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The Truth About Jaundice in Newborns

In the first few days after birth, your baby’s skin might develop a yellowish tinge called jaundice. Research studies have shown that this is a rather benign issue that is known to affect nearly 60% of all healthy babies who are born after 38 weeks. Apart from that, the condition is most common in babies who are either born prematurely or are unwell at birth.

Jaundice basically disappears over time and shouldn’t really be considered a problem. However, most parents worry about it being a serious illness. If truth be told, all the monitoring that is performed on such babies is enough to make parents think that it’s a major problem. Jaundice is actually triggered due to an increase in red blood cell breakdown, and the inability of a baby’s immature liver to remove bilirubin from the bloodstream.

With that, here’s an in-depth look into the occurrence of jaundice in newborns and its treatment:

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6 What Exactly is Jaundice?

Jaundice is a condition that is caused by the excess of bilirubin in a baby’s blood. For those who don’t know, bilirubin is a yellow substance that is produced by the body during the break down of red blood cells. During the time your baby is in the womb, it is the responsibility of the placenta to remove the bilirubin from his body. However, after delivery, this function is then performed by your baby’s liver. 

But the downside to this is that the liver of a newborn baby is not fully developed at birth and it takes from a few days to a few weeks for it to function fully. All through this time, your baby’s body continues to recycle red blood cells, and eventually, there is far more bilirubin produced than can be excreted.

It’s fairly normal for a baby to have jaundice in the first 5 days of life. Most babies actually leave from the hospital by the time jaundice sets in. for this reason, there’s a good chance that your doctor may call you back for a follow-up exam when your baby is around 3-5 days old. 

Problems caused by untreated jaundice

Babies typically have milk jaundice that tends to get better or go away on its own within a week without causing any major problems whatsoever. However, it needs to be taken seriously in certain cases. This is because if the bilirubin level stays high and isn't treated, it can cause brain damage called kernicterus. This can lead to serious lifelong problems.

Severe jaundice with bilirubin levels of over 25 mg that remain untreated can cause deafness, cerebral palsy, or other forms of brain damage. In rare cases, jaundice may be a sign of another condition, such as an infection or a thyroid problem.

5 The Different Types of Jaundice

Some of the most common types of jaundice are inclusive of:

  • Physiological jaundice: A majority of newborns suffer from this form of mild jaundice for the simple reason that their bodies aren’t mature enough. It appears when the baby is about 2-4 days old and goes away in maximum 2 weeks.
  • Jaundice of prematurity: A premature baby’s body is even less capable of excreting bilirubin, which is why this form of jaundice is common in them. In order to avoid further complications, it’s normal for premature babies to be treated even when their bilirubin levels are lower than those of full-term babies with normal jaundice.
  • Breastfeeding jaundice: At times babies suffer from jaundice because they don’t receive enough breast milk. This lack of breast milk maybe caused by difficulty with breastfeeding or because the mother’s milk has not set in yet. It must be mentioned here that the problem is not caused by the breast milk on its own, but actually a lack of it. If a baby has this type of jaundice, it's important to involve a lactation (breastfeeding) consultant.

  • Breast milk jaundice: In about 1 to 2 % of breastfed babies, jaundice may also be triggered due to substance found in breast milk that may lead to a rise in bilirubin levels. These substances may hinder the excretion of bilirubin through the intestines, thereby leading to the onset of jaundice. Recovery in this case may take up to 3 to 12 weeks.

Blood group incompatibility

In case a mother and baby have different blood types, it’s natural for the mother’s body to produce antibodies that destroy the baby’s red blood cells. This leads to a buildup of bilirubin the blood the baby, thereby triggering jaundice.

4 The Causes of Jaundice in Newborns

The major reason why babies suffer from jaundice is because their bodies have far more bilirubin that they can get rid of. Just so you know, bilirubin is a yellow substance that is produced when the body breaks down old red blood cells. It is passed out of the body through urine and stool. All through pregnancy, your body removes bilirubin from your baby by means of the placenta. However, after being delivered, your baby’s body needs to get rid of the bilirubin by itself.

Babies typically suffer from what is known as physiologic jaundice. The major cause of physiologic jaundice is that their organs are not yet capable of getting rid of excess bilirubin effectively. This particularly form of jaundice basically appears about 24 hours after birth. Although it goes away in about a week, it tends to get worse on the third or fourth day. However, there are other factors as well that may lead to the onset of jaundice in rare cases. 

These include an infection, problem with the mom’s and baby’s blood type or even a problem with the baby’s digestive system. If your baby suffers from jaundice less than a day after birth, then there’s a good chance that he has one of the aforementioned problems.

A much rarer cause

At times babies swallow blood during the birthing process. The blood they swallow is then broken down in their intestines and then absorbed into the bloodstream. This basically leads to a rise in serum bilirubin, which leads to jaundice.

3 Symptoms of Jaundice

To begin with, a baby who is suffering from jaundice will develop a yellow tinge on his body beginning from the face and head and often spreading downwards. The yellow tinge may not be as obvious in case the baby has olive or dark skin. With the onset of jaundice, the whites of her eyes, palms of the hands, soles of the feet and inside the mouth may also turn a bit yellow. 

Apart from that, the baby may also be very sleepy and drowsy, may not feed effectively, and have dark yellow urine and pale stools. With the bilirubin levels increasing in the baby’s body, the skin may turn yellow from the head down.

Jaundice is typically known to appear around the second or third day after delivery. Apart from the face, the chest, stomach and even the legs of a jaundiced baby tend to have a yellow appearance. Considering that most newborns are sent home after delivery one or two days after birth, it is extremely important for them to be checked by the doctors for jaundice about a day or two later.

Parents need to pay attention too

It is equally important for parents to watch their babies for jaundice. The fact of the matter is that jaundice can be hard to see at times, particularly in babies who have dark skin. In case you are unsure, gently press the skin on your baby's nose or forehead — if jaundice is present, the skin will appear yellow when you lift your finger.

5. Diagnosis of Jaundice in Newborns

The diagnosis of jaundice in babies depends on performing an examination of the newborn and carrying out a blood test to check the amount of serum bilirubin in their blood. After delivery, your doctor may follow your newborn closely to keep an eye on the development of jaundice. It’s also common practice for some hospitals to check total bilirubin levels on newborns prior to sending them home.

Although the blood is the most accurate means of diagnosing neonatal jaundice, a bilirubin reading can also be obtained by placing a handheld sensor against the skin of the newborn. In case the reading is high, a blood test will be ordered in order to acquire an accurate reading of bilirubin levels. 

Additional blood tests may be ordered for those newborns who require treatment and monitoring, or for those who may have other underlying conditions thought to be causing neonatal jaundice. Considering the dangers of jaundice in case it goes undiagnosed and untreated, it’s extremely important for you, as a parent, to keep an eye on your child’s skin color and for your doctor to check your baby for jaundice before sending him home.

The risk factors for jaundice in newborns

Nearly 60% of all newborns suffer from jaundice. However, there are certain risk factors that may increase a baby’s chance of developing neonatal jaundice. A few of these are:

1. Being a preterm baby

2. Having siblings who have had neonatal jaundice

3. Blood type incompatibility

4. Mother with diabetes

5. Congenital infection

2 Treatment of Jaundice

Any baby with a bilirubin level that is above the normal range will require treatment for jaundice. The baby will actually be placed under a type of fluorescent light for treatment purposes. This treatment process is known as ‘phototherapy’ and is meat to help the skin absorb light. Upon doing so, the light changes the bilirubin so that it becomes easier for the body to get rid of it. Although the treatment is usually performed in a hospital setting, at times babies are also treated with phototherapy at home.

Apart from that, an exchange transfusion may also be performed on babies suffering from neonatal jaundice. In this particular form of blood transfusion, only a small amount of the baby’s blood is removed. After removal, the same amount is replaced with blood from a matching donor. As a parent, it is best for you to refrain from treating jaundice at home by placing your baby in the sun. 

Special lights and controlled surroundings are always needed to treat jaundice safely. Also, if jaundice was triggered by a health problem, it will be necessary for the underlying condition to be treated as well. For example, a baby with severe jaundice caused by Rh incompatibility may need a blood transfusion.

How can I help my baby?

As a parent, it is highly recommended for you to look closely at your baby’s skin at least twice a day to make sure that his skin color is coming back to normal. For those who have darker babies, just take a good look at the white part of the eyes. While you are at it, make sure that you take your baby to the doctor for all follow-up tests.

1 Complications Caused by the Condition

In case a baby with extremely high levels of bilirubin remains untreated, there’s a good chance that he will develop permanent brain damage. The condition is typically known as ‘kernicterus’. However, the good news is that the condition is extremely rare and affects only 1 in every 100,000 babies born.

Apart from that, in newborns that have very high levels of bilirubin in the blood, it is possible for the bilirubin to cross the thin layer of tissue that separates the brain and blood. High levels of bilirubin can also damage the brain and spinal cord, which can prove to be life-threatening for the baby. Brain damage caused by high levels of bilirubin is also called bilirubin encephalopathy.

Further details

If significant brain damage occurs before treatment, a child can develop serious and permanent problems. Some of these are inclusive of:

  • Cerebral palsy – a condition that is known to impact a child’s co-ordination and movement
  • Involuntary twitching of different parts of their body
  • Hearing loss that may range from mild to severe
  • Poor development of the teeth
  • Learning difficulties

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