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What is causing my newborn's yellow skin?

Many babies develop yellow skin (jaundice) during the first week of life which then goes away. The cause usually is a mild immaturity of the liver. On occasion, the jaundice may be due to a blood incompatibility between baby and mother. This resolves but may take a few more days. It is also possible, in a small number of babies that the yellow skin reflects something else wrong with the liver that would require more extensive testing. Your baby's doctor can tell this by looking at other simple laboratory tests. Jaundice that doesn't go away after 7-10 days is cause for your baby to be seen by the pediatrician.

The most common condition causing a yellowish coloring to the newborns skin is physiologic jaundice. Physiologic jaundice is present to some degree in the majority of newborns. The yellowish skin discoloration is temporary and is most visible on the infant’s nose, forehead, chest, and abdomen and in the sclera (the whites) of the eyes. In dark skinned infants it is more difficult to see the yellow coloring of the skin. Premature babies are more likely to develop jaundice than full-term babies.

Physiologic jaundice is the result of high levels of bilirubin in the blood. Bilirubin is a yellow pigment that is created during the normal process of recycling old red blood cells. Prior to birth the placenta removed the bilirubin from the infant’s circulation. However at birth the baby needs to take over the process of removing the bilirubin from the blood and this can take a couple of day for the infant’s to become efficient in this process. Therefore the bilirubin levels are normally a little higher in the days following birth and may result in a yellow discoloration of the skin.

Shelley Webb
Nursing

Yellow skin in newborns (called neonatal jaundice and which can include the normally white schlera of the eyes) is a fairly common clinical condition found in newborns.  About 70% of newborns exhibit some degree of jaundice. Jaundice could be caused for several different reasons, the most common of which is that their liver has not yet become effecient at processing the bilirubin that is produced due to the breakdown of old red blood cells.  This is called physiological jaundice.

For newborn jaundice, the physician may recommend a test to check for bilibrubin levels and if they are out of range, phototherapy will be ordered.  Increased fluid (breastfeeding or formula) intake is also helpful.

Because there are other more serious causes of neonatal jaundice, the condition cannot be ignored.

There may be a descrepancy between the mother's blood type and the baby's blood type, such as AB/O incompatability or a positive/negative incompatibility.  The mother's body will produce antibodies that attack the baby's blood cells. This causes a breakdown of the red blood cells and thus an increased release of bilirubin from the red cells.

Sometimes babies are born with too many red blood cells (a condition called polycythemia) which can break down and cause an increased release of bilirubin. 

Large bruises on the scalps of babies (from the birthing process) can also cause increased break down of red blood cells and again, an increased release of bilirubin.

A condition called biliary atresia is one of the more serious reasons for neonatal jaundice.  It is a congenital blockage of the tubes that carry bile from the liver to the gall bladder.

There are also other reasons for neonatal jaundice.

Because newborns have frequent early visits with physicians, jaundice is usually caught quickly but if the yellowing in your baby's skin is increasing, contact your physician.  

As always, if your newborn is refusing to eat, is excessively sleepy or cranky, has floppy muscle tone, has a fever greater than 100.6 or higher, OR has yellowing that is extending lower than the nipple line,  please contact your physician immediately or go to the emergency room.

The yellowish color of the skin is called jaundice—a common occurrence
in newborns. The first hint of yellow typically appears on the face and then progresses down the body. In otherwise healthy infants, it is usually at its worst around day 4 or 5 of life and then begins to resolve, although the yellow color on the face and in the whites of the eyes can linger for a week or two.

It may reassure you to know that most babies turn a bit yellow after birth; some are just more noticeable than others. It develops from a very normal process that occurs in all babies by the breakdown of red blood cells. The normal breakdown of red blood cells produces bilirubin. This occurs in the liver and is excreted in the intestines (in the form of poop!). Because this excretion process is very immature, some babies just can’t keep up and extra bilirubin lingers in the blood and then gets deposited in the skin,
causing the yellow color.

The most common reason for jaundice is breastfeeding jaundice. This usually occurs in the first week when the baby is not taking in enough milk, either because mom’s milk supply is not fully in or the baby has yet to master the
art of nursing.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.