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HealthFrom sweet corn-on-the-cob to tart lemon meringue pie, the color yellow is usually associated with things that are bright and cheery. However, when it comes to a yellowish skin color in a newborn or an adult, things are not so cheerful. As many may already know, that yellow cast to the skin is a symptom of jaundice, which, according to the Centers for Disease Control and Prevention (CDC), affects 60% of all babies born.

Jaundice is not a disease but a condition that occurs when a chemical called bilirubin builds up in a baby's blood. According to the Cleveland Clinic, bilirubin is a compound that is produced by the breakdown of hemoglobin from red blood cells. The National Institutes of Health (NIH) adds that if you have ever had a bruise and noticed that the skin went through a series of color changes during the healing process, the point at which you were seeing yellow in the bruise was the result of accumulated bilirubin. The NIH adds that approximately 1% of our red blood cells retire every day and are replaced with new red blood cells. The old red blood cells are processed by the liver and disposed of by the body in stool. If there are too may red blood cells retiring for the liver to process, yellow pigment levels build in the body. When there is enough to be visible, the result is jaundice. The NIH notes that most babies experience some degree of jaundice during the first week of life. The birthing process can force many red blood cells into early retirement and a newborn baby's liver is often unprepared to handle the load. In addition, bilirubin accumulates more easily as it takes a while for a mother's milk to come in and for a baby to begin stooling regularly to expel the bilirubin from their system. Jaundice can occur in babies of any race or ethnicity.

HealthThe CDC advises that although jaundice is common and usually passes on its own, if not treated, high levels of bilirubin can lead to a condition called kernicterus. Kernicterus is a form of brain damage that can develop when the levels of bilirubin in the blood system become so high that it moves out of the blood and into the brain tissue. A baby with kernicterus will be lethargic, sleepy or difficult to awaken, will have a high-pitched cry, decreased muscle tone making their body floppy combined with episodes or arching the head and back backwards. According to the CDC, untreated kernicterus can lead to a form of cerebral palsy, hearing loss, problems with vision and teeth, and mental retardation. Early detection and management of jaundice can prevent kernicterus. The CDC adds that, at a minimum, babies should be checked for jaundice every 8 to 12 hours in their first 48 hours of life and again before 5 days of age. Since jaundice can have such serious effects, the CDC advises remembering the acronym ACT:

  • Ask your doctor or nurse about a bilirubin test.
  • Create a follow-up plan before leaving the birth hospital. A nurse or a doctor should check all babies 3 to 5 days of age because it is the time period when a baby's bilirubin level is highest. The timing of a follow-up visit will depend upon your baby's age when you leave the hospital and any additional risk factors. Babies with jaundice in the first 24 hours of life or with high bilirubin levels before being discharged from the hospital should have an early follow-up plan.
  • Treat jaundice seriously.

Additionally, the CDC says you should ask the pediatrician to see your baby the day you call if your baby:

  • Is very yellow or orange (skin color changes start from the head and spread to the toes and the whites of the eyes can also look yellow)
  • Is hard to wake up or will not sleep at all
  • Is not breastfeeding or sucking from a bottle well
  • Is very fussy, or
  • Does not have enough wet or dirty diapers.

The CDC goes on to advise that parents should get emergency medical help if a baby:

  • Is crying inconsolably or with a high pitch
  • Is arched like a bow (the head or neck and heels are bent backward and the body forward)
  • Has a stiff, limp, or floppy body, or
  • Has strange eye movements.

Jaundice can be treated. The CDC notes that babies with high bilirubin levels will be undressed and put under special lights. The baby's milk intake may also need to be increased. In cases where the bilirubin level is very high, the doctor may do an exchange transfusion of the baby's blood. There are certain circumstances that will increase the chances of jaundice in a baby. The CDC lists the following risk factors that indicate a baby should be checked and monitored closely for early jaundice management:

  • Babies with darker skin color. Jaundice may be missed or not recognized in a baby with darker skin color. Checking the gums and inner lips may detect jaundice. If there is any doubt, a bilirubin test should be done.
  • Blood type. Women with an O blood type or Rh-negative blood factor might have babies with higher bilirubin levels.
  • Bruising. A baby with bruises at birth is more likely to get jaundice. A bruise forms when blood leaks out of a blood vessel and causes the skin to appear black and blue. When large bruises heal, high levels of bilirubin can form causing a baby to develop jaundice.
  • Feeding difficulties. A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to develop jaundice.
  • Heredity. A baby born to an East Asian or Mediterranean family is at a higher risk of becoming jaundiced. Some families also inherit conditions that increase the likelihood of their babies developing jaundice.
  • Pre-term babies. Babies born before 37 weeks, or 8-1/2 months, of pregnancy might have jaundice because their liver is not fully developed and is not able to rid the body of excessive bilirubin.
  • Sibling with jaundice. A baby with a brother or sister that had jaundice is more likely to develop jaundice.

Remember that jaundice is a common condition in newborn babies. By educating yourself to the risk factors, knowing the signs, being observant, and asking the right questions, you and your doctor will be fully capable of detecting jaundice at the earliest stage and providing the appropriate treatment to prevent any possible complications—and the color yellow can keep its bright and cheery designation!

Centers for Disease Control and Prevention—
Cleveland Clinic—
National Library of Medicine/National Institutes of Health—

Articles are provided for the general interest of our readers. Gerber Life Insurance is not responsible for any content and recommends that you consult the appropriate professional with any questions or concerns you may have concerning any financial or health related issues.

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