Jaundice, another word for “yellow,” is very common in newborns. The term “jaundice” refers to the yellow color of the skin and whites of the eyes due to excess bilirubin. Bilirubin is produced by the normal breakdown of red blood cells and usually passes through the liver before it is excreted.

When bilirubin builds up faster than a newborn’s liver can break it down and pass it, the baby becomes jaundiced. Jaundice is usually not harmful, but if it is severe it can cause brain damage. 

Vicki Kruse, RNC, is a patient care supervisor in the Family Birth Center at Wheaton Franciscan – St. Joseph Campus. She frequently works with parents of babies with jaundice, and is very familiar with educating moms and dads about the phototherapy treatment procedures. She provides the following information for anyone with questions.

In the hospital after birth, your nurse and your newborn’s doctor will watch baby’s skin color; the nurse will perform a painless skin test on your newborn’s forehead at about 24-36 hours of age. A special light meter will measure how jaundiced baby is. If the value is normal, the nurse and doctor will continue to watch. If the value is high, the nurse will order a blood test.  Depending on the results, the doctor may continue to monitor your baby, or he may recommend treatment.

Monitoring for jaundice may include additional blood tests and frequent feedings that help baby pass the jaundice through stool and urine.  If the doctor decides to treat for jaundice, this may include blood tests, frequent feedings, and phototherapy.

Phototherapy is the use of a special light that helps baby break down the jaundice to pass it. There are two types of phototherapy lights. One is called a “Bili blanket.”  The Bili blanket is a soft, flat rectangular light that is placed between baby and his clothing. The newborn may need to have eye covers, depending on the strength of the light. Baby can be fed, held, changed, or sleep in the crib with the Bili blanket on.

The other type of phototherapy is called “high intensity light.” Baby is undressed, except for a diaper and eye covers that protect the eyes; she is then placed in an isolette to keep warm. The high intensity lights are placed over the isolette and directed at baby like a spot light. These lights are kept on her except for feedings, when she is taken out of the isolette to be dressed and remove the eye coverings. Every eight hours, the nursing staff will wash baby’s eyes with normal saline.

Sometimes the doctor will treat a baby with the Bili blanket and the high intensity lights at the same time.  With each treatment option, the nursing staff will set up and check the Bili blanket, isolette, and high intensity lights. They will also teach the parents how to care for their newborn with jaundice and answer any questions.

After discharge, the doctor may wish to see baby in a day or two for blood tests and/or to check skin color. The doctor may recommend placing baby by a sunny window at home, since natural sunlight helps newborns get rid of jaundice. Some babies will also go home with a Bili blanket, which will be used until the doctor discontinues it. The majority of babies recover very nicely from jaundice.