Newborn Jaudice

What is Newborn Jaundice

Jaundiced means yellowish discolouration of skin and other body parts due to buildup of a chemical called bilirubin in the tissues of the body. The white portion of the eyes are the first to be noticed yellow and as the levels of bilirubin go higher even the palms and soles will appear yellow. Jaundice in a Newborn baby is very common in the first two weeks of a baby’s life. It is usually harmless but may be due to a serious problem which needs to be treated.

What causes jaundice in newborn babies?

Newborn babies have more red blood cells which contain fetal Haemoglobin(HbF) than adults and when the red blood cells are broken down, bilirubin is released into the blood. Normally liver handles and eliminates bilirubin from the body, but the newborn’s immature liver is unable to handle the bilirubin load causing Jaundice. Usually this is harmless and is called physiological jaundice. This type of jaundice is usually first seen between day 2 and day 4 of life, increases to a peak at day 7 and then fades and disappears by day 14.

Jaundice may be due to other problems if

  • It starts in the first day of life
  • If the bilirubin level is very high
  • baby is unwell (eg, irritable or not feeding well).
  • If present two weeks after the birth, or  baby passing pale/white stools
  • Mothers Blood group is Rhesus negative and babys blood has antibodies against the red blood cells

How is Newborn Jaundice treated

Usual treatment for Newborn jaundice is Phototherapy. Other tests and treatments may also be needed if needed.  Phototherapy uses a blue light (wavelength 420-470 nm) that converts bilubin into a form that can be easily excreted in the urine and feces. Phototherapy light is not related to ultraviolet lights and is safe and effective. Standard charts are used to see if the bilirubin level is high enough to need treatmentBabies receiving phototherapy need as much skin exposed to the light as possible. Your baby will need eye pads to protect their eyes. In addition maintaining good volume of feed intake is essential to avoid dehydration If the jaundice levels are very high and depending on the underlying cause baby might need Intravenous fluids, antibiotics, IV immunoglobulin and very rarely exchange transfusions which involves replacing baby’s blood with compatible fresh blood.

PS: Sunlight is not advised as a treatment for newborn jaundice as the might get cold or get sunburns.

How long this jaundice lasts?

In breastfed babies, jaundice may lasts for two to three weeks. In formula-fed infants, usually they disappear by two weeks.

What is Prolonged jaundice?

Jaundice that lasts until and after 14 days after birth (or 21 days for premature babies) is called prolonged jaundice. Most often due to breast-feeding but this is harmless and is not a problem for the baby.

What tests are needed for neonatal jaundice?

A blood test is needed to measure the level of bilirubin. Other tests may be needed.which include tests for any infection, blood counts, thyroid functions, and an ultrasound scan of your baby’s liver. Noninvasive methods are available to check bilirubin levels but not widely used in our country.

What are complications of neonatal jaundice?

If the level of bilirubin goes very high then this can damage a baby’s brain and cause problems like cerebral palsy, learning difficulties and hearing problems. This is called kernicterus.

Author:Dr. S. Boopathi