Treating jaundice

Some treatments may not be suitable for your baby, depending on their exact circumstances. If you have questions about specific treatments and options covered in this information, please talk to a member of your baby's healthcare team.

If your baby needs treatment for jaundice, this will be done in hospital. Your baby will be monitored to see if the treatment is working, and tests for conditions that may have caused the jaundice should be carried out.

Information about treating jaundice

The doctor or midwife should tell you about the treatments for jaundice and give you appropriate information. The information should include:

  • the different options available, why they are being considered and how they can help treat jaundice (see below)

  • benefits, possible problems and any long‑term effects of the treatments

  • what the treatment involves

  • how long the treatment is likely to last

  • what will happen if the treatment does not work

  • how you can hold, touch and feed your baby during their treatment.

Phototherapy

If the doctor or midwife decides that treatment is needed because your baby's bilirubin level is higher than expected, your baby should be treated in hospital using phototherapy.

Phototherapy involves placing the baby under a special light (not sunlight). Light of a certain wavelength helps the body to break down the bilirubin and pass it out of the body.

During phototherapy your baby will be placed on his or her back unless they have other conditions that prevent this. Your baby's eyes should be protected and they should be given routine eye care. Your baby may be placed in a cot or an incubator. Your baby's temperature should be monitored and your baby should be checked to make sure he or she stays hydrated (has enough fluid in their body). This is done by weighing your baby every day and assessing their wet nappies.

The treatment may be stopped from time to time for up to 30 minutes so you can hold, feed and cuddle your baby, and change their nappy. You should be given help with feeding.

Intensified phototherapy

If your baby's bilirubin level is very high or rising quickly, or if your baby's jaundice does not improve after phototherapy, your baby's treatment should be stepped up. The healthcare team should offer 'intensified' phototherapy. This involves increasing the amount of light used in phototherapy. The phototherapy lamp may be turned up or another light source added at the same time to give more light. During intensified phototherapy, it is not usually possible for you to carry on breastfeeding. This is because the treatment should not be stopped for breaks. However, you can express your breast milk, which can then be given to your baby through a feeding tube that passes up your baby's nose and into their stomach. Rarely, fluids may be needed and these are given straight into a vein using a 'drip'. Your baby can be breastfed normally again after intensified phototherapy is stopped, and you should be offered extra help with this.

Checking to see if phototherapy is working

The level of bilirubin in your baby's blood will need to be checked with a blood test every 4–6 hours after starting phototherapy to see if the treatment is working. Once the levels of bilirubin become stable or fall, they will still have to be checked every 6–12 hours. When your baby's jaundice does get better, phototherapy can be stopped but your baby will need another blood test 12–18 hours later to make sure the jaundice has not returned to a level that would need further treatment. Your baby won't necessarily have to stay in hospital for this.

Other treatments for jaundice

If the level of bilirubin in your baby's blood is very high, your baby might need a complete changeover of blood (an exchange transfusion) because this is the quickest way to lower the bilirubin levels. Your baby will need to be admitted to an intensive care bed for this. After the exchange transfusion your baby will need a blood test within 2 hours so that the bilirubin level can be checked to see how well the treatment has worked.

If your baby has haemolytic disease (this is when antibodies in the mother's blood attack the baby's blood cells) and their blood bilirubin level is rising rapidly, the doctor may suggest a treatment called intravenous immunoglobulin (sometimes called IVIG), which is a blood product. Intravenous means it needs to be injected into a vein.

The doctor should not offer any of the following to treat jaundice in your newborn baby: agar, albumin, barbiturates, charcoal, cholestyramine, clofibrate, D‑penicillamine, glycerin, manna, metalloporphyrins, riboflavin, traditional Chinese medicine, acupuncture or homeopathy.

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