Can newborn jaundice return after phototherapy?

Question

Hello doctor,

I have a question about my newborn baby.

My baby was born about 12 days ago. Two days after birth, her jaundice level was 16.8 mg/dL, and she was admitted to the NICU for phototherapy.

After discharge, her jaundice rebounded within a few days, and the level increased to 17.8 mg/dL. She was admitted to the hospital again and received double-light phototherapy for four days.

Yesterday, her bilirubin level was 10.8 mg/dL, and she was discharged. However, today she still looks yellow to me.

Is this normal, or should I be concerned about the jaundice returning again?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

It can be worrying to see your baby looking yellow again after two admissions for jaundice.

In newborns, especially during the first two to three weeks of life, it is not uncommon for the skin to continue to appear somewhat yellow even after the bilirubin level has fallen significantly.

A bilirubin level that decreased from 17.8 mg/dL to 10.8 mg/dL after phototherapy is reassuring. However, whether the current yellow appearance is normal depends on your baby's age, feeding, weight gain, and the current bilirubin level.

Since your baby is still very young, some babies may develop breast milk jaundice, which can persist for several weeks despite otherwise being healthy and feeding well.

However, because your baby had rebound jaundice requiring readmission, I would recommend contacting your pediatrician and arranging a repeat bilirubin measurement if the yellow color seems more noticeable again.

Please seek urgent medical attention if your baby:

Is feeding poorly or refusing feeds.
Is difficult to wake.
Has a weak cry.
Has fewer wet diapers than usual.
Develops a fever.
Appears very sleepy or less active than normal.

To guide you better, please let me know:

Was your baby born at term or prematurely?
What was the birth weight and current weight?
Is your baby breastfeeding, formula feeding, or both?
What is your baby's blood group and the mother's blood group, if known?
Is the yellow color mainly on the face and eyes, or does it extend to the chest, abdomen, arms, and legs?
Has a bilirubin level been checked since discharge?

If your baby is feeding well, passing urine and stools normally, and is otherwise alert, the yellow appearance may simply reflect residual jaundice. Nevertheless, given the recent rebound hyperbilirubinemia, a follow-up bilirubin check would be prudent rather than relying on appearance alone.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.