You should see your GP or midwife if your baby develops jaundice. They will be able to assess whether it needs to be treated.
If your baby develops jaundice within the first week of life, treatment is not usually necessary as long as your baby is healthy. Your GP or midwife may monitor your baby by measuring the level of bilirubin in their blood.
If you are breastfeeding, you should continue to breastfeed your baby regularly, waking them up for feeds if necessary.
Jaundice usually disappears after 10 to 14 days, but it may last up to three weeks in premature babies (babies born before the 37th week of the pregnancy). In babies who are breastfed, 1 in 10 will still have jaundice when they are one month old.
See your GP if:
- your baby’s jaundice does not disappear after two weeks
- the jaundice does not start until seven days after they are born
- your baby’s faeces (stools) are chalky white
If your baby’s jaundice does not improve, or it is severe, they may be admitted to hospital and treated with:
- phototherapy
- an exchange transfusion
Phototherapy
Phototherapy is treatment with light. Phototherapy lowers the bilirubin levels in your baby’s blood by photo-oxidation. Oxidation is the process of adding oxygen to change a substance (in this case, the bilirubin).
The photo-oxidation converts the bilirubin into a substance that dissolves easily in water. This makes it easier for your baby’s liver to break down and remove the bilirubin from their blood.
There are two types of phototherapy.
- Conventional phototherapy, where your baby is placed under a halogen or fluorescent lamp with their eyes covered to prevent damage to eyes.
- Fibreoptic phototherapy, where your baby lies on a blanket that incorporates fibreoptic cables. Light travels through the fibreoptic cables and shines onto your baby’s back.
In both methods of phototherapy, the aim is to expose your baby’s skin to as much light as possible.
In most cases, conventional phototherapy is the first choice for treatment. However, if your baby was born prematurely, fibreoptic phototherapy may be used first.
If possible, the phototherapy will be stopped for 30 minutes every three to four hours so that you can feed your baby, change their nappy and give them a hug.
In more severe cases, phototherapy will not be stopped. Instead, your baby will be fed with a tube intravenously (through a vein) or orally (through their mouth).
The bilirubin levels will be tested every four to six hours after phototherapy has started. Once levels start to fall, they will be checked every 6-12 hours.
Phototherapy will be stopped when the bilirubin level is at a safe level. Most courses of phototherapy take around 1-2 days to complete.
Side effects of phototherapy
It is possible for your baby to become dehydrated (when the normal water content of their body is reduced) during phototherapy.
As your baby’s body expels the bilirubin, more water is lost through their skin, and more urine is produced.
Your baby may need to have intravenous hydration (where water is given into a vein) if they are not able to drink a sufficient amount.
Exchange transfusion
A blood transfusion, known as an exchange transfusion, will be considered if:
- your baby has, or is at risk of, high levels of bilirubin in the blood (hyperbilirubinaemia)
- your baby has hyperbilirubinaemia and phototherapy has not worked
Exchange transfusions have been used since the 1950s and are very effective. The transfusion normally takes place through a(a tube that is inserted into a vein.
During an exchange transfusion, some of your baby’s blood will be removed and replaced with blood from a suitable, matching donor (someone with the same blood group). As the new blood will not contain bilirubin, the overall level of bilirubin in your baby’s blood will fall.
Throughout the process, your baby will be monitored and any complications that arise will be treated.
Other treatments
If jaundice is caused by something else, such as an infection, this will usually be treated with medication or surgery.
If the jaundice is caused by Rhesus disease (when the mother has rhesus-negative blood and the baby has rhesus-positive blood), intravenous immunoglobulin (IVIG) may be used.
The immunoglobulin is a solution of antibodies (proteins produced by the body to destroy disease-carrying organisms) from healthy donors. It is injected into a vein (intravenous).
IVIG will only be used if phototherapy alone has not worked, and the level of bilirubin in the blood is continuing to rise.
