Jaundice in Newborns Was Fairly Common

Jaundice in breastfed newborns may occur even a month after birth

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Hospital employees usually watch for jaundice, a yellowing of the skin and eyes, in newborns. Recent research suggests many newborns have this condition.

In mostly breastfed babies, jaundice occurred in 20 to 30 percent of newborns, a recent study found.

Jaundice is a condition caused by a baby having excess bilirubin in its body. Bilirubin forms when red blood cells break down. Normally, the body just absorbs bilirubin, but newborns' bodies cannot always do that right away.

"Tell your pediatrician about yellowing in your newborn's skin."

The study, conducted by M. Jeffrey Maisels, MB, DSc, of the Department of Pediatrics in Beaumont Children’s Hospital in Royal Oak, Michigan, and colleagues, looked at how common jaundice is in breastfed babies.

To learn how common jaundice is among newborns, the researchers measured the skin bilirubin levels of 1,044 babies during their first month.

The babies were mostly breastfed and were born at least 35 weeks or more into their mothers' pregnancies.

Higher levels of skin bilirubin put a baby at risk for jaundice.

Researchers found that 43 percent of the babies had bilirubin levels of at least 5 milligrams per deciliter when they were about 3 weeks old. About a third (34 percent) of the babies were officially diagnosed as having jaundice.

When the babies were about a month old, 34 percent had bilirubin levels of at least 5 milligrams per deciliter, and 21 percent had jaundice.

The authors of this study noted that bilirubin levels and levels of jaundice did not match perfectly, but the two did correlate.

The researchers concluded that it was normal for anywhere from one in five to one in three primarily breastfed babies to have jaundice.

It is also normal, the researchers noted, for 30 to 40 percent of these babies to have bilirubin levels at or above 5 milligrams per deciliter.

This knowledge, they wrote, "should be of practical value to practitioners who care for newborns and reassuring to the parents of infants who are still jaundiced at age four weeks."

Thomas Seman, MD, a pediatrician at North Shore Pediatrics in Danvers, Mass., said it is common to see jaundice in primarily breastfed babies even up to four to six weeks after birth.

"Initially it is an issue of mild dehydration as the child does not get enough fluid for the first three days after birth until the mother's breast milk starts coming in," Dr. Seman said. "Once her milk is in, there is usually a fairly rapid drop in the perceivable jaundice of the child."

Although bilirubin levels and jaundice may be present over the first month and a half of life, Dr. Seman said it should start declining after its peak.

"Further, the parent should notice that the stools are the appropriately yellow as well since the yellow in the bowel movements and urine is the bilirubin that the baby is trying to eliminate," he said.

"Should the stool stay dark green or clay-colored – either the red clay or the white/grey modeling clay – then the pediatrician should be notified," Dr. Seman said. "This could be a sign that the infant's liver is having a difficult time."

The study was published July 21 in the journal Pediatrics. The research did not use external funding.

One author has consulted for Draeger Medical, Inc. No other authors reported possible conflicts of interest.

Review Date: 
July 21, 2014
Last Updated:
August 2, 2014