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Jaundice Care Plan

Jaundice

 

Definition:  Jaundice is a yellow color in the skin.  It is a common condition, affecting more than half of newborns, that is usually harmless and goes away quickly.

 

Signs and symptoms: 

·        Baby’s skin and/or whites of the eyes become yellow.

·        Jaundice usually begins in the face and then moves to the chest and belly, then legs and arms.

·        Excessive sleepiness can sometimes be a symptom of jaundice.

 

Causes: 

·        All babies are born with extra red blood cells and when the baby’s liver begins to break them down, a yellow pigment called bilirubin is produced. 

·        Bilirubin seeps from the baby’s blood and into her skin.  The amount of bilirubin in the blood can be determined with a blood sample from your baby’s heel.

·        Jaundice leaves your baby’s body in the poop, so effective breastfeeding will help get rid of jaundice.  Ineffective breastfeeding, caused by poor latch or sleepy or infrequent feedings, can result in a higher bilirubin level in your baby’s blood.  See ‘Breastfeeding as a treatment for jaundice’ below.

·        Other risk factors for jaundice in your baby are premature birth (more than 2 weeks), illness, rapidly rising bilirubin levels, or excessive bruising.

 

Treatments:

·        Jaundice treatments are different depending on how many days old your baby is and how high the bilirubin blood level is.

·        Three to five days of age is the normal time for a newborn to have jaundice.  If the bilirubin levels stay below 15 mg/dL, and your baby doesn’t have any other medical conditions, the jaundice is considered harmless.  Bilirubin levels should peak at this time and then go down if baby is feeding well.

·        If bilirubin levels are above 17- 20 mg/dL or your baby has other risk factors, the jaundice will need to be treated with phototherapy.  This is a special light therapy.  When these lights are shined on your baby’s skin, it helps break down the bilirubin faster, which helps the jaundice go away faster.

·        Phototherapy is ordered by your baby’s doctor and could be a special blanket with the lights built in that you would use at home, or a larger set of lights at the hospital that the baby lies under

 

.·          Placing your baby in indirect sunlight, offering water in a bottle, or replacing breastmilk with formula to treat jaundice are practices now discouraged by the American Academy of Pediatrics.  Please share the information in this web link with your healthcare provider.  http://aappolicy.aappublications.org/cgi/reprint/pediatrics;114/1/297.pdf

·          If your healthcare provider advises that you stop breastfeeding for a time and offer formula instead, please refer to pumping and supplementing suggestions below.

·          If baby seems too sleepy to nurse effectively, please refer to pumping suggestions below.

 

Breastfeeding as a treatment for jaundice:

·        Breastfeeding your baby or offering your baby expressed breast milk 8-10 x/day helps to eliminate bilirubin in the pees and poops (green stools are common during this time).

·        If your baby is not able to nurse effectively (not latching well, not swallowing at the breast, not alert for feeds, and not having wet and dirty diapers), it may be necessary to express breastmilk for your baby.  This will protect your milk supply as well as aid the baby’s efforts to eliminate bilirubin.

·        If you need to express breastmilk for the baby, a hospital grade breastpump is needed.  These pumps are strong, effective, and comfortable enough to replace the baby at the breast for as long as necessary to treat jaundice and transition baby back to the breast.  Hospital grade pumps cost $1000 or more and are that much better than retail pumps that you would buy in a store.  Renting a hospital grade breastpump for the 1st 30 days of baby’s life is a good idea for many families, especially first time breastfeeding families.  Please refer to our local resources page for information regarding how to rent a hospital grade breastpump.

 

Copyright: Chasta Hite, RN, IBCLC, RLC, Gloria Dudney, RN, IBCLC, RLC, Ann Perry, RN, IBCLC, RLC

Updated June 11, 2010