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Newborn Jaundice: A Brief Guide

Neonatal jaundice
Did you know that up to 60% of term babies and 80% of premature babies develop newborn jaundice in their first week of life? Keep reading to learn about newborn jaundice, its causes, and how to diagnose and treat it.

What is newborn jaundice?

Newborn or neonatal jaundice is when there is a yellowish discolouration of the skin, eyes, and mucous membranes of a newborn baby. It is caused by an excess of bilirubin in the blood. Bilirubin is a yellow-coloured pigment that gets formed when red blood cells break down.

Is jaundice in newborns normal?

This condition can affect up to 60% of newborns in their first week of life. In most cases, it resolves on its own, and few babies need medical attention.

What are the types and causes of newborn jaundice?

It may be physiological or due to some underlying condition.
  • Physiological jaundice happens because a newborn’s liver is not mature enough to process the excessive levels of bilirubin, leading to its accumulation in the blood. It occurs between 24 to 72 hours after birth and resolves on its own. Total bilirubin levels remain less than 5 mg/dl
  • Pathological jaundice occurs due to some underlying condition. Total bilirubin levels are greater than 5 mg/dl. These include :

When do I need to be worried about my baby’s jaundice?

Consult a doctor if:
  • Your baby was born prematurely
  • Your baby develops jaundice within 24 hours of being born Jaundice is still present beyond 3 weeks of age
  • Any of your previously born children suffered from this condition
  • There was some kind of brain or skull injury during your baby’s birth, or if there is bruising around their head

What are the associated symptoms of newborn jaundice?

Besides a yellowish discolouration of the skin, eyes, and mucous membranes, symptoms include:

  • Dark-coloured urine that is staining the diapers
  • Clay coloured stools
  • Irritability
  • High-pitched crying
  • Baby not feeding properly, or not gaining weight
  • Excessive drowsiness or sleepiness
  • Fever (in case of sepsis)

How is newborn jaundice diagnosed?

Your baby’s paediatrician can make the diagnosis based on a visual examination. Doctor will ask you about the appearance and duration of jaundice in detail, the colour of urine and stools, any accompanying symptoms, and family history of certain diseases. They will advise the following test:
  • Blood test to measure serum bilirubin levels and to check for the shape and structure of the red blood cells. Additionally, your doctor can check for sepsis, thyroid abnormalities and hemolytic disorders
  • Blood group testing of the mother and the baby is also done to rule out any kind of incompatibility
  • Urine testing
  • Genetic testing if your doctor suspects a hereditary condition
  • Enzyme studies to rule out any kind of enzyme deficiency

How is newborn jaundice treated?

In physiological cases, no further course of action is required. You must regularly breastfeed your baby and look out for any signs, such as dark-coloured urine that stains the diaper. Take your baby to the hospital if it looks extremely yellow or if the palms and soles of the feet appear to be stained.

In pathological cases, phototherapy is the preferred mode of treatment. Phototherapy is a type of light therapy during which bilirubin, an insoluble compound, gets converted to lumirubin, a more soluble compound, which is then passed out of your baby’s system through the urine or stool. To optimise the benefits of this procedure and ensure maximum skin exposure, your baby will only be wearing a diaper and eye patch during the sessions.

In case your baby is not benefiting from phototherapy or has extremely high serum bilirubin levels, your doctor will recommend a double volume exchange transfusion (DVEF). In this, the doctor removes your baby’s blood while simultaneously transfusing a donor’s blood who has the same blood group. This leads to an overall reduction in your baby’s serum bilirubin levels in the blood.

What are the complications of newborn jaundice?

Extremely high bilirubin levels can lead to damage to the brain. This life-threatening condition is called kernicterus. Symptoms of kernicterus include:

  • Irritability
  • High-pitched crying
  • Not feeding properly
  • Excessive drowsiness or sleepiness
  • Loss of muscle tone, or ‘floppy’ muscles
  • Seizures

Can newborn jaundice be prevented?

While this condition cannot be prevented, it is advisable that you regularly breastfeed your baby. If your baby is not breastfeeding properly, your doctor may recommend alternatives. In case of any worsening of the colour of the skin or baby’s palms and soles, ensure to go to a doctor as soon as possible. If your family has a history of any genetic conditions, be sure to inform your doctor during your pregnancy.
Dr. Aditi

Dr. Aditi

An MBBS and a medical reviewer with a penchant for healthcare articles and blogs. Read her contributions and writings about various healthcare topics.

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