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Sunday
Apr042010

Visualizing Jaundice in the Newborn

After a baby's birth, one of the things a midwife does is check for jaundice. (Jaundice will be discussed in the "Jaundice" post.) One way, shown here, is to gently press one's thumb into the baby's skin to see if there is a different colored/yellow thumbprint left once the thumb is removed.

1. Look at the whole baby.

2. Does the baby have a red color or a yellow tinge. (A bright red color is indicative of polycythemia, which moves to jaundice as it resolves, but jaundice also occurs without polycythemia. I'll talk about polycythemia when I get a baby that has it.)

3. If you see the baby darker in the upper body, yet lighter in the lower body, the jaundice isn't terribly pronounced, letting you know the bilirubin isn't very high. In this picture, however, you see a baby with yellowing down to her toes,  causing me enough concern to send the parents in for a "bili check." However, because the baby didn't have any other symptoms of serious jaundice, the doctor said they could remain home, nursing like crazy to help the bilirubin pass through the system.

4. Pressing, starting at the chest and moving down the body, note where the lowest area is that turns yellow after letting pressure release. Chart that location.

5. Decide, based on experience, whether the baby needs to be seen or if leaving mom and baby alone to work it out is the best option.

(More in "Jaundice" post.)

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Reader Comments (2)

My first had polycythemia (pretty severe too) as a result of a CHD that was making her blood oxygen levels low. The homebirth midwife erroneously thought at first that it was because we had let the cord pulse an unusually long time, but that actually ought to make no difference at all.

April 4, 2010 | Unregistered CommenterLily

My daughter had breast milk jaundice. It probably lasted about 3-4 weeks total. My husband and I are both redheads, our daughter is too, and we are all very pale skinned. Her skin was *very* yellow (eyes were fine) and made me nervous but her levels were always low.

My friend and her husband are both olive skinned, so is her son. He remained a few extra days in the birth center under the lights for high levels (possibly ABO related). He didn't look yellow at all.

Funny how natural skin tone can change the appearance of jaundice.

April 7, 2010 | Unregistered CommenterJen

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