Jaundice in newborns is one of those things that can be very worrying when first encountered.
Here is how to deal with it.
What Is Jaundice
Jaundice in newborns is short-term condition that causes a yellowish tinge to appear on their skin and in the whites of their eyes.
It is quite common and easily dealt with in most cases.
Jaundice is caused by an excess of bilirubin in the blood.
It affects more than half of the newborn population and up to 80% of those born premature.
Types of Jaundice in Newborns and Their Causes
Bilirubin is a byproduct of red cell degeneration.
This is a process that occurs constantly in our bodies to replace older red blood cells with new ones. The liver removes bilirubin as a waste product in the form of bile.
The bilirubin buildup is what causes the yellow tinge to newborns with jaundice. The medical term for it is hyperbilirubinemia.
There are a few different types.
Physiological Jaundice
This is by far the most common type of jaundice. A newborns liver is not yet fully developed and will take some time to be able to process the bilirubin.
Physiological jaundice normally resolves within two weeks.
Breastfeeding Jaundice
Breastfeeding jaundice occurs in breastfed babies for multiple reasons.
The newborn could be reluctant to drink milk as they are still getting used to feeding. The mother could be having difficulty producing milk which is normal in the first few days.
All these things add up to the baby not getting enough breastmilk; which is the root cause.
Both mother and baby have things they need to get used to, so do not be worried when breastfeeding jaundice occurs.
There are helpful tips for mothers to get help at this stressful time. Eventually it will be cured as they settle into a routine and the baby gets the nutrition it needs.
It is not very common and either formula or pumped breast milk can supplement the baby’s diet.
Breast Milk Jaundice
This not the same thing as breastfeeding jaundice. Breast milk can change the way the liver processes bilirubin due certain proteins that it contains.
Breast milk jaundice is not classified as harmful; however, it should still be followed up by a doctor as long as it persists. Cases can last from three up to 12 weeks.
Haemolytic Jaundice
This is a very rare type of jaundice but it is one of the most serious.
It can be seen within 24 hours after birth and is caused by a condition called hemolysis.
This is the excessive destruction of red blood cells that produces an extreme excess of bilirubin which cannot be processed and excreted quickly enough by the liver.
Incompatible blood types of mothers and child may be one of the causes. Haemoglobin disorders, infection and incompatible Rhesus (Rh) factor could also cause haemolytic jaundice.
Symptoms of Jaundice
The most obvious sign of jaundice is yellowish skin. This includes the whites of the eyes and underneath the tongue; which are actually the first places you should look for signs.
It usually starts in the face, after which the yellowing spreads to the chest, abdomen, arm and legs.
One way to check for jaundice is to place your baby in a well-lit place and gently press their forehead or nose.
If the impressions appear yellow, then it is a clear indication to contact your paediatrician for further advice. They may ask you to bring in your baby for a bilirubin test.
For darker skinned babies, there is the issue of the yellowish tinge not showing up on their skin. Signs of jaundice can still be checked by their eyes, palms, soles of the feet and underside of their tongues.
Other signs of jaundice are pale grey or yellow stools and dark, tea coloured urine. This is caused by liver malfunction including hepatitis and blocked bile ducts.
This is very rare but parents should be aware of any indications of disease from their baby’s excrement.
Prevention of Jaundice
There is no way to completely prevent jaundice in newborns, especially the more common forms.
It is a normal condition and typically disappears on its own; especially physiological jaundice.
The best pre-emptive step is to feed your baby frequently as per your paediatrician’s instructions.
Overfeeding may make your baby sick but the right amount will promote bowel movement to get rid of excess bilirubin.
Treatment of Jaundice
Treatment isn’t usually required apart from observation as bilirubin resolves when the baby’s liver develops.
If the jaundice persists past a week or two, the doctor will conduct bilirubin tests once more.
If your baby’s bilirubin is normal or slightly above average you can try feeding them often (every 2 to 3 hours) to increase bowel movement which will excrete the bilirubin. The baby’s stool will take on a brownish-yellow colour.
If your baby’s bilirubin level is high or continues to rise, your paediatrician may recommend phototherapy treatment.
To conduct phototherapy, your baby will be undressed and placed under special blue lights. Only a diaper and a mask to protect the eyes will be worn.
Phototherapy helps your baby’s liver get rid of excess bilirubin by changing its chemical composition so it does not need to be processed by the liver.
It only takes one or two days and if your baby’s bilirubin levels aren’t too high it is possible to treat your baby with phototherapy at home.
In very severe cases or ones where phototherapy doesn’t work, doctors will recommend a blood transfusion. This will provide clean blood to the baby and filter out the old blood.
What to Do Next
After your baby’s jaundice is cured, you should continue feeding them well and making sure they get enough nutrition.
There is a small possibility the jaundice will return if not taken care of properly.
If your baby is prone to jaundice or it does not disappear, follow up with your paediatrician. This may be worrying but there is always a solution for any problems your baby may be facing.
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