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Physiologic Jaundice

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Physiologic hyperbilirubinemia



  • Physiologic jaundice is the development of a yellow-colored skin in the newborn infant, a normal occurrence that is seen in the majority of babies; in some infants, however, it requires therapy or observation.

  • Jaundice, or a yellowish tinge to the skin
  • This usually starts on the face, and moves down the body as the level of bilirubin in the blood increases.
  • Icterus, or yellow tinge to the whites of the eyes, is sometimes also seen.

  • Jaundice is caused by accumulation of a compound called bilirubin.  Bilirubin is created when old blood cells are broken down and their biochemical parts are recycled.  In the newborn infant, this process is slower, for a variety of reasons.  Consequently, bilirubin levels become elevated and jaundice develops.

  • Babies with jaundice require blood testing to determine both the level of bilirubin in the bloodstream and the type of treatment.  The blood testing also helps to confirm that the jaundice is due to normal processes, rather than an illness or infection.

  • Premature babies are at a higher risk of developing physiologic jaundice; additionally, these infants require phototherapy for lower bilirubin levels.

  • Generally no treatment is required
  • Therapy depends upon the level of bilirubin in the blood.
  • If the level is high enough, it probably is not physiologic jaundice but is" jaundice of unknown cause" and special lights, called "phototherapy," may be used to help the baby lower the blood concentration of bilirubin.  Phototherapy can often occur at home, with daily blood level checks accomplished by visiting nurses, or at the doctor's office.  Most infants need phototherapy for only a few days.
  • If the baby's bilirubin is very high, hospitalization may be required for more intense phototherapy.
  • If the level is only slightly elevated, it can often be brought back down with several simple measures at home:
    1. Bilirubin is excreted in the baby's stool.  Increasing the number and volume of feedings, so as to increase the frequency of bowel movements, will help the infant to clear the bilirubin.
    2. Sitting in the sunlight, or near a window, with the baby for 10 or 15 minutes several times a day might work much like phototherapy.

  • Untreated hyperbilirubinemia can lead to serious problems, including brain damage.
  • If hyperbilirubinemia is treated correctly, affected infants do very well, with no long-term problems.

  • Contact your pediatrician immediately.




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