Diagnosis
If your newborn appears jaundiced in the hospital, the nurse or doctor may do a jaundice screen with a device applied to the skin (transcutaneous bilirubinometer), and confirm the bilirubin level by a blood test from a heel prick.
Based on your newborn's age and level of bilirubin, the doctor will advise you on what to do. Phototherapy may be needed in a small proportion of newborns before discharge or you will be advised to bring your baby to the doctor within 24 - 72 hours after discharge to review your baby's jaundice and feeding pattern.
Please bring your newborn to the doctor if:
- Your baby develops jaundice during the first 48 hours of life, if the level of jaundice increases rapidly to involve the lower tummy and legs, or jaundice is still present after day 14 of life
- You have difficulty with breastfeeding, and baby does not pass adequate amount of stool and urine, and appears more jaundiced.
- Your baby's stools turn cream-beige or chalky-white or if the urine is dark (tea-coloured), and baby continues to have jaundice after day 14 of life.
Treatment
Blue-light phototherapy is used to treat jaundice in the hospital. Your baby will be kept undressed under the phototherapy lights for about 24 hours, and taken out for feeding and change of diapers. Blue light can be given using an overhead bank of lights, or via a blanket-like device. Each has its own advantages.
During phototherapy, some babies may need supplemental fluids if recommended by the doctor. Generally, you can continue to breastfeed. If you are separated from your baby during this period, remember to continue expressing your breast milk 6 to 8 times every 24 hours to maintain your milk supply and prevent engorgement.
In the minority of cases where bilirubin levels increase rapidly to very high levels, a blood exchange therapy is performed to lower bilirubin levels in the hope of preventing brain damage.
Giving water or glucose feeds will not lower the jaundice. Sunlight does not effectively reduce the jaundice. No oral or tropical medicine is available to decrease the jaundice. Since bilirubin is excreted from the body in the stools, breastfeed your baby frequently to encourage frequent bowel movement.