappy, and give them a hug.

If your baby's jaundice doesn't improve after conventional or fibreoptic phototherapy,continuous multiple phototherapy may be offered.This involves using more than one light and often a fibreoptic blanket at the same time.

Treatment won't be stopped duringcontinuous multiple phototherapy. Instead, milk that has been squeezed out of your breasts in advance may be given through a tube into your baby's stomach, or fluids may begiven into one of theirveins (intravenously).

During phototherapy, you baby's temperature will be monitored to ensure they're not getting too hot and they'll be checked for signs of dehydration.Your baby may need intravenousfluids if they're becoming dehydrated and aren't able to drink a sufficient amount.

The bilirubin levels will be tested everyfour to six hours after phototherapy has started. Oncelevels start to fall, they'll be checked everysix to 12 hours.

Phototherapy will be stopped when the bilirubin level falls to a safe level, whichusually takesaday or two.

Phototherapy is generally very effectivefor newborn jaundice andhas very few side effects, although your babymay develop a temporary rash or tan as a result of the treatment.

Exchange transfusion

A Blood transfusion , known as an exchange transfusion, may be recommended if your baby has particularly high levels of bilirubin in their blood or if phototherapy hasn't been effective.

During an exchange transfusion, small amounts of your baby's blood are removed through a thin plastic tube placed into blood vessels in their umbilical cord, arms or legs. The blood is then replaced with blood from a suitable matching donor (someone with the same blood group).

As the new blood won't contain bilirubin, the overall level of bilirubin in your baby's blood will fallquickly.

Your baby will be monitored throughout the transfusion process, which can take several hours to complete. Any problems that may arise, such as bleeding, will be treated.

Your baby's blood will be tested within two hours of treatment to check if it's been successful. If the level of bilirubin in your baby's blood remains high, the procedure may need to be repeated.

Other treatments

If jaundice is caused by an underlying health problem, such as an infection, this usually needs to be treated.

If the jaundice is caused by rhesus disease (when the mother has rhesus-negative blood and the baby has rhesus-positive blood), intravenous immunoglobulin (IVIG) may be used.

IVIG is usually only used if phototherapy alone hasn't worked and the level of bilirubin in the blood is continuing to rise.

Learn more about IVIG treatment for rhesus disease .

Antibodies
Antibodies are your body's natural defence against any foreign antigens that enter your blood. An antibody is a protein that is produced by the body to neutralise or destroy disease-carrying organisms and toxins.
Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Liver
The liver is the largest organ in the body. Its main jobs are to secrete bile (to help digestion), detoxify the blood and change food into energy.
Oxygen
Oxygen is an odourless, colourless gas that makes up about 20% of the air we breathe.
Retina
The retina is the nerve tissue lining the back of the eye, which senses light and colour, and sends it to the brain as electrical impulses.
Content supplied by the NHS Website

Medically Reviewed by a doctor on 24 Nov 2016