Jaundice is a liver-related condition that causes a yellowing of the skin and the whites of the eyes, and sometimes other less obvious symptoms. While it’s quite common and temporary in newborns, jaundice in children can be a sign of a more serious medical problem.
Jaundice is the result of hyperbilirubinemia, the buildup of a substance called bilirubin in the bloodstream. Bilirubin is produced during the normal breakdown of red blood cells. It’s an orange-yellow substance that usually passes through the liver and is excreted from the body.
When there are abnormally high levels of bilirubin in the blood, jaundice develops, and signs of skin and eye color changes appear. Jaundice in children and adults is unusual and an indication of health issues requiring treatment. It’s important to see a doctor if your child shows any signs of this condition.
In newborns, jaundice usually occurs because an infant’s liver isn’t fully developed enough to properly break down and excrete bilirubin. Jaundice in older children, however, has other causes. They can generally be divided up into three types:
- obstructive jaundice, which results from blockage in the bile duct between the pancreas and the liver
- hepatocellular jaundice, which appears if there is liver disease or damage
- hemolytic jaundice, which develops when there is an abnormal breakdown of red blood cells, leading to excessive levels of bilirubin in the blood
The most apparent signs of jaundice are yellowing of the skin and of the whites of the eyes. Jaundice can also cause color changes to bodily fluids, such as pale stools and dark urine.
If your child’s jaundice is related to a serious medical condition, such as hepatitis, they may have other symptoms, including:
Symptoms of jaundice should be taken seriously, but if they’re accompanied by other signs of distress, get your child to an emergency room or a walk-in clinic as soon as possible.
Jaundice has a range of several possible causes. Knowing the origin of your child’s jaundice is critical in making sure the right treatment plan is put in place. Among the more common causes of jaundice are:
There are five basic types of transmittable hepatitis, each one triggered by a different virus.
- Hepatitis A is often the result of consuming contaminated water or food.
- Hepatitis B is transmitted through bodily fluids. A mother with hepatitis B may transmit the virus to her baby at birth.
- Hepatitis C is typically transmitted through contaminated blood or drug needles, so it may be less likely a cause of jaundice in young children.
- Hepatitis D often develops in people who already have the hepatitis B virus.
- Hepatitis E is usually isolated to developing regions of the world.
Hepatitis A and hepatitis B are preventable by vaccines. Another type of hepatitis, known as autoimmune hepatitis, occurs when the body’s immune system mistakenly attacks healthy cells in the liver.
All forms of hepatitis involve inflammation of the liver. Over time, this can cause serious harm to liver function.
Epstein-Barr virus (EBV)
EBV is a virus, affecting children and adults alike. It tends to be transmitted through bodily fluids, such as saliva.
A child who shares a toothbrush or a drinking glass with someone who has EBV is vulnerable. You or your child could have EBV and experience no symptoms or lasting health problems. But in more serious cases, jaundice, fever, enlarged lymph nodes, and other signs may be present.
Gallstones are small, hardened deposits of bile, a digestive fluid. The deposits form in the gallbladder, a small organ located just below the liver.
It’s not always clear why gallstones develop, but it may be due to an abundance of bile in your child’s cholesterol or too much bilirubin in the bile. If the gallbladder doesn’t properly empty of bile, the fluid can build up and form gallstones.
Cancers of the pancreas and liver may cause jaundice, among other symptoms. However, these are rare in children.
There are several types of hemolytic anemia, but they all cause the destruction and removal of red blood cells at a faster rate than is healthy and normal. Hemolytic anemia can be an inherited condition, passed down from one or both parents, or it can result from an infection or an autoimmune disease, among other things.
An initial diagnosis of jaundice can be made by a physical examination and observation of your child’s skin and eyes. Determining the cause of jaundice can be more difficult.
Your child’s doctor may look for signs of liver disease by checking for unusual bruises or for spider angiomas, which are small, abnormal clusters of blood vessels just under the surface of the skin. If the fingers and palm of the hand turn a reddish color (palmar erythema), that could be a sign of liver disease. A physical exam to check for swelling of the liver will also be done.
A blood test and urinalysis can reveal high levels of bilirubin in the body along with problems with liver function and anemia. Blood tests can also help diagnose conditions such as hepatitis and Epstein-Barr.
If your child has anemia in addition to jaundice, your child’s doctor may also order a screening known as a Coombs test to confirm or rule out whether antibodies are attacking red blood cells. This is a sign that an autoimmune disease is at the root of your child’s jaundice.
The proper treatment for jaundice depends on the underlying condition. Jaundice in newborns resulting from elevated bilirubin levels may be treated with phototherapy. With this treatment, your child is exposed to a special blue light to help reduce bilirubin levels.
If the problem is related to accelerated red blood cell destruction, your doctor may recommend blood transfusions, certain medications, or plasmapheresis, a process that separates plasma from blood cells.
For newborns with very high levels of bilirubin, a blood exchange transfusion may be helpful. During this treatment, small amounts of blood are withdrawn and given to your child to help boost the red blood cell count and drive down the bilirubin levels.
Hepatitis treatments vary, depending on the type of virus. Hepatitis A, for example, usually leaves the body without treatment, though it can take several months. Hepatitis B and C require antiviral drugs.
EBV has no antiviral cure other than time. For EBV and some other causes of jaundice, treatments tend to focus on managing other symptoms, such as nausea and fever.
If liver disease, hepatitis, or another serious medical problem is causing jaundice, you need to follow your doctor’s recommendations for treatment.
Mild cases of jaundice in children can sometimes go away without treatment once the cause has resolved, the way it often does with infants.
Making sure your child has regular bowel movements may also help rid the body faster of bilirubin. Tips for avoiding constipation and establishing regular bowel movements include making sure your child:
- is well-hydrated
- has regular physical activity
- gets enough dietary fiber, which can be found in fruit, beans, and bran cereals
A mild case of jaundice will usually disappear on its own. Once an underlying cause, such as hepatitis or hemolytic anemia, is treated, jaundice and other symptoms will also vanish.
Preventing jaundice isn’t always possible, especially if your child has an inherited condition or an autoimmune condition that’s causing the bilirubin buildup. However, good hygiene and avoiding the sharing of cups and other items that might carry a virus may reduce the risk of conditions such as EBV. Two of the most common types of hepatitis are preventable by vaccines.