Although we all see photographs of beautiful chubby babies with milky white skin, the reality more likely to be that he will look red, a bit squashed, or even yellow! An Apgar test, done at birth, is a non-invasive method of checking whether the baby is fine, including a check on his appearance. However, the yellowiness usually only appears after a couple of days.
What is jaundice?
Jaundice comes about when there is an excess of bilirubin in the blood. This is caused because a baby's young liver is not as good at getting rid of this yellow by-product during the perfectly normal process of breaking down red blood cells after birth.
In many babies, this colouring will be only add a slight tinge to the skin tone (and will appear on the palms of the hands in darker-skinned babies). In others there will be a noticeable colouring of the whites of the eyes, as well as the skin. The jaundice spreads from the head downwards.
It tends to clear after about a week, by which time the body is better able to clear itself of this bilirubin.
Is jaundice a cause for concern?
In most cases, slight jaundice is not a worry and will clear in a few days. Any pediatrician, midwife or health visitor you see during this time should be able to gauge whether the problem is clearing up or needs further attention.
Premature babies may develop the problem a little later and it might last for a couple of weeks, because their liver is not as well developed as a full-term baby's.
Other babies more prone to jaundice include those whose mothers had induced labour or are diabetic, or babies who lose quite a bit of weight after birth.
If blood tests show there to be higher levels of bilirubin building up, it is possible that a baby has a rare condition called pathologic jaundice. If it develops on the first day, it may be caused by a blood group incompatibility with the mother. However, these cases are often prepared for already due to the routine blood tests women now get during ante-natal check ups. It is possible, where jaundice develops later, that there is a problem with liver function.
What treatment is there for jaundice?
Careful monitoring of a baby's progress in the first few days (by midwife visits to your home, or clinic visits by you) will help keep tabs on any possible problem jaundice. This would then be treated at hospital, but is very rarely needed.
In most cases, the slightly yellowy skin will clear of its own accord and no treatment is needed.
In some cases, 'phototherapy' is required. Many neo-natal wards caring for premature babies, now have cots that can be set up with ultraviolet lamp light, to improve the baby's condition. In some newer wards, you may even see mother and baby rooms fitted with ultraviolet lighting for this purpose. Babies have their eyes safely protected during such treatment.
In problems linked to liver function, other medical treatments will be followed depending on individual cases, but should not be a cause for major alarm. Only unchecked severe jaundice would cause real harm.
