New guidelines on newborn jaundice:

Most newborn babies turn at least a little bit yellow. Known as jaundice, this condition is a very common and usually normal part of the newborn period. But in some very rare cases it can lead to, or be a sign of, a more serious problem. That’s why parents need to know about it.

What causes jaundice?

The yellow color of newborn jaundice is caused by high levels of a substance called bilirubin in the blood. Bilirubin mostly comes from the breakdown of red blood cells. It gets processed in the liver to make it easier for the body to get rid of through the urine and stool.

Newborn livers need some time to get up and running when it comes to getting rid of bilirubin. Newborns also have more red cells than older children and adults, and those brand-new red cells don’t last as long as red cells made as babies grow older. The combination of these two factors is what makes jaundice so common.

What do the new guidelines recommend?

The new guidelines stress the importance of preventing and assessing jaundice. Doctors and parents can work together to

  • Make sure that the mother’s blood type and antibodies have been checked. If there is a concern, the baby should be checked, too.
  • Assess all possible risks for jaundice: not just the mother’s blood type but also gestational age, family history, any bruising, how early jaundice appears, and other factors.
  • Use a device to check bilirubin level at 24 to 48 hours of life, or sooner if a newborn looks jaundiced or is going home earlier.
  • Make sure mothers get good support with feeding. When babies don’t get enough to eat in the first three to five days of life, they have a higher risk of getting jaundice.
  • Set up a follow-up appointment with the baby’s doctor. The best timing for this depends on bilirubin level and risk factors. Parents, it’s important to follow these instructions!

How is newborn jaundice treated?

The most common treatment is phototherapy. The baby is put under a special light (or wrapped in a special blanket with the light inside it) that helps the body get rid of bilirubin. This is safe and effective. When bilirubin levels are extremely high and there is concern for the possibility of brain damage, therapies such as exchange transfusion, where blood is taken out and new blood put back in, are necessary. However, this is extremely rare.

Feeding is an important part of therapy as well, because it helps the body get rid of bilirubin through the blood and urine. Feeding a newborn frequently also helps prevent problems with jaundice. Babies should wet at least six diapers over a 24-hour period, and should have stools regularly. The stool should change from the normal newborn black, tarry stools to stools that are lighter in color, looser, and “seedy.”

What else do parents need to know about newborn jaundice?

Before going home, you should receive written information about jaundice, information about your baby’s bilirubin level and other lab tests, and clear instructions about when the baby should see the pediatrician.

It’s important to keep an eye on your baby’s jaundice after you go home from the hospital. Jaundice can be harder to see in dark-skinned babies. A good way to look for it is to press down for a moment on the baby’s skin in a spot where the bone is close (the forehead, nose, chest, or shin are good places to do this). This pushes out the blood briefly and should make the skin paler for a few seconds. If it looks yellow instead of pale, there may be jaundice.

Jaundice tends to spread from the face downward as bilirubin levels go up. For that reason, doctors worry far less about a baby who is yellow just in the face and upper chest than one who is yellow below the knees.

Call the doctor if your baby:

  • is looking more yellow, especially if it is spreading down below the knees
  • is feeding poorly, and/or isn’t wetting at least six diapers in 24 hours and having regular stools
  • is very sleepy, especially if they don’t wake to feed
  • is very fussy and hard to console
  • arches their head or back, or is otherwise acting strangely
  • has a fever or is vomiting frequently.

Remember: jaundice is common, and serious problems are rare! But call your doctor if you are worried; it’s always better to be safe than sorry.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Suppose you find fifty righteous people living there in the city—will you still sweep it away and not spare it for their sakes? (Genesis 18:24) And the Lord replied, “If I find fifty righteous people in Sodom, I will spare the entire city for their sake.” (Genesis 18:26)

And be sure to say, ‘Look, your servant Jacob is right behind us.’” Jacob thought, “I will try to appease him by sending gifts ahead of me. When I see him in person, perhaps he will be friendly to me.” (Genesis 32:20)
to say to you: ‘Please forgive your brothers for the great wrong they did to you—for their sin in treating you so cruelly.’ So we, the servants of the God of your father, beg you to forgive our sin.” When Joseph received the message, he broke down and wept. (Genesis 50:17)

“Forgive my sin, just this once, and plead with the Lord your God to take away this death from me.” (Exodus 10:17)
Pay close attention to him, and obey his instructions. Do not rebel against him, for he is my representative, and he will not forgive your rebellion. (Exodus 23:21)

Moses Intercedes for Israel The next day Moses said to the people, “You have committed a terrible sin, but I will go back up to the Lord on the mountain. Perhaps I will be able to obtain forgiveness for your sin.” (Exodus 32:30) So Moses returned to the Lord and said, “Oh, what a terrible sin these people have committed. They have made gods of gold for themselves. (Exodus 32:31) But now, if you will only forgive their sin—but if not, erase my name from the record you have written!” (Exodus 32:32)

The Lord passed in front of Moses, calling out, “Yahweh! The Lord! The God of compassion and mercy! I am slow to anger and filled with unfailing love and faithfulness. (Exodus 34:6) I lavish unfailing love to a thousand generations. I forgive iniquity, rebellion, and sin. But I do not excuse the guilty. I lay the sins of the parents upon their children and grandchildren; the entire family is affected— even children in the third and fourth generations.” (Exodus 34:7)

And he said, “O Lord, if it is true that I have found favor with you, then please travel with us. Yes, this is a stubborn and rebellious people, but please forgive our iniquity and our sins. Claim us as your own special possession.” (Exodus 34:9)
just as he does with the bull offered as a sin offering for the high priest. Through this process, the priest will purify the people, making them right with the Lord, and they will be forgiven. (Leviticus 4:20) Then he must burn all the goat’s fat on the altar, just as he does with the peace offering. Through this process, the priest will purify the leader from his sin, making him right with the Lord, and he will be forgiven. (Leviticus 4:26)

Then he must remove all the goat’s fat, just as he does with the fat of the peace offering. He will burn the fat on the altar, and it will be a pleasing aroma to the Lord. Through this process, the priest will purify the people, making them right with the Lord, and they will be forgiven. (Leviticus 4:31) Then he must remove all the sheep’s fat, just as he does with the fat of a sheep presented as a peace offering. He will burn the fat on the altar on top of the special gifts presented to the Lord. Through this process, the priest will purify the people from their sin, making them right with the Lord, and they will be forgiven. (Leviticus 4:35)

The priest will then prepare the second bird as a burnt offering, following all the procedures that have been prescribed. Through this process the priest will purify you from your sin, making you right with the Lord, and you will be forgiven. (Leviticus 5:10) Through this process, the priest will purify those who are guilty of any of these sins, making them right with the Lord, and they will be forgiven. The rest of the flour will belong to the priest, just as with the grain offering.” (Leviticus 5:13)

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