What Do You Know About Neonatal Jaundice In Newborns?
Jaundice is a common and usually harmless condition in newborn babies that causes yellowing of the skin and the whites of the eyes.
Many newborn babies develop neonatal jaundice. This is a condition in which the skin and white of the eyes turn yellowish in colour, a few days after birth. In fact, about half of all newborns develop mild jaundice in the first few days. In premature babies, jaundice may start early and last longer than in full-term babies.
What Causes Neonatal Jaundice?
Jaundice typically occurs because newborns normally produce increased levels of bilirubin. Doctors call this "physiologic jaundice." Bilirubin, which is yellowish in colour, is produced when your body breaks down red blood cells. Your liver removes bilirubin from your body's bloodstream. In newborns, the body may produce more bilirubin than the liver can process.
Physiologic jaundice usually appears within a few days after birth and resolves within two weeks. Other types of newborn jaundice can be due to prematurity; problems related to breastfeeding; infection, blood type mismatch between mom and baby; as well as other blood or liver problems.
Since many mothers and babies leave the hospital soon after delivery, jaundice may not appear until your baby is at home. A newborn check is typically scheduled with your paediatrician. The check should happen within the first few days of going home from the nursery to check for jaundice.
It is important to contact your doctor if you notice signs of jaundice in your baby. If you suspect jaundice you will likely need to see your doctor that same day. While jaundice is usually very treatable, in the most extreme cases it can cause brain damage.
The good news is that in most cases, newborn jaundice goes away on its own. It happens as your baby’s liver develops and as the baby begins to feed, which helps bilirubin pass through the body.
Babies at highest risk for developing newborn jaundice are:
- premature babies (babies born before 37 weeks’ gestation)
- babies who aren’t getting enough breast milk or formula, either because they’re having a hard time feeding or because their mother’s milk isn’t in yet
- babies whose blood type isn’t compatible with the blood type of their mother
Other causes of neonatal jaundice include:
- bruising at birth or other internal bleeding
- liver problems
- an infection
- an enzyme deficiency
- an abnormality in your baby’s red blood cells
What are the symptoms of neonatal jaundice?
The first sign of jaundice is a yellowing of a baby’s skin and eyes. The yellowing may begin within 2 to 4 days after birth, and may start in the face before spreading down across the body.
Bilirubin levels typically peak between 3 to 7 days after birth.
If a finger lightly pressed on a baby’s skin causes that area of skin to become yellow, it’s likely a sign of jaundice.
How do doctors diagnose neonatal jaundice?
A distinct yellow coloring confirms that your baby has jaundice, but they'll need additional tests to determine the severity of the jaundice.
Babies who develop jaundice in the first 24 hours of life should have bilirubin levels measured immediately, either through a skin test or blood test.
Doctors will need additional tests to see if a baby’s jaundice is due to an underlying condition. This may include testing your baby for their complete blood count (CBC), blood type, and Rhesus factor (Rh) incompatibility.
Additionally, a Coombs test may be done to check for increased red blood cell breakdown.
How is newborn jaundice treated?
Phototherapy is a common and highly effective method of treatment that uses light to break down bilirubin in your baby’s body.
In phototherapy, they'll place your baby will on a special bed. He will be under a blue spectrum light while wearing only a diaper and special protective goggles. A fiber-optic blanket may also be placed underneath your baby.
In very severe cases, doctors may recommend an exchange transfusion. It's a procedure in which your baby receives small amounts of blood from a donor or a blood bank.
This replaces the baby’s damaged blood with healthy red blood cells. This also increases your baby’s red blood cell count and reduces bilirubin levels.
Can you prevent jaundice in your baby?
There’s no real way to prevent neonatal jaundice. During pregnancy, you can have your blood type tested.
After birth, doctors will test your baby’s blood type, if necessary. This is to rule out the possibility of blood type incompatibility that can lead to newborn jaundice. If your baby does have jaundice, there are ways you can prevent it from becoming more severe:
- Make sure your baby is getting enough nutrition through breast milk. Feeding your baby 8 to 12 times a day for the first several days ensures that your baby isn’t dehydrated. It helps bilirubin pass through their bodies more quickly.
- If you’re not breastfeeding, feed your baby formula: give your baby 1 to 2 ounces of formula every 2 to 3 hours for the first week. Preterm or smaller babies may take smaller amounts of formula than babies who are also receiving breast milk.
- Talk to your doctor if you’re concerned your baby is taking too little or too much formula; or if they won’t wake to feed at least 8 times per 24 hours.
Carefully monitor your baby for the first five days of life for the symptoms of jaundice, such as yellowing of the skin and eyes.
If you notice that your baby has the symptoms of jaundice, call your doctor immediately.