When the rosy baby turns into a child whose skin appears yellow, this is known as bilirubinaemia of the newborn. The yellow colour is not only visible on the body, but also in the eyes. The white sclerae turn yellow.
The breakdown product from the red blood cells is not excreted by the baby in sufficient quantities. It therefore accumulates under the skin in the fatty tissue. The child becomes yellowish in colour.
Many children have this. This is because newborn babies break down their red blood cells particularly quickly. They are not yet able to excrete the breakdown product well. In most cases, the increase in bilirubin is completely normal. After the first week of life, the yellow discolouration decreases visibly. Only rarely does the baby's bilirubin level rise to a level that is dangerous for the baby.
You can recognise the first signs of an excessively high bilirubin level by your child sleeping for an unusually long time. You will soon notice that they are also drinking less. You may notice that your child appears generally more listless. This is a warning sign. It does not mean that the baby is "peaceful". It indicates that the baby is under a lot of strain due to the breakdown of bilirubin. The "calm" child can quickly turn into a baby who - with a sharp cry - is stretching his head backwards a lot and has a fever.
That's why it's important for your child that you act now.
What you can do if you have bilirubinaemia
Wake him up at regular mealtimes if he does not wake up on his own. Support your milk flow reflex and motivate the child to drink. If you don't succeed, pump the breast milk out of the breast and feed it to the baby. Observe his general condition and check his temperature.
You cannot judge for yourself how high the bilirubin level in your blood actually is. The value cannot be observed. You have to measure it. This requires technical support.
Many midwives and paediatricians offer this measurement. If you don't have a doctor or midwife, take your child to the clinic where you gave birth. This check can also be carried out there.
Whether and how your baby is treated depends on the measurement result and the general condition of your child. Your observations are important. They help in the further decision-making process.
If the child drinks regularly, neonatal jaundice will improve.
How bilirubin is measured
The bilirubin is in the child's body. The amount, i.e. how high the bilirubin level is, can therefore be determined with a blood sample. But not every yellow baby needs to be pricked. There is a simple test procedure that has been replacing blood sampling for some years now. This is the so-called "transcutaneous bilirubin test". The value is measured through the skin. Blood is not required for this. It is a small device that is held against your baby's skin. A beam of light measures the bilirubin level. The result is so accurate that an additional check of your baby's blood is only necessary if the value is particularly high.
The transcutaneous control is safe for your baby. It does not hurt him.
The treatment of hyperbilirubinaemia
If your baby shows mild signs of impairment, frequent meals are sufficient therapy. If the bili value exceeds the normal limit, the doctor will prescribe phototherapy for your child. The baby will be temporarily exposed to blue-green light in a hospital cot. Of course, it can continue to be breastfed. The treatment usually only lasts a few hours. As soon as the bilirubin level drops steadily, you can go home with your baby. You do not have to leave your baby alone in the clinic. If phototherapy is started while you are still at the clinic, you will simply be discharged later. If you have already been at home with your baby, you will be given a bed and something to eat at the paediatric clinic. You can of course continue to nurse and breastfeed the baby. The staff will be pleased to have your support.
Very rarely, the value is so high that there is a real danger to the baby's brain and development. In this case, phototherapy is not enough. The child also needs special medication. Some babies receive an exchange transfusion. This involves replacing the child's blood with donated blood. The high bilirubin level is lowered by replacing the blood. The doctors will carefully consider which additional therapy is required once they have found the cause of the severe progression.
Does breastfeeding make the baby yellow?
Breastfed children actually have a higher risk of turning yellow. This is also due to the fact that they often have less food to start with than bottle-fed children. The intestinal flora of breastfed babies also plays a role. Of course, this does not mean that you should not breastfeed your baby. It is important that you take the time to breastfeed. So that your baby also gets enough nutrition in the first few days. Breast milk is good for the baby. Frequent feeds are a good prophylaxis for neonatal jaundice.
Just in case -
What you need for your hospital stay
If you accompany your baby to the clinic because of jaundice, you will be admitted as an accompanying mother. If possible, the clinic will give you a shared room with your baby. The baby will be fully cared for. You will only need suitable clothing for the journey home and a suitable baby carrier for the car journey and the documents:
- Child examination booklet.
- Referral licence.
- Health insurance card (if you already have one).
Just pack what you need for the next few days.
- Breastfeeding-friendly clothing*.
- Sleeping clothes.
- Towels, flannels, hygiene products (including sanitary towels for the menstrual flow).
- Shoes that you can slip into quickly (e.g. slippers).
- Breastfeeding aids, such as Nursing cap*, Nursing pads*, Nursing pillow* if you use them (most clinics have a breast pump and accessories available).
- Food for in-between meals (bars, almonds, fruit, etc.).
- Mobile phone, charging cable.
- Perhaps you have the time and desire to read something. Then take a book with you.
- Health insurance card from the parent with whom the child is insured, if you do not yet have the child's card.
- Your maternity pass.
- Telephone number of your midwife (she will also visit you in the clinic).
Some small change. It is better to leave valuables at home.
