Infant Jaundice

Parenting a child is the most wonderful thing, but at the same time it is the toughest job. One of the biggest challenges for parents is protecting their little ones from sickness. Newborns are prone to illness often, as their immune system is still trying to build up and cope with the environment. A very common condition in newborns is Jaundice.

About Jaundice

Jaundice is a disease that usually affects newborn in their first week of life. It is also called as yellow fever because it turns the baby’s skin, whites of eyes, sole, palm of hands, and mouth yellow in color. Jaundice affects almost about 90% of newborns.

Jaundice is caused when there is excess bilirubin (a waste product from liver) in the blood that is produced by baby’s liver after birth. Jaundice in its mildest form is harmless. Remember, jaundice is NOT a liver disease. Liver disease may sometime result in jaundice.

Causes

To know how jaundice affects a newborn we need to know what bilirubin is. Bilirubin is a reddish-yellow pigment that is found in the bile. Bile, in turn, is found in the liver that plays a vital role in digesting fats. Bilirubin is produced during the breakdown of old Red blood cells (RBC). To maintain a relatively stable level of bilirubin, the body normally excretes it through urine and stool. However, in newborns the body cannot process bilirubin, and it starts building up in the body leading to jaundice.

Newborn babies may not be able to process bilirubin. In a newborn baby, the life span of RBCs is much shorter than the normal 120 days in adults. Therefore, excess RBCs are broken down, resulting in excess bilirubin.

Liver, which has to do the job of removing the excess bilirubin is still developing in newborns, and may not be able to remove so much of bilirubin. Excess amount of bilirubin is absorbed back from the intestine, before it is excreted, causing jaundice.

When the baby is still in the mother’s womb the job of removing waste from the baby’s body was carried out through the placenta. But once the baby is born, it becomes independent and the baby’s body has to carry out all the functions.

It might take some time for the baby’s body to start working and to effectively remove all wastes from the body. Due to this, in early days of your baby’s life some waste may build up in their body and one such waste product is bilirubin, which causes jaundice.

Symptoms

Jaundice usually starts around the second or third day of baby’s life. The symptoms begin at the top head and processes downward. Symptoms of jaundice are best noticed in daylight or in fluorescent light. A few symptoms are listed below:

  • Yellowing of face, whites of the eyes, then chest, stomach, and legs.

  • May pass very less or no urine in first 24 hour after birth.

  • Forceful vomiting after every feeding.

  • Gently pressing the baby’s skin usually should show white color but it shows yellow color in babies with jaundice.

Complications

In different babies, the duration of jaundice is different. Usually newborn develops jaundice within 2-3 days after birth, and then after few days the level of bilirubin goes back to normal. But in some infants, who have very high level of bilirubin, may result in neurological problems and brain damage. Therefore, regularly checking the level of bilirubin is very important to prevent it reaching high enough to hurt the baby.

Outlook

Jaundice is not a serious health problem in most healthy babies. It just comes and goes and many do not even require any treatment. Parents should be well aware of the condition and should take proper medical assistance at the required time to avoid complications.

It is necessary that the doctor recognizes the risk factors for jaundice so that providing follow-up and support is possible when the baby leaves the hospital. The doctor should also educate parents about after care procedures.

If the baby looks jaundiced during the first few days after birth, doctors will perform some tests to diagnose and confirm jaundice.

A little sample of baby’s blood is drawn to check the levels of bilirubin in blood. A blood bilirubin test is mandatory, if the baby develops jaundice within 24 hours.

The color of urine and stool is also tested. If the urine is yellow in color due to the presence of bilirubin, it indicates liver disease. Babies with liver disease can also have jaundice.

Similarly, liver disease prevents the excretion of bilirubin in stools therefore stools of babies with liver disease are pale in color.

If the blood test of baby shows very little increase in bilirubin level, then he/she may not require any treatment, doctor will just advice to feed him/her more often so that the baby produces more urine and the bilirubin is excreted in urine.

The baby can also be exposed to sunlight that helps to reduce bilirubin levels. If bilirubin levels are very high and it is increasing very fast, then the baby may be subjected to light therapy called as phototherapy.

During phototherapy the baby’s eyes are covered and he/she is placed naked under white, green or blue light. The light helps to break down the bilirubin in the baby’s skin. Sometimes, the baby may also be placed on a special light producing blanket called bili-blanket.

Phototherapy is carried on for 1 or 2 days. Due to phototherapy the baby may experience dehydration and loose stools, which are quite normal as this is the way the body removes excess bilirubin.

Doctor will watch the baby carefully and try to prevent or treat these problems. If phototherapy doesn’t work then the baby might require exchange transfusion, where some of the baby’s blood is removed and fresh blood is transfused.