Newborn or Infant Jaundice is the name given to yellowing of the skin and whites of the eyes. It is very common in newborns. Usually, the jaundice of the newborn does not need any special treatment and will heal on its own within about two weeks.
Causes of Jaundice in Newborns
Newborn babies produce large amounts of bilirubin due to the breakdown of red blood cells. A baby’s liver is not mature enough to process bilirubin and pass it through the intestines. The increased amount of bilirubin in the bloodstream causes yellowing of the newborn skin and eyes.
The good news is that most babies do not need any treatment or monitoring for jaundice. The infant jaundice disappears on its own as the baby’s liver develops and the baby begins to feed, which helps bilirubin to pass through the body.
In most cases, jaundice disappears within 2 to 3 weeks. Jaundice that lasts longer than 3 weeks can be a symptom of an underlying condition. When babies develop high levels of bilirubin, it can be harmful if left untreated and even cause brain damage.
Signs of Jaundice in Newborns
The first sign of jaundice is yellowing of the baby’s skin and eyes. Yellowing may begin 2 to 4 days after birth and may begin on the face before it spreads throughout the body.
Bilirubin levels typically peak 3 to 7 days after birth.
If pressing lightly on baby’s skin with your finger causes that skin area to turn yellow, this is probably a sign of jaundice.
When to see a doctor
Your baby should be examined for jaundice between the third and seventh days after birth when bilirubin levels are usually highest. If your baby is discharged 72 hours after birth, make a follow-up appointment to check for jaundice within two days of discharge.
The following signs or symptoms may indicate severe jaundice or complications from excessive bilirubin. Call your doctor if:
- Your baby’s skin and eyes become more yellow
- The skin on your baby’s stomach, arms or legs looks yellow
- Your baby looks weak or sick or difficult to wake up
- Your baby is not gaining weight or is malnourished
- Your baby is crying loudly
- Your baby has a fever
Tests for Jaundice
Parents need to bring their babies to check a few days after birth because bilirubin levels peak 3 to 7 days after birth.
Your doctor will diagnose your baby’s jaundice based on your baby’s appearance. However, it is still necessary to measure the level of bilirubin in your baby’s blood. The bilirubin level (jaundice severity) will determine the course of the treatment.
Tests performed to detect jaundice and measure bilirubin include:
- A physical exam
- Lab testing of your baby’s blood
- Skin test with a device called a transcutaneous bilirubin meter, which measures the reflection of a special light shining through the skin
In babies who develop jaundice in the first 24 hours of life, bilirubin levels are measured immediately by skin test or blood test.
If there is evidence that your baby’s jaundice is caused by an underlying disorder, your doctor may order additional blood tests or urine tests. This may include testing your baby for 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 destruction.
Treatments for Newborn Jaundice
Mild jaundice usually resolves spontaneously as the baby’s liver begins to mature. Frequent feeding (8 to 12 times a day) will help babies pass bilirubin through their bodies.
More severe jaundice may require other treatments.
Phototherapy is a common and highly effective treatment that uses light to break down bilirubin in your baby’s body. In phototherapy, while your baby is placed in a special bed under blue spectrum light, only diapers and special protective glasses are worn. A fibre-optic blanket can also be placed under your baby.
Intravenous immunoglobulin (IVIg):
Jaundice may be due to differences in blood type between mother and baby. This condition causes the baby to carry antibodies from the mother that contribute to the rapid breakdown of red blood cells. Intravenous transfusion of an immunoglobulin, a blood protein that can lower antibody levels.
Blood exchange transfusion:
In very severe cases, when severe jaundice does not respond to other treatments, a blood exchange may be necessary where the baby receives a small amount of blood from a donor or a blood bank. This procedure is performed in a neonatal intensive care unit.
When infant jaundice is not severe, your doctor may suggest changes in eating habits that may lower bilirubin levels. Talk to your doctor if you have questions or concerns about how much or how often your baby is feeding, or if you have trouble breastfeeding
Prevention of Jaundice in Newborns
There is no real way to prevent jaundice in newborns. You can have your blood type tested during pregnancy.
After delivery, your baby’s blood type will be tested, if necessary, to exclude the possibility of a blood type incompatibility that could lead to neonatal jaundice. If your baby has jaundice, there are ways to prevent it from becoming more severe:
- Feeding your baby 8-12 times a day for the first few days ensures that your baby is not dehydrated, which helps bilirubin pass through the body faster.
- If you are not feeding your baby with formula, give your baby 1-2 ounces every 2-3 hours for the first week. Premature or younger babies may receive smaller amounts of formula, such as babies who are also breastfed.
- If you are worried that your baby is getting too little or too much, or will not wake up to breastfeed at least 8 times in 24 hours, talk to your doctor.
Watch your baby carefully for signs of jaundice such as yellowing of the skin and eyes for the first five days of life.
If you notice your baby showing signs of jaundice, call your doctor right away.
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