More About Jaundice

Hyperbilirubinemia happens when there is too much bilirubin in your baby’s blood.

Bilirubin is made by the breakdown of red blood cells. It’s hard for babies to get rid of bilirubin at first. It can build up in their blood, tissues, and fluids.

Bilirubin has a color. It makes a baby’s skin, eyes, and other tissues turn yellow (jaundice). Jaundice may first appear when your baby is born. Or it may also show up any time after birth.

High levels of bilirubin can travel to your baby’s brain. This can cause seizures and brain damage. This is called kernicterus.

The timing of when your child’s jaundice first starts matters. It may help his or her healthcare provider make a diagnosis.

  • First 24 hours. This type of jaundice is often serious. Your child will likely need treatment right away.
  • Second or third day. This is often physiologic jaundice. Sometimes it can be a more serious type of jaundice. It's important to be sure the baby is getting enough milk at this point.
  • Toward the end of the first week. This type of jaundice may be from breastmilk jaundice but may be due to an infection or other rare serious problems.
  • In the second week. This is often caused by breastmilk jaundice but may be caused by rare liver problems.

Your child’s healthcare provider may do the following tests to confirm the diagnosis:

  • Direct and indirect bilirubin levels. These levels show if bilirubin is bound with other substances by your child’s liver. Normal physiologic jaundice involves indirect bilirubin. Jaundice due to more serious problems can have high levels of either type of bilirubin.
  • Red blood cell counts
  • Blood type and testing for Rh incompatibility (Coomb's test)

Symptoms can occur a bit differently in each child. They can include:

  • Yellowing of your baby’s skin and the whites of his or her eyes. This often starts on a baby’s face and moves down his or her body.
  • Poor feeding
  • Lack of energy

The symptoms of this health problem may be similar to symptoms of other conditions. Make sure your child sees a healthcare provider for a diagnosis.