Our Mommy MD Guide’s reply: I had to deal with this problem with all three of my children. While I was completely freaked out by it with my daughter, it definitely seemed much more manageable with my third child.
I distinctly remember that when my daughter was born, my mother commented on her perfect “peaches and cream” complexion and that she was sooo beautiful. (But she didn’t look at all like me!) Within the first one to two days, however, her complexion seemed to be less rosy and more pale. I have to say that I really did not notice any yellowness in her skin or eyes, and that I was majorly floored when I was told that her total bilirubin was a whopping 13mg/dL! (And here I was a new gastroenterology/hepatology fellow!!)
Treatment of neonatal jaundice, when indicated, includes maintaining adequate hydration with frequent nursing and/or formula, and phototherapy. Several forms of phototherapy are available.
When my daughter was born, about 12 years ago, we had phototherapy lights installed over her crib. We had to put little felt “sunglasses” over her eyes to prevent any ocular damage, and turn her from her front to her back at 10 to 15 minute intervals. She looked like she was catching rays in a tanning booth!
My boys were prescribed more portable phototherapy “vests” that were applied directly to their torsos, which applied light to their front and back simultaneously.
All of my kids required frequent rechecks of their bilirubin levels, which peaked and then dropped in less than a week.
For my daughter, I also had a visiting nurse come to the house. She gave me a card where I was supposed to record the amount of time my daughter was under the “Bililights,” how many minutes I nursed her, and how much formula I gave her. I remember that I was so freaked out about the whole situation, that I stayed up the whole first night with her, and was very diligent about recording everything. In the morning, the nurse’s eyes nearly popped out of her head when she saw how much I had recorded! Her next bilirubin level dropped like a rock! After taking Internal Medicine and then GI fellowship call every third or fourth night for the past four years, for me, taking care of only one “patient” was a snap!
I think that my kids inherited this problem from my husband, although my mother-in-law vehemently denies it. However, she did relate a story that when David was born he was so “nice and brown” because she ate so many carrots when she was pregnant, and that the pediatrician told her to keep him in from of a sunny window. I don’t know, what do you think?
—Stacey Weiland, MD, a mother of a 12-year-old daughter and 7- and 5-year-old sons, and an internist/gastroenterologist in Denver, CO