Jaundice in Newborn or Neonatal Jaundice

April 8th, 2024 | 10:33 am

Jaundice is a common problem among babies, affecting about 60% of the full-term children and more than half of the premature ones. It is a medical condition in which newborns develop the most prominent sign, i.e., yellow colouration of the skin and eyes. Neonatal jaundice is usually harmless and transient; most of the time, it goes away without treatment, although the condition can be worrying for the parents. It is always wise to consult your doctor as it might also be a symptom of chronic medical conditions before they deteriorate further.

What is Jaundice in Newborns?

An infant developing jaundice means that the levels of bilirubin in your baby’s blood are high, which causes the skin (including the whites of the eyes) to become yellowish. The term used in medicine for this medical condition is Hyperbilirubinemia. When red blood cells degrade, your body produces yellow bilirubin. Throughout your pregnancy time frame, your liver removes the bilirubin for your unborn child. Your baby’s liver, however, needs to start eliminating bilirubin after birth. Your infant’s liver might be unable to eliminate bilirubin if it isn’t fully grown. Your newborn may have yellow skin when there is an accumulation of excess bilirubin.

Types of Newborn Jaundice

There are several varieties of jaundice that affect babies:

Physiological Jaundice: Physiological jaundice is the most common kind of jaundice in infants. Most babies have physiological jaundice by the second or third day of life. It happens because the liver, which is still developing, cannot effectively handle bilirubin. Usually, physiological jaundice is not dangerous and resolves on its own in two weeks.

Breastfeeding Jaundice: Breastfed infants are more likely to develop jaundice than formula-fed babies. Jaundice from breastfeeding usually appears in your infant within the first week of life. It usually happens when your infant doesn’t get enough breast milk. It might be the result of breastfeeding issues or a delayed onset of milk production. Jaundice from breastfeeding may require more time to resolve.

Breast Milk Jaundice: Breast milk jaundice differs from breastfeeding jaundice. The components in your breast milk can influence the bilirubin breakdown process in your baby’s liver. A bilirubin accumulation may result from this. Jaundice from breast milk may develop after your baby’s first week of life and may take up to a month to go away.

Symptoms of Jaundice in Newborn

Yellowing of the skin and eyes of an infant, which may begin in the face and then spread to other parts of the body, is one of the first symptoms of jaundice in a newborn. It often shows up two to four days after delivery. Apply gentle pressure to your baby’s forehead or nose to check for newborn jaundice. If when you push on the skin, it appears yellow, your infant probably has mild jaundice. In the event that your child is not jaundiced, the skin tone should momentarily appear somewhat paler than usual. Get in touch with your baby’s doctor if you have any questions or concerns, especially if the whites of their eyes seem yellow.

What are the Causes of Jaundice in Newborns?

An excess of bilirubin in an infant’s blood causes jaundice. In the first few days of life, jaundice typically develops in newborns. This is due to the fact that your baby’s liver needs a few days to mature and become more adept at eliminating bilirubin. A baby may experience severe jaundice if they have:

  • Sepsis, or blood infection
  • A liver condition such as Biliary Atresia
  • Hypoxia, or low oxygen levels
  • An anomaly in your infant’s red blood cells that leads to its rapid deterioration
  • When the baby’s and the mother’s blood types are incompatible
  • Bruises from a difficult delivery
  • A lack of an enzyme

Diagnosis & Treatment of Jaundice in Newborns

Based on your baby’s appearance, your doctor will probably diagnose newborn jaundice. Measuring the amount of bilirubin in your baby’s blood is still required, nonetheless. Treatment will be decided based on the degree of jaundice and bilirubin level. Among the tests used to assess bilirubin levels and identify jaundice are:

  • Physical Examination: The baby’s skin tone and eye colour will be evaluated by the paediatrician.
  • Bilirubin Test: The amount of bilirubin in a baby’s blood is determined by a blood test known as a bilirubin test. This aids in assessing the level of jaundice and the need for therapy.
  • Additional Tests: Blood typing, the Coombs test, and liver function tests may be carried out in situations when underlying diseases are suspected.

If there’s proof that there’s an underlying cause for your baby’s jaundice, your doctor could prescribe more blood or urine testing.

Mild jaundice in infants usually goes away on its own in two to three weeks. Your infant might need to be readmitted to the hospital or stay longer in the newborn nursery if their jaundice is severe or moderate. Jaundice in newborn treatment that follows may be used to reduce the amount of bilirubin in your baby’s blood:

  • Light Therapy (Phototherapy): A piece of equipment that produces light in the blue-green range could be used to examine your infant. In order for bilirubin molecules to be eliminated in both urine and faeces, they must undergo structural and form changes caused by light.
  • Intravenous Immunoglobulin (IVIg): Different blood types between the mother and the child may be linked to jaundice. Because of this issue, the infant’s red blood cells break down more quickly because of antibodies from the mother that are carried by the newborn. The use of an exchange transfusion may be avoided, and jaundice may be lessened by intravenous transfusion of an immunoglobulin, a blood protein that can lower antibody levels.
  • Exchange transfusion: Rarely, a newborn may require a blood exchange transfusion if their acute jaundice is unresponsive to conventional therapies. This is done in a neonatal critical care unit and entails taking small quantities of blood out and replacing it with donor blood several times to dilute the bilirubin and maternal antibodies.
  • Better diet: Your doctor could advise supplements or more frequent feedings to keep your baby’s weight from dropping and to make sure they get enough nutrients.

If your baby’s jaundice isn’t too bad, your doctor could suggest making adjustments to your feeding schedule to help reduce your bilirubin levels. More frequent feedings will result in more milk being given to your baby and more bowel movements, which will increase the quantity of bilirubin your baby excretes in their stool. Your doctor might advise supplementing breastfeeding with formula or expressed milk if your infant is not gaining weight, is experiencing difficulties breastfeeding, or is dehydrated. In certain situations, your doctor might advise switching to formula for a few days before starting to breastfeed again. Find out from your doctor which feeding choices are best for your infant.

Prevent Jaundice in Newborns

Ensuring your baby gets enough food—whether via formula or breastfeeding—will help avoid jaundice since it helps in the body’s removal of bilirubin. Promote regular meal times to avoid dehydration, which can make jaundice worse. Furthermore, identifying and addressing any risk factors for jaundice early on can be facilitated by providing appropriate prenatal care and attending all planned prenatal visits. Work with a doctor to create a strategy for treating your newborn’s jaundice if you have a history of blood type incompatibility from prior pregnancies. In general, difficulties may be avoided, and your newborn’s well-being can be ensured by maintaining good prenatal health, encouraging frequent feeding, and getting medical care as soon as any indications of jaundice develop.
Even though neonatal jaundice / jaundice in newborns is a frequent occurrence in infants, parents must be on the lookout for any alarming signs and seek medical assistance immediately. The infant’s health and the avoidance of problems from severe jaundice depend on an early diagnosis and adequate treatment. Most neonates with jaundice will recover without any long-term effects if they get the right care and monitoring.