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Breastfeeding and Newborn Jaundice

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Before baby was born, he or she was in the uterus and received nourishment and oxygen from mom. The oxygen passed from mom’s red blood cells to baby’s red blood cells. The uterus is a low-oxygen environment, so baby made extra red blood cells in order to get enough oxygen. People who move to mountain areas, where the oxygen is also low, make extra red blood cells to get enough oxygen.

Once he is born, baby doesn’t need those extra red blood cells and his body starts to break them down. Hemoglobin, the part of the red blood cell that carries oxygen, is released into the circulation outside the red cells. The liver breaks down hemoglobin to a number of products, one of which is bilirubin, a bright yellow pigment. Most of it travels tightly held by a protein in blood. A little bit is free in the blood.

The liver normally turns bilirubin into bile and secretes the bile into the digestive system. Some of it may be processed there and reabsorbed. Most passes from the body in the form of a bowel movement. The liver of a newborn doesn’t yet have the capacity to do this quickly. Bilirubin may build up in the blood, causing the typical symptom of jaundice: baby looks yellow. In fact jaundice comes from jaune the French word for yellow.

There are some additional factors that can make this worse that include parents and babies’ blood types, or some medical problems. Health care providers screen for these if baby looks yellow. Usually baby just has the “normal” jaundice of the newborn.

It is common for new babies to experience neonatal jaundice (newborn jaundice) for a short time. Most newborns have an increase in bilirubin after they are born; about 50% actually looked jaundiced. For most babies, jaundice is mild and goes away by itself. Sometimes it is more severe and needs treatment with special lights. A very high bilirubin can be dangerous. Fortunately, the light or phototherapy is very effective.

Things to do for mild jaundice:

  • Nurse frequently, every two to three hours around the clock. Breastmilk helps baby pass bowel movements and clear the bilirubin.
  • Wake up baby well before feeding. This may be hard as jaundice makes baby sleepy.
  • Undress baby to diaper.
  • Change diaper.
  • Stimulate feet, up and down spine, head.
  • Place cool cloth to forehead.
  • Rock baby from lying to sitting position until eyes open.
  • Make sure baby is getting milk. Watch for large jaw movements, a pause to swallow and a soft swallowing click.
  • Placing baby in sunlight is not effective.
  • In general, jaundice will clear from the feet and hands first. The face and head tend to look yellow longest.

When to seek help

  • difficulty breastfeeding
  • baby is lethargic or very sleepy at the breast
  • baby’s trunk appears yellow
  • decrease in urine output and stools