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 know what exactly this condition is, how it is caused, and how to diagnose and treat it.
What is newborn jaundice?
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 only a minority of 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 lesser than 5 mg/dl
- Pathological jaundice occurs due to some underlying condition. Total bilirubin levels are greater than 5 mg/dl. These include –
– Prematurity
– Inadequate breastfeeding
– Sepsis
– Hemolytic disease of the newborn (Rh or ABO blood group incompatibility)
– G6PD deficiency
– Thalassemia
– Polycythemia
– Brain haemorrhage
– Hepatitis
– Metabolic disorders
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. They will ask you about the appearance and duration of jaundice in detail, the colour of your baby’s urine and stools, any accompanying symptoms and if you have a family history of certain diseases. They will advise the following tests –
- 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 they look 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 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