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There is a common misconception that jaundice isn’t a severe condition and that eventually, it will clear up on its own. While that may be true in some instances, in other cases a severe case of jaundice can lead to brain damage, which can cause cerebral palsy.
Learn about the causes, different types, symptoms, and treatments of jaundice, as well as what to watch out for at home and when to call your baby’s doctor.
What is Jaundice?
According to the Centers for Disease Control and Prevention (CDC), jaundice is a medical condition marked by a yellowish tint to a newborn’s skin. Jaundice occurs when bilirubin accumulates in a baby’s body. Bilirubin is a yellowish-brown substance found in bile, created after the body’s older red blood cells break down. 
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Newborns produce more red blood cells when compared to adults, which results in a higher turnover of the blood cells, leading to jaundice. Normally, bilirubin is eliminated via bowel movements or broken down in the liver. A newborn baby’s liver (especially those born prematurely) is still developing and is less effective in removing bilirubin.
Around 60% of all infants born in the United States have jaundice. While some infants have mild cases, the babies with high levels of bilirubin must be monitored closely as untreated jaundice can lead to severe medical problems, and in some cases, death.
Different Types of Jaundice
“Normal” Jaundice: Many newborns will have at least some jaundice while their liver continues to develop. Mild jaundice usually disappears within a few weeks after birth, but it’s always important to have your baby’s pediatrician rule out any medical concerns.
Breastfeeding Jaundice: A number of breastfed babies may develop jaundice. This generally occurs when an infant doesn’t get enough breast milk, as the mother’s breast milk isn’t fully in yet. This isn’t the same as breast milk jaundice since the jaundice isn’t a result of breast milk.
Premature Infant Jaundice: Jaundice is more common in premature babies since their livers are less developed than a full-term baby.
Breast Milk Jaundice: This type of jaundice occurs when breast milk substances make bilirubin levels rise. This form of jaundice is rare, only accounting in around 1% to 2% of newborns. It generally occurs within a week after birth and subsides within a few weeks. The exact cause of breast milk jaundice isn’t known, but scientists suspect it has something to do with a substance in the mother’s milk that stops the baby’s liver from breaking the bilirubin down properly.
Blood Incompatibility: Blood incompatibility between mother and baby can also cause the infant to develop jaundice. The mother’s blood may produce antibodies that cause the baby’s blood cells to break down into bilirubin. This, in turn, causes bilirubin to build up.
Symptoms of Jaundice
Jaundice usually appears shortly after birth, and the yellowish tint is more easily detectable on infants with light skin shades. It can appear all over the face, as well as the arms, legs, stomach, neck, head, and toes.
Other symptoms include:
- Difficult to wake up or difficulties falling asleep
- Lack of wet diapers
- Unusual fussiness
- Skin coloring that may go to yellow or orange
If jaundice is severe and left untreated, babies are in danger of developing kernicterus, a rare form of brain damage that occurs when bilirubin builds up to extremely high levels and enters the brain.
According to the U.S. Library of Medicine, kernicterus is a life-threatening neurological condition that typically developed within the first week of life. If an infant develops kernicterus, a host of other associated disorders may follow, including cerebral palsy, seizures, hearing loss, and vision problems. 
If your baby exhibits any of the following symptoms associated with kernicterus, seek medical help immediately:
- Still or limp body movements
- High pitched crying while doing a back arch
There are three stages of kernicterus, including:
- Difficulties with feeding/poor feeding
- Acute jaundice
- A bulge in the infant’s fontanel (the “soft spot” on the baby’s head)
- Extreme high-pitched crying
- Difficulties with moving (movement disorders)
- Hearing loss (high-frequency)
- Mental/Intellectual issues
- Speech problems
- Rigid muscles
In severe cases, especially if treatment isn’t started as soon as possible, kernicterus can lead to death.
If an infant has high bilirubin levels, physicians will generally put the baby under specialized lighting (known as light therapy or phototherapy) in order to bring the levels down. Phototherapy facilitates the breakdown of bilirubin in the skin. If the bilirubin levels are significantly high, a blood exchange procedure may be performed. 
Causes and Risk Factors
Babies born prematurely have the highest rates of developing jaundice and kernicterus. Other risk factors include blood incompatibilities, maternal infections, and macrosomia. 
Medical neglect caused by physicians and other professionals can also lead to kernicterus. The following instances are examples in which healthcare professionals act negligently, which can cause brain damage and other medical issues.
- Stalling or postponing jaundice treatment
- Failure to remove red blood cells in time (exchange transfusion)
- Failure to have safety measures for bilirubin in place at medical centers and/or hospitals
- Failure to examine, diagnose, and treat jaundice and/or bilirubin in a timely manner
- Failure to diagnose blood incompatibility between infant and mother
Unfortunately, some babies have developed kernicterus and cerebral palsy at the hands of negligent physicians and medical staff. If your baby was injured due to medical negligence, keep in mind that you have the legal right to file for damages against the responsible party.
Things to Remember About Jaundice
Even if your baby’s jaundice seems mild, never assume that it will go away on its own. It’s always a good idea to check with your baby’s doctor. Keep in mind that it’s hard to determine if the jaundice is severe by just looking at your baby.
Additionally, it’s more difficult to see jaundice on infants with darker skin, but if you press your hand on your baby’s skin and the area turns yellowish, this may indicate that your infant has jaundice.
Call your baby’s doctor right away if:
- The jaundice seems to be spreading
- Your baby seems unusually fatigued
- Your baby stops feeding or begins to have poor feeding
- Your baby has a fever of over 100°F (37.8°C)
- What Are Jaundice and Kernicterus? (2019, December 3). Centers for Disease Control and Prevention.
Retrieved from: https://www.cdc.gov/ncbddd/jaundice/facts.html
- Bilirubin Encephalopathy: MedlinePlus Medical Encyclopedia. (n.d.). National Library of Medicine - National Institutes of Health.
Retrieved from: https://www.nlm.nih.gov/medlineplus/ency/article/007309.htm
- Selner, M. (n.d.). Breast Milk Jaundice: Causes, Symptoms & Diagnosis. Healthline.
Retrieved from: https://www.healthline.com/health/breast-milk-jaundice#Overview1
- Meredith L. Porter|Maj. Beth L. Dennis. (2002, February 15). Hyperbilirubinemia in the Term Newborn. AAFP American Academy of Family Physicians.
Retrieved from: https://www.aafp.org/afp/2002/0215/p599.html