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On Call: Well-Baby Newborn Visits

Q. When our baby was born four years ago, we didn't go to the pediatrician until she was 2 weeks old, but now with the birth of our second, I'm told we should go at 5 days old or sooner. Why?


A. Because of jaundice  -- a buildup of bilirubin in the bloodstream that causes a newborn's skin to turn a yellowish color. In 2004 the American Academy of Pediatrics introduced new guidelines; their goal was to make the evaluation and treatment of jaundice more consistent and to prevent complications that can occur.

Jaundice is common and, in the vast majority of cases, harmless. However, when bilirubin levels get too high, especially if the infant is premature, sick, or otherwise at risk, it can cause hearing loss or even brain damage. Exposing a baby with jaundice to ultraviolet light  -- photo-therapy  -- changes the bilirubin into a substance that's easier for the body to dispose of, and is the most typical and effective treatment used. In many cases, it can even be done in the comfort of your home.

Now before you leave the hospital with your newborn, a careful jaundice risk assessment is done, including:

  • taking more blood tests than pediatricians did in the past.
  • recommending that babies be seen earlier for jaundice checks after leaving the hospital.
  • noting how much  -- as well as how often  -- they're eating, especially in exclusively breastfed babies, because poor feeding can cause higher bilirubin levels.

It can be tough to go back out again so soon, but it's important. As a pediatrician, I like the earlier visits  -- not only so I can check for jaundice but because I'm better able to help with breastfeeding. And moms and dads leave more relaxed, knowing that their newborn has checked out just fine.

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