Tests and treatment for your baby s jaundice

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1 Southend University Hospital NHS Foundation Trust Patient Information Service Women and children s business unit Tests and treatment for your baby s jaundice SOU2993_110974_0518_V1.indd 1 31/05/ :59

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3 What is jaundice of the newborn? It is a temporary yellow discolouration of the skin of a baby caused by increased levels of bilirubin in the blood. What causes jaundice? Before birth your baby had a high level of red blood cells. These are not required after birth and are broken down by the liver, producing a substance called bilirubin. The liver in the newborn is immature so may not be able to clear the bilirubin at the same rate as it is produced. The excess bilirubin travels around the body, discolouring the skin and sometimes the whites of the eyes to a yellow colour. This is referred to as physiological jaundice of the newborn, which is the commonest type of jaundice and can affect up to 80 per cent of babies. It normally occurs around three days after birth. Premature babies are particularly at risk of developing jaundice, as are babies who sustained bruising/trauma at delivery, and some babies whose mothers had irregular antibodies/rhesus negative. These babies will be monitored more closely. There are other less common causes of jaundice and these can be explained to you by the midwifery/nursing staff or your baby s consultant. 1 SOU2993_110974_0518_V1.indd 1 31/05/ :59

4 Frequently Asked Questions How would I know if the jaundice is affecting my baby? In cases of mild jaundice, regular feeding will assist baby to resolve this him/herself and active treatment may not be required. You should respond to baby s feeding cues and if baby is not waking for feeds frequently, breastfed babies should be woken to feed at least three hourly whilst the jaundice persists. What test does my baby need? If your baby is not already undergoing treatment for jaundice, is over 24 hours of age and more than 35 weeks gestation at birth the bilirubin level can be tested using a handheld device which is placed on your baby s skin. This gives an instant result which will be plotted on a chart to indicate if treatment is required. If this indicates that your baby requires treatment then all repeat testing will be done (with your consent) by taking blood from heel-pricks and analysing it. The result will then be plotted on the chart as above. How is jaundice treated? If the level of bilirubin indicates that treatment is necessary, your baby will be placed under an ultraviolet light (a blue light) which reduces the level of bilirubin. This is called phototherapy. Depending on how much bilirubin your baby has in the blood, the doctor may order double phototherapy which is twice the strength of the single light. 2 SOU2993_110974_0518_V1.indd 2 31/05/ :59

5 The excess bilirubin is then excreted from your baby in stools and urine. It can make the stools very loose and green in colour. If your baby is treated with phototherapy they will need to drink more fluids, so top-ups may be recommended. Are there any complications of neonatal jaundice? If the level of jaundice goes very high then this can damage a baby s brain and may cause problems like cerebral palsy, learning difficulties, and hearing problems. This is called kernicterus. Kernicterus is very rare in developed countries like the UK, affecting about 1 in every 100,000 babies. What will my baby look like during treatment? In order to expose as much skin as possible your baby will be naked apart from wearing a nappy. It is advisable to leave the baby under the lights for as long as possible and only remove for feeding. Your baby will feel no pain from this procedure. An amber shield or soft wrap will be used at all times to protect the eyes. For how long will my baby need treatment? Each baby is different and will need to be treated accordingly. Initially the baby is treated for six hours, then a second blood test is taken. Treatment is only stopped when two consecutive tests have shown results below the treatment line. 3 SOU2993_110974_0518_V1.indd 3 31/05/ :59

6 If the bilirubin level is very high your baby may need to go to the neonatal unit for care. Although your baby may have the lights removed it is not uncommon, in prematurity, for babies to require subsequent phototherapy sessions. Rare complications If the bilirubin level is excessively high an exchange blood transfusion would be ordered. This is extremely rare and would be fully discussed with you prior to commencement. Once treated, physiological jaundice should not return. Prolonged jaundice in a premature baby will require further investigations and these will be discussed with you by your neonatal consultant. If you have any questions regarding this leaflet please do not hesitate to speak to the midwife, nurse or nursery nurse looking after your baby. SOU2993_110974_0518_V1.indd 4 31/05/ :59

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8 For a translated, large print or audio tape version of this document please contact: Patient Advice & Liaison Service (PALS) Southend University Hospital NHS Foundation Trust Prittlewell Chase Westcliff-on-Sea Essex, SS0 0RY Telephone: Fax: pals@southend.nhs.uk Southend University Hospital NHS Foundation Trust Patient Information Service If this leaflet does not answer all of your questions, or if you have any other concerns please contact your GP surgery or call NHS 111 for further advice. NHS 111 service is the NHS non-emergency number. It s fast, easy and free. Call 111 to speak to a highly trained adviser, supported by healthcare professionals. NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones. Reviewed by Caryn Himsley and Beena Saji Reviewed and revised May 2018 Leaflet due for revision May 2020 Form No. SOU2993 Version 7 SOU2993_110974_0518_V1.indd 6 31/05/ :59