Treatment:

Treatment is usually not needed.

When determining treatment, the doctor must consider:

• The baby's bilirubin level
• How fast the level has been rising
• Whether the baby was born early (babies born early are more likely to be treated at lower bilirubin levels)
• How old the baby is now

Your child will need treatment if the bilirubin level is too high or is rising too quickly.

Keep the baby well hydrated with breast milk or formula. Frequent feedings (up to 12 times a day) encourage frequent bowel movements, which help remove bilirubin through the stools. Ask your doctor before giving your newborn extra formula.

Some newborns need to be treated before they leave the hospital. Others may need to go back to the hospital when they are a few days old. Treatment in the hospital usually lasts 1 to 2 days.

Sometimes special blue lights are used on infants whose levels are very high. This is called phototherapy. These lights work by helping to break down bilirubin in the skin.

The infant is placed under artificial light in a warm, enclosed bed to maintain constant temperature. The baby will wear only a diaper and special eye shades to protect the eyes. The American Academy of Pediatrics recommends that breastfeeding be continued through phototherapy, if possible. Rarely, the baby may have an intravenous (IV) line to deliver fluids.

If the bilirubin level is not too high or is not rising quickly, you can do phototherapy at home with a fiberoptic blanket, which has tiny bright lights in it. You may also use a bed that shines light up from the mattress.

• You must keep the light therapy on your child's skin and feed your child every 2 to 3 hours (10 to 12 times a day).
• A nurse will come to your home to teach you how to use the blanket or bed, and to check on your child.
• The nurse will return daily to check your child's weight, feedings, skin, and bilirubin levels.
• You will be asked to count the number of wet and dirty diapers.

In the most severe cases of jaundice, an exchange transfusion is required. In this procedure, the baby's blood is replaced with fresh blood. Treating severely jaundiced babies with intravenous immunoglobulin may also be very effective at reducing bilirubin levels.

Expectations (prognosis):

Usually newborn jaundice is not harmful. For most babies, jaundice usually gets better without treatment within 1 to 2 weeks.

Very high levels of bilirubin can damage the brain. This is called kernicterus. However, the condition is almost always diagnosed before levels become high enough to cause this damage.

For babies who need treatment, the treatment is usually effective.

Complications:

Rare, but serious, complications from high bilirubin levels include:

• Cerebral palsy
• Deafness
• Kernicterus -- brain damage from very high bilirubin levels

Calling your health care provider:

All babies should be seen by a health care provider in the first 5 days of life to check for jaundice.

• Those who spend less than 24 hours in a hospital should be seen by age 72 hours.
• Infants sent home between 24 and 48 hours should be seen again by age 96 hours.
• Infants sent home between 48 and 72 hours should be seen again by age 120 hours.

Jaundice is an emergency if the baby has a fever, has become listless, or is not feeding well. Jaundice may be dangerous in high-risk newborns.

Jaundice is generally NOT dangerous in term, otherwise healthy newborns. Call the infant's health care provider if:

• Jaundice is severe (the skin is bright yellow)
• Jaundice continues to increase after the newborn visit, lasts longer than 2 weeks, or other symptoms develop
• The feet, especially the soles, are yellow