Jaundice is a condition that causes the skin and the whites of the eyes to turn yellow, according to the Centers for Disease Control and Prevention (CDC).
It occurs when a yellow substance called bilirubin builds up in the blood. Bilirubin forms when hemoglobin (the protein in red blood cells that transports oxygen) is broken down, per the Merck Manual.It binds with bile in the liver and moves into the digestive tract, where it is mostly eliminated in stool. (A small amount is eliminated in urine.) However, if bilirubin cannot travel through the liver and bile ducts quickly enough, it accumulates in the blood and is deposited in the skin, eyes, and other tissues, which leads to jaundice.
Jaundice is common in newborns. When babies have jaundice, it usually goes away on its own, but in some cases, it can become severe and cause bigger issues. It can also occur in adults from specific disease.
Signs and Symptoms of Jaundice
Infants
Typically, the telltale yellow or orange coloring of jaundice first appears on a baby's face, then it migrates down the body to the chest, abdomen, arms, and legs, notes the CDC.The whites of the eyes can also take on a yellowish hue. Signs in babies that warrant a same-day visit to the doctor include:
- Very yellow or orange skin color
- Extreme fussiness
- Difficulty waking up
- Not sleeping
- Poor feeding
- Limited wet or dirty diapers
If your baby exhibits any of the following symptoms, seek emergency medical assistance:
- Inconsolable or high-pitched crying
- Arching their body like a bow
- Stiff, limp, or floppy body
- Unusual eye movements
Adults
Certain adults are also susceptible to jaundice, according to the Cleveland Clinic.While some don’t exhibit any symptoms, for others, signs may include:
- Change in skin color
- Flu-like symptoms, like fever and chills
- Dark urine
- Clay-colored stool
- Itchy skin
- Weight loss
Per the Merck Manual, other signs of jaundice in adults include:
- Blood in vomit or stool
- Tarry black stool
- Extreme abdominal pain and tenderness
- Sudden drowsiness, agitation, or confusion
- Easy bruising or bleeding, sometimes causing a rash of tiny reddish-purple dots or larger splotches
How Is Jaundice Diagnosed?
Infants
The CDC asserts that newborns should be checked for jaundice at least every 8 to 12 hours in the first 48 hours of life and then again before 5 days old.
Testing options include:
Light Meter Here, a light meter is placed on a baby’s head to check the transcutaneous bilirubin (TcB) level.
Blood Test The baby’s total serum bilirubin (TSB) level is tested after a small blood sample is taken from baby’s heel. According to the CDC, this is the best way to accurately measure bilirubin levels in an infant.
Adults
For adults, the yellowing of jaundice may be easy to spot, but zeroing in on the underlying cause requires a physical exam. According to the Merck Manual, further testing may include:
- Blood Tests Various blood tests may be utilized, including a complete blood count, blood cultures, liver enzyme tests, and hepatitis tests.
- Imaging Tests Ultrasonography of the abdomen is often used to detect blockages in bile ducts. A computerized tomography (CT) scan, magnetic resonance imaging (MRI), or other tests to evaluate the flow of bile through the liver may also be used.
- Liver Biopsy If viral hepatitis, drug use, or exposure to a toxin are suspected (or if a diagnosis is unclear), a biopsy may be required.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) ERCP is a procedure that looks at the bile ducts through an endoscope, according to MedlinePlus.
- Laparoscopy (Rarely) Here, your doctor makes a small incision below the navel and inserts a tube fitted with a camera (laparoscope) to examine the liver and gallbladder. (If a larger incision is required, this procedure is then called a laparotomy.)
Prognosis of Jaundice
Newborn jaundice is not harmful in most cases, and usually gets better without treatment, notes MedlinePlus.
Jaundice typically doesn’t require treatment in adults. However, its causes and complications are the focus of treatment and management, per the Cleveland Clinic.
Treatment and Medication Options for Jaundice
Infants
Treatment and medication options for jaundice differ for infants and adults. According to the Mayo Clinic, if a baby has moderate or severe jaundice, the following treatment options may come into play:
- Additional Feeding Your doctor may advise more frequent feedings or supplementation.
- Phototherapy Here, the baby is undressed down to a diaper and put under special blue-green lights that help break down bilirubin in the skin so that it can be excreted.
- Blood Protein Transfusion When baby’s jaundice is related to blood type incompatibility with mom, an IV transfusion of immunoglobulin (IVIg) may be required. Immunoglobulin is a blood protein that can reduce the level of antibodies that are contributing to the breakdown of baby's red blood cells.
- Exchange Transfusion On rare occasions when severe jaundice doesn’t respond to earlier treatments, the baby may require what’s called an exchange transfusion of blood. Here, small amounts of blood are repeatedly withdrawn and then replaced with donor blood. This process helps dilute bilirubin and antibodies from the mother.
Adults
In adults, the underlying cause of the jaundice is treated, not the jaundice itself, notes the Merck Manual.For example, if jaundice has been caused by acute viral hepatitis, it may clear up gradually as the liver improves. If the cause is a blocked bile duct, a procedure may be performed to open the bile duct.
Medication Options
Treatment focus is always on the underlying causes. Taking cholestyramine by mouth can relieve itchy skin caused by jaundice, yet many patients do not have itchy skin.
Alternative and Complementary Therapies
HealthyChildren.org notes that exposing baby to sunlight through a window may help lower the bilirubin level.This, of course, only works if the baby is undressed. (Newborns should never be put in direct sunlight outdoors.)
There are some studies on herbal medicine used with and without phototherapy for neonatal jaundice, yet the results are not widely conclusive and more studies are needed in the United States.Talk to your pediatrician before starting any complementary and alternative medicine (CAM) approach, especially with infants.
Prevention of Jaundice
Infants
The best way to prevent infant jaundice is to make sure they get enough feedings, according to the Mayo Clinic.For the first few days of life, breastfeeding infants should have 8 to 12 feedings a day. Formula-fed infants typically should have 1 to 2 ounces of formula every two to three hours for the first week of life.
“Regular feeding can help bring the bilirubin level down, so be sure your newborn is going no longer than four hours between feeds,” says Dr. Hill.
Adults
Since there are numerous causes for jaundice in the adult population, there are no hard-and-fast preventive guidelines. With that, here are some helpful steps to take, according to the Cleveland Clinic.
- Avoid hepatitis infection
- If you drink alcohol, drink in moderation, or stop if you have a history of hepatitis or liver injury
- Avoid becoming overweight or obese
- Keep your cholesterol levels healthy
Research and Statistics: How Many Babies and Adults Get Jaundice?
Newborn jaundice is very common. Approximately 3 in 5 babies (60 percent) have jaundice, according to the March of Dimes.
Jaundice is the number one reason why newborns are readmitted to hospital. However, severe cases of jaundice occur in less than 2 percent of full-term infants, notes American Family Physician.
Jaundice is not common in adults, but when it is present, it can be a sign of a serious issue, per American Family Physician.
Related Conditions and Causes of Jaundice
According to MedlinePlus, certain conditions an cause jaundice, including:
- Liver infections from a virus (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E) or a parasite
- Birth defects or disorders that makes it difficult for the body to break down bilirubin (such as Gilbert syndrome, Dubin-Johnson syndrome, Rotor syndrome, or Crigler-Najjar syndrome)
- Chronic liver disease
- Gallstones or gallbladder disorders
- Blood disorders
- Pancreatic cancer
- Bile buildup in the gallbladder due to pressure in the abdominal area during pregnancy
Resources We Love
Centers for Disease Control and Prevention
The CDC is the nation's health protection agency. Their website offers information about the signs, symptoms, diagnosis, risk factors, and treatment of jaundice.
Cleveland Clinic
Cleveland Clinic, a nonprofit academic medical center, is one of the largest and most respected hospitals in the United States and a leader in research, education, and health information. Their website offers information about the causes, symptoms, diagnosis, treatment, and prevention of jaundice in adults.
March of Dimes
The nonprofit organization focusing on mothers and babies has information about the causes of jaundice, along with diagnosis and treatment.
Editorial Sources and Fact-Checking
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