Page 202 - 16Neonatal Jaundice_compressed

Appendix E: Implementation tools

How is jaundice treated?
Slightly elevated levels of bilirubin are not harmful but you may need additional support to
establish breastfeeding. Ask your midwife to assist with this.
If the level of bilirubin in your baby’s blood is found to be unusually high or continues to rise,
then your baby may need to receive treatment in hospital. This treatment usually consists of
light therapy or ‘phototherapy’. Phototherapy involves placing the baby under a lamp which
shines a special type of light (light in the blue spectrum) onto the skin. This light helps to break
down the bilirubin so it can be removed from the body in urine. Phototherapy does not involve
giving the baby medicine.
Your baby will be placed under the light naked apart from a nappy. This is to make sure that the
light can shine on as much of the skin as possible. During phototherapy your baby’s bilirubin
levels will need to be measured every six hours.
Your baby’s eyes will be protected from the light with eye pads or a Perspex eye shield. If the
doctor is confident that the treatment is working and the bilirubin level is not too high, you will
be encouraged to take your baby out for short breaks for feeds.
If your baby’s bilirubin level is very high then more than one lamp will be used at the same
time. In this situation the baby will need to remain under the light without breaks until the
bilirubin level has dropped.

Are there any complications of jaundice?
Jaundice does not cause any problems in the majority of babies. In some rare cases the bilirubin
level may become very high and this could result in a serious condition called kernicterus
which can cause long term problems such as hearing loss and cerebral palsy.

If your baby is at risk of kernicterus they will need to have a different type of emergency
treatment in an intensive care unit. This emergency treatment is called an exchange transfusion.
An exchange transfusion involves replacing the baby’s blood with new blood from a donor.
Though neonatal jaundice is very common, kernicterus is extremely rare.

What if my baby remains jaundiced?
In most babies jaundice clears up within a few days. However if jaundice lasts more than two
weeks (or more than three weeks in babies that were born premature) then it is called prolonged
jaundice. If your baby has prolonged jaundice contact your midwife or another healthcare
professional straight away because your baby may need some additional blood tests to ensure
that there are no liver problems.
Will my baby recover from jaundice?

The outcome for a baby with jaundice is extremely good, as long as the jaundice is recognised
before the levels get too high and it is treated appropriately.

Where can I find out more information?
NICE website: www.nice.org.uk
Yellow Alert website: www.childliverdisease.org/education/yellowalert

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