Many newborns have a yellow color to their skin and eyes. This is called jaundice. Jaundice represents the accumulation of a chemical called bilirubin in the blood.
Why Does Jaundice Occur?
We all have bilirubin in our blood. Bilirubin is removed from the blood by our liver. Before a baby is born, the mother’s liver removes the bilirubin for the baby. After the baby is born, the baby’s liver has to take over. Most babies develop jaundice within the first few days after birth because it takes some time for the baby’s liver to become good at removing bilirubin.
More about Bilirubin
There are two types of bilirubin: indirect and direct bilirubin. A simple blood test can determine the total bilirubin and the direct bilirubin level. Therefore, the indirect bilirubin level can easily be calculated by knowing these two values. Ask your baby’s doctor to check a bilirubin level. Make sure they determine the indirect and direct bilirubin values and not just the total bilirubin.
Should I Be Concerned If My Baby Is Yellow?
Most babies with jaundice have elevated indirect bilirubin. Based on the indirect bilirubin level, your baby’s doctor may recommend using special bilirubin lights at home or in the hospital to help bring down the level of indirect bilirubin and eliminate the jaundice. Treatment is important because extremely high levels of indirect bilirubin can lead to brain damage.
Some babies have high levels of direct bilirubin. Any abnormal level of direct bilirubin should be taken seriously and further investigated, even if your baby does not look yellow. Elevated direct bilirubin indicates injury to the liver. Determining if there is injury to your baby’s liver can lead to early treatment and hopefully prevent liver transplantation. The most common cause of liver transplant in babies is biliary atresia.
What Is Biliary Atresia?
Biliary atresia is a chronic inflammatory process that affects the liver and leads to destruction of the bile ducts. This gradually leads to loss of liver function, and children usually do not survive past two years of age without a liver transplantation. However, with early detection and diagnosis of biliary atresia, babies can have an operation called a Kasai procedure. With a successful Kasai procedure, the jaundice disappears and the bilirubin levels return to normal. The earlier the Kasai procedure, the better the outcome.
Common Signs of Biliary Atresia
- Yellow skin or eyes
- Pale or white stools
- Dark or tea colored urine
Most babies with biliary atresia are born full term and of normal weight. Click here to read about what happened to one baby who was diagnosed with biliary atresia and to learn what to ask your baby’s doctor and what to look for!