Causes for Newborn Jaundice

Updated on April 10, 2009
R.S. asks from Kalama, WA
14 answers

Does anyone have an explanation for newborn jaundice other than "immature liver"? My last baby had it, causing a wealth of health problems (eczema, food allergies, no sleep, etc), and I'd like to avoid it if possible with my next (due in 2 weeks). I have heard one theory of too much IV fluids to Mom in labor causing baby's red blood cells to burst and overload their little liver. Anyone have any books about natural birth with this type of information to recommend? The one I'm reading now is "The Thinking Woman's Guide to a Better Birth" and that is where I got that information.

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So What Happened?

Well, no baby yet, but thanks for all the input. We are going to try "natural" birth in hospital, with my midwife and a doula too this time. It was baby #2 that had jaundice, and he had a completely uncomplicated term birth, so that is what I don't get. We checked his levels right away (and every 2 days after) and though they were never high enough to put him under lights, he still was yellow for about a month (eyes were the last place you could tell). We did sun as much as possible in the Pacific Northwest in April, and breastfed exclusively too. He wasn't sleepy either, and was a good nurser, although he 'itched' from the time he was about 3 weeks old (well, it was wiggling that turned into itching as soon as he was big enough to itch). When we finally got him allergy tested at 18 months, the first question (after looking at bloodwork) she asked was "did he have jaundice at birth?", and she told us his blood was full of undigested carbs and proteins because his liver had never recovered from that (that were coming out his skin as eczema). With her treatment plan (digestive enzymes and probiotics to help breakdown his food and give his liver a chance to flush out) he is allergy and eczema free now. So, I have to believe she was right, since the treatment worked immediately, and he's been good for over 6 months. Kid #1 is healthy as can be, and had a much more traumatic/long/induced birth, so I would expect him to be the one with issues. Oh well, who knows. I guess we'll just wait and see what #3 brings...

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S.S.

answers from Seattle on

My son was jaundiced when he was born and it was simply a case of me not producing enough milk even after it came in finally and him getting dehydrated. Apparently this is pretty common, too.

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A.H.

answers from Portland on

Heya! I'm a NICU nurse and we deal with jaundice on a very regular basis, so hopefully I can help with some insight! The current research suggests that all babes have some amount of hyperbilirubinemia (aka jaundice). Some babies just seem to have higher levels than others, and some babies seem to be able to process it better than others. There is no "prevention". It just is what it is. (And yes, immature/young/newly functioning liver really is the only current medical explanation)
Also remember that every baby is different and just because your first struggled with it (did he/she have to go under phototherapy/lights?) it does not mean that future siblings will necessarily have the same/similar problem with it. And even if he/she does, they might not have the accompanying related problems, although I will say I have not heard of some of those problems being related to high bili levels (like usually babies with a high bili level are sleepier and more lethargic than a baby with a normal/lower levels). I would take anecdotal information with a grain of salt - there is so much information out there that isn't necessarily based in medical truth, and so much of that seems like it is out there to give us mom's one more thing to worry about but isn't really based on much more than someone's opinion (though they often try to pass it off as fact).
Sorry if I'm rambling, I keep getting interrupted!
Anyway, in short - try not to worry, and there really isn't anything you can do to "prevent" it anyway, so no point in stressing over something out of your control!
My only thought is maybe be more proactive in treatment if a problem develops...? Maybe an earlier intervention could have prevented the complications in your first? (Again, or not, it was just a side thought...)

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J.H.

answers from Seattle on

Hi there! I am also a NICU nurse that deals with the questions that are constantly asked by parents who deliver babies prematurely and also at term who deal with hyperbilirubinemia (Jaundice). While I won't repeat anything that has already been mentioned, bilirubin is excreted in the urine and stool. One of the ways that we recommend parents help the initial jaundice resolve is to breastfeed the baby first and then supplement with formula until your milk supply is established. Many times the baby goes the first couple of days without much nutrition and hydration which can slow their digestive tract ability to remove waste (and the bilirubin). This means that the body holds onto the bilirubin longer which can cause higher levels in the blood. Usually the jaundice level peaks within the first 5 days and will slowly resolve itself as the liver begins to function on it's own.
I have never heard that mom's IV fluids can cause higher levels of bilirubin in newborns. I have also never heard of high bili levels causing the wealth of problems your first child suffered. Babies with high bili levels are usually very sleepy and don't eat well. They tend to be a challenge to feed. Good luck on the birth of your second child!

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C.F.

answers from Seattle on

Hi there,

I'm a labor/delivery and NICU nurse and have never heard of the IV causing jaundice theory. There are many risk factors and a multitude of reasons for different babies getting jaundice - just a few are: preterm, bruising on body (from rapid delivery, vacuum extraction), shoulder dystocia (the shoulders getting caught up at delivery), mother with O+ blood, ABO incompatibility - many more also. Each baby is different.

One practice among the "natural birth" folks that increases the risk of jaundice is delaying clamping the cord until all pulsations stop. This just pumps the baby up with many more red blood cells then they need (they already have more than enough for life outside the uterus) and when those extra red blood cells die, they increase jaundice.

Another reason to not do that practice is in areas where they collect cord blood for the blood bank, it makes it so the person can not donate (if that is something that they wanted to do).

When red blood cells break down (this happens in all babies due to the increased number of red blood cells that they have) the waste products are eliminated by pooping - the extra is reabsorbed and causes jaundice (a simple explanation). The very best thing to do is breastfeed your baby as much as possible. Eating and pooping are the best remedy.

The jaundice baby may get very sleepy and not eat well - this causes a whole downward spiral of dehydration - more jaundice and weight loss. When we see this happening it is recommended to supplement with formula (as a medical treatment). The protein in the formula helps bind the waste so that the baby can poop it out.

Remember that you can never overfeed a breastfed baby and it is the absolute best thing to do.

Good luck -

C.

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J.W.

answers from Seattle on

Re-read Alexia's response. She's right on. Every baby is different, even siblings. Jaundice is the body's inability to process the high bilirubin (sp), liver just needs to mature a little bit longer. I know that sunlight and photo therapy help in resolving the issue. Don't borrow trouble. You went thru this once before so now you know what some of the symptoms are and will react sooner if it happens with this baby.

It will be okay. Have a talk with your ob/gyn about your concerns and then talk with your pediatrician who will probably be coming in to check on your baby after delivery. Again, let them know of your concerns and what can or will be done if this were to happen again. They're apt to be extra vigilent if you let them know or remind them of your previous experiences.

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L.G.

answers from Portland on

my daughter was jaundiced because she didn't get enough breastmilk, but also because she had dad's blood type, not mine. at least that was what i was told.

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C.D.

answers from Spokane on

Lots of breast feeding will help tremendously, and aslo eat really well and make sure the baby gets moderate sunlight. It will make a huge difference. My last 2 kids both had Jaundice and I breastfed like crazy and went for afternoon walks, 2 week checkup..... they were both fine! Good luck!

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K.R.

answers from Portland on

R.--

Not a nurse, but I agree with the one who said all babies have it to some extent ;). All four of mine did ... but after the first one I knew breastfeed like crazy (I supplemented with water, because I don't trust formulas) and get them in the sunlight (the first two were deep in the winter, so I couldn't do that part).

I let all four have their umbilical blood back, although if I had been in a hospital for the later ones (when it was available) I might have donated or stored their cord blood instead. The only baby who had a problem 'kicking' the jaundice within a week or two was #1, and that was because after a 38 hour labor I was so tired I was glad she was too sleepy to want to eat constantly--OOPS! bad Mommy! So although I was lucky she latched on just fine from the start, I goofed--I figured the baby would ask to eat. I started waking her to feed after the first 36 hours.

(I did all-natural all four, clinic, clinic, home, home. I wish I'd done home for all four ... it's crazy comfortable. I mean, for a birth ;). )

Books about natural birth: I started with Husband-Coached Childbirth, and it is a fabulous transition book for someone who is starting with the language/outlook of standard medical practice, because it was written by an OB who converted himself to natural childbirth (it's also patriarchal in spots, he started in like the 1940s). Birth Reborn is an astounding book a little further along the spectrum: Michelle(?sp) Odent is a French MD who got assigned with nothing but textbook knowledge to a clinic with a midwifery center ... he translates not only what birth physically is (like Dr Bradley in the first book), but what natural instincts we have for birth that are very very different from the 20th c hospital standards. Birthing from WIthin is a classic text that speaks more broadly to "what is right for your birth choices?" without being dedicated to the "if you take meds you failed" sort of viewpoint that a lot of books that discuss natural birth hit.

Have a wonderful, blessed birth :).

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M.L.

answers from Seattle on

My daughter was born with jaundice as well, but has no long term effects. We literally went from the hospital to the park and walked around a little. It was a sunny day and we feel like the early sun exposure helped her body naturally break down the bilirubin. We had to stay in the hospital an extra day after she was born because of her jaundice, but it was gone by day 3.

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L.C.

answers from Anchorage on

My daughter developed jaundice and needed to be hospitalized for the light treatment soon after we came home from the hospital. The birth was long and her head was pretty banged up when she arrived, poor baby. Our pediatrician said the bruising on her head was the reason for the jaundice. I think it had something to do with her white blood cells, but can't remember the physiology of it anymore. She is doing great now! I also read "The Thinking Woman's Guide to a Better Birth", that book seemed to really freak me out! "Husband Based Childbirth"is a good one, which is the Bradley Method. Good luck with everything as welcome your next little one!!

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S.W.

answers from Portland on

i never heard why my son, born 2 weeks late, and had jaundice. i was also not pumped full of fluids or drugs during my (9 hr) labor, so that doesn't sound like the culprit either. i don't have any advice per se, but more like a debunking of the possible causes. sorry i can't be more helpful.

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C.A.

answers from Portland on

I hate to be the bearer of bad news but there really is a variety of causes...this is my third baby and all three had various degrees of jaundice. Also I did total natural birth - didn't even have time for an IV AT ALL. I am a very healthy person (the nutritionalist was stunned at what I was asking to eat in the hospital - salad greens, fruits and lean cuts of meat). The worst was my first which they said was cause by my breastmilk - I have no idea what that means and to be honest they didn't sound a hundred percent sure either. I breastfed all three of them.

I do know that a natural birth and breastmilk are the best start you can give a baby regardless. I don't think less of those who had drugs (had my labors been longer I am sure I would have), but as for avoiding jaundice well I think most babies have it to some degree. All three of mine did - all three of my sisters did - my other sisters son did.

I do hear you and I was so afraid with my second. My first was horrible - had to get the blanket thingy, he cried constantly and was sick for months. It was heart breaking but my second had it slightly and within days it was gone. Don't worry too much - every baby is different!

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D.B.

answers from Portland on

My son was born with jaundice because of our different blood types (I am O+ and he is A+). Since I had a c-section and was in the hospital for 4 days we had plenty of time for him to spend under the 'bili-lights' to correct the jaundice. He just needed plenty of light (either from the bili-lights or natural light) to bring up his bilirubin levels.

I know there are other reasons for jaundice, but this may be one of the most common.

J.S.

answers from Seattle on

Hey R. - I've read some info about Jaundice online (Wikipedia, for example, and some Dr's papers) just to find out what the problem physically is and how to treat it in response to my Midwife's question about the Vitamin K shot after delivery. It's WA law that babies get it, but as a mother you can "refuse access to the child" and avoid it. I didn't even know that a Dr/nurse can give anything to your child without you knowing about it. I'm so thankful for my midwives who told me EVERYTHING they were doing and let me have a say.

Anyway, long story short we let the cord quit pulsing and didn't give our 3rd the Vitamin K shot. Cheryl down below stated (as every good western medicine nurse should) that letting the cord quit pulsing causes jaundice, but I disagree. There is a theory that when you catch the pulse where the blood goes into baby, rather than one that goes back to mom, you have "overloaded" baby with too much blood. But that's why you let it stop pulsing completely, because it has achieved a neutral state by then.

I'm probably not answering your specific question, but just don't stress yourself out about the jaundice. Chances are your second baby won't get it, and if you are able to do a quiet and uninterrupted natural labor, you'll appreciate the whole experience as compared with a hospital birth whether your baby ends up jaundiced or not.

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