Newborn jaundice is yellowing of newborn’s skin and whites of eyes. It is quite common and develops due to excess buildup of bilirubin, the yellow pigment produced during the breakdown of red blood cells.
It is common in babies born before 38 weeks of gestation (preterm babies) and babies who are not adequately fed with breast milk or formula milk. It generally occurs as the baby’s liver is yet to mature to effectively remove the bilirubin and other underlying health conditions might also cause newborn jaundice. Also Read: Jaundice: Learn What Causes The Disease In Children And Adults
It is normal for the newborn's bilirubin level to be slightly high after birth. While the fetus is growing in the womb, the placenta plays a major role in removing the bilirubin from the fetus, the placenta nourishes and feeds the fetus during pregnancy. Soon after birth, the newborn’s liver starts this job and it might take some time for the newborn’s liver to perform this function effectively.
Hyperbilirubinemia (excess bilirubin) is the cause of jaundice. The newborns generally secrete more bilirubin than adults due to faster production and breakdown of red blood cells in the initial few days of life. Generally, the liver filters bilirubin from the bloodstreams and releases it into the gastrointestinal tract. The neonate’s immature liver cannot filter bilirubin rapidly, which leads to the spike of bilirubin levels. This type of jaundice is categorized as physiologic jaundice and it shows on the second or third day of life, which is harmless and settles within two weeks.
Other disease conditions that can cause newborn jaundice includes hemorrhage, sepsis, bacterial infections, a mismatch between mothers and baby blood, liver disorder or malfunction, enzyme deficiency and malfunctioning of newborn red blood cells that leads to rapid breakdown.
The first and foremost signs and symptoms of newborn jaundice is yellowing of the skin and whites of the eyes, typically observed between 2 or 4 days of birth. The colour change is initially visible in the face first before spreading throughout the body. The level of bilirubin peaks 3- 7 days after birth. Also Read: Yellow Eyes? It Could Be Jaundice
The normal values of total bilirubin range from 0.3-1.0 mg/dl and the normal direct bilirubin value is 5.2 mg/dl within 24 hours of birth. Generally, phototherapy is started when the total serum bilirubin level is at or above 15mg/dl in newborns within 25-48 hours of birth.
Some of the risk factors for severe jaundice that may worsen the condition in newborn’s include:
Premature Birth: A neonate born before 38 weeks of gestation may not be able to produce bilirubin as quickly as full-term babies. Moreover, preterm babies may feed less and have fewer bowel movements, resulting in a minimal amount of bilirubin excreted via stool.
Bruising During Birth: Infants who become bruised during delivery gets bruises from the delivery and may have higher levels of bilirubin due to the breakdown of more red blood cells.
Nature Of Blood Type: If the mother’s blood type is different from her newborn’s, then the baby might have received antibodies via the placenta that leads to an abnormally rapid breakdown of red blood cells.
Breast-Feeding: New-born babies who have difficulty latching or getting sufficient nutrition from breastfeeding are at an increased risk of developing jaundice. While dehydration or a low-calorie intake may also contribute to the onset of jaundice. As the benefits of breastfeeding outweigh, medical experts highly motivate lactating mothers to continue breastfeeding even if the babies find it difficult. Apart from this, it’s essential to ensure your baby gets adequate nutrition and is well hydrated.
Diagnosis And Treatment
The doctors generally diagnose the condition based on the newborn’s appearance; a complete physical examination is performed to determine the colour changes in the body. The doctors also suggest certain tests such as blood and urine test to measure the bilirubin level. A skin test with a device called transcutaneous bilirubin meter specifically detects the reflection of special light flicked through the skin.
Generally, mild jaundice settles on its own within two to three weeks, however, for moderate jaundice, the infant requires hospitalization and treatment includes phototherapy where the newborn will be placed under a special lamp that emits light in the blue-green spectrum. The light has the potential to change the structure of bilirubin which enables it to be excreted via the urine and stool. In the course of the treatment, the baby will wear only a diaper and protective eye patches.
Intravenous immunoglobin is given to newborns where jaundice is caused due to Rh compatibility. In severe cases, a blood transfusion may be needed if other methods of treatment fail to work.
Doctors suggest the mothers feed the newborn frequently which provides them with more milk and improves the bowel movement that allows the excess amount of bilirubin to be excreted via the stool. It is recommended to breastfeed the babies on an average 8-12 times during the first few days of life.