How to Deal with Jaundice or... "My Baby is all Yellow and Stuff!"

If you're reading this then chances are you've just had a new addition to your family. First and foremost, congratulations! You may also be feeling a little anxious so let's get on with the nitty gritty already.

What is Jaundice Anyway?

Jaundice is actually normal in most newborns and usually requires no treatment other than breastfeeding. Lots of breastfeeding. This is known as Physiological Jaundice and is caused by the normal breakdown of red blood cells which produces a product called bilirubin. In healthy adults most bilirubin is metabolized by the liver, becomes bile and is ultimately excreted in the urine and stool. In fact, it is bilirubin that gives urine it’s yellow color, and stool it’s brown color (I know you were just dying to know that). However, since a newborn’s liver isn’t yet fully developed this process is much slower which causes bilirubin to build up in the blood. This is the reason babies with jaundice will have a yellow tone to their skin and eyes.

Other types of Jaundice are breastfeeding Jaundice, which in my opinion, is just an extension of Physiological Jaundice. The reason I suggest that breastfeeding Jaundice is also physiological is that, within the first couple of days, Mom’s milk hasn’t come in yet and baby is just getting colostrum. While colostrum is arguably some of the most important nutrition in a person’s life, it is not a lot of substance and naturally, baby will have very small and very few eliminations.  As long as Mama is healthy and producing colostrum and then milk, that’s all the baby needs. Breastfeeding Jaundice should not be confused with Breast Milk Jaundice which is a fairly rare condition where a substance in the actual breast milk causes a rise in bilirubin. Even in this case however, the jaundice usually clears up in a period of several weeks. Again, if Mama is healthy and has good nutritional status, I would imagine that this is an even more rare occurrence than seen in the general population.
In some cases jaundice can be caused by the incompatibility of mama’s blood and baby’s blood. In this situation Mom actually produces antibodies to the baby’s blood which accelerates the destruction of their red blood cells. In more severe cases the treatment is to place baby under ultraviolet light or “bililights.” (Side Note: I was actually the first baby in NY State to be treated for jaundice by this method. It also gave me super powers which I’m not allowed to talk about. Oops.) Prior to this light therapy it was typical for infants with more severe cases to need an actual blood transfusion.
So What To Do.

As I said, in most cases no treatment is needed and baby’s bilirubin levels will naturally drop within a couple of weeks. Typically, the liver is functionally developed in about 8 days which increases bilirubin metabolism. The absolute best thing for jaundice is breast milk. Healthy breast milk has everything baby needs to facilitate the healthy development of the liver. More importantly, the more baby feeds, the more baby will poop and the more baby poops, the more bilirubin is excreted.

We were told several times that we needed to supplement with formula in the hospital. We did not. Even at our fist well visit to the pediatrician a few days later, we were told to supplement. Not only were we told to use formula, we were told that soy based formula is better. I guess I shouldn’t have been surprised but suggesting soy is absurd. It’s not the docs fault of course as they typically have absolutely no nutritional training in all those years of medical study. I couldn’t let it go of course and told the doc (who we actually really liked by the way and was very nice and well intentioned) about the problems with soy. That in fact, there is so much exogenous estrogen in soy formula that it’s the equivalent to giving your baby a few birth control pills. Not so healthy and that’s the tip of the iceberg when it comes to soy formula. I’ll probably write a separate blog post on the subject one of these days... but I digress.

The other thing we did was to give the little guy a little safe sun exposure. The reason the “bililights” are effectively used is because the UV rays converts bilirubin into a form that can more easily be excreted in the urine. This was a bit tricky for us since Mason was born in January. Fortunately, we had a pretty mild winter here so we blasted the heat, opened the back sliding glass door and let the little man soak up some sun. About 15 - 20 minutes once a day for a couple of days and I think that really helped a lot. Don’t over do it of course. You obviously don’t want them to get a sunburn and you REALLY don’t want them looking like a tiny member of Jersey Shore. THAT would be tragic indeed. You may want to start with 5 minutes and work up from there. Use your own discretion and again, don’t over do it. A little sun can go a long way.

Again, I’m not here to give you medical advice. Always consult your doctor when it comes to any medical condition. I just wanted to share our experience and opinion on this deal in hopes to help some folks out in the paleosphere and beyond.