What is newborn jaundice?
Newborn jaundice is a common and usually harmless condition in which a
newborn's skin and eyes turn yellow. About 60% of babies suffer from it.
Jaundice occurs when too much bilirubin builds up in the blood.
Sometimes it goes away on its own, or your doctor may suggest light therapy or
other treatments to clear it up.
Causes
Some of the body's red blood cells are broken down daily and create
bilirubin in the blood. The task of the liver is to filter it from the
bloodstream. When your baby is still in the womb, your liver removes bilirubin
for him. After birth, your baby's liver takes over.
Sometimes your newborn's liver can't break down bilirubin as fast as his
body can, and it starts to accumulate. Because bilirubin is a yellow compound,
it turns your child's skin and eyes yellow.
Children are more prone to jaundice if they:
- Born before 37 weeks
- Of East Asian or Mediterranean descent
- Having trouble breast or bottle feeding
- A younger sibling of a child who had jaundice
- Born to a mother with type 0 or Rh-negative blood
Jaundice usually appears 2 to 3 days after the baby is born and resolves
within the first two weeks. Some types may appear earlier or much later.
Jaundice image
Jaundice during breastfeeding occurs due to the fact that the child eats
little. The milk may not come yet, or the baby may have problems latch-on. The
more your child eats, the faster his body removes waste products from the body,
including bilirubin.
Breast milk jaundice appears after the first week. Doctors don't know
exactly why this happens, but they believe something in breast milk is
preventing your baby's liver from processing bilirubin efficiently. This type
of jaundice can last for several months.
The most serious types of jaundice are caused by diseases or conditions
such as:
- Hemorrhage (bleeding) somewhere inside your baby's body
- Infection of the blood (sepsis)
- Bacterial or viral infections
- Liver problems
- Lack of certain enzymes
- Problem with red blood cells that makes them break too easily
Jaundice can also occur if the mother has a different blood type than
her baby. If this is your case, your body may produce antibodies that attack
your child's red blood cells. In some cases, you can help prevent this by
giving injections during pregnancy.
Symptoms
A clear sign of jaundice is the yellow color of your baby's skin and the
yellow color of the whites of his eyes. Usually starts on the face. As soon as
the level of bilirubin in the blood rises, the yellow color moves to the chest
and abdomen, and then, finally, to the legs and arms. Severe jaundice can be an
emergency, so call your doctor right away if:
- Your baby isn’t eating or their diapers aren’t wet
- Your baby is hard to wake up
- Your baby won’t stop crying or is making a high-pitched cry
- Your baby is limp or stiff with their back arched
- Your baby’s eyes are moving strangely
Diagnostics
Usually, a doctor can tell that your baby has jaundice by looking at
them. But they will also want to know the amount of bilirubin in your child's
blood so they can decide on a treatment plan. They can:
- Take your child's blood and send it to a lab to measure bilirubin levels and types.
- Check your child's skin with a device that measures bilirubin by illuminating it with a special light.
If your doctor suspects an illness is causing your child's jaundice,
they may do other tests, such as:
- A urine sample to check for infection
- A complete blood count to measure the number of red blood cells
- A reticulocyte count to see if the number of newly formed red blood cells is normal
- A blood type test to see if the mother’s blood is incompatible with the baby’s
- A Coomb’s test to see if the immune system is destroying the baby’s red blood cells
- A liver function test
Treatment
In many cases, jaundice resolves on its own within 1 to 2 weeks. Your
doctor will decide if your child should wait or start treatment, such as:
- Additional supplements. Taking more breast
milk or formula will help your baby poop more often, which will help clear the
bilirubin from the body. Or, if your baby is having trouble breastfeeding, your
doctor may recommend that you also give him breast milk from a bottle or
formula.
- Phototherapy. The doctor puts
your baby under a blue-green light. This can help flush bilirubin out of the
body in the urine. They will only wear a diaper so that most of their skin can
absorb light. They will wear eye patches. The light may come from a special
pillow or mattress that emits blue-green light.
- Intravenous immunoglobulin. If your baby's
jaundice is because he has a different blood type than his mother, your doctor
may need to give him an intravenous blood protein that helps stop the breakdown
of red blood cells.
- Exchange transfusion. If your child has
severe jaundice that doesn't get better with other methods, they may need a
blood transfusion called an exchange transfusion. During this process, your
doctor takes a small amount of your child's blood and replaces it with a
donor's blood.
Your baby will need to stay in the newborn intensive care unit for the
procedure. Babies rarely need this level of treatment for jaundice.
Complications of newborn jaundice
Do not hesitate to examine the child if you notice signs of jaundice.
It's rare, but if severe jaundice isn't treated, bilirubin can get into the
brain and cause permanent damage. This condition is called kernicterus, a
complication that includes:
- Cerebral palsy
- Hearing loss
- Vision problems
- Seizures
- Developmental disabilities
Prevention of jaundice in newborns
There is little you can do to prevent typical newborn jaundice. But you can help keep it going by making sure your child is well fed. If you are breastfeeding, aim for 8-12 feeds a day for the first few days of your baby's life.