Jaundice in Newborn Baby
Jaundice in newborn babies is also called as neonatal jaundice, neonatal icterus, neonatal hyperbilirubinemia, all of which indicates the yellowing of the newborn baby’s skin and other tissues during which bilirubin level in baby blood increases more than 85 μmol/l (5 mg/dL). Increased bilirubin level in the baby blood makes clear that baby suffers clinical jaundice. Baby shows symptoms of blanch skin (means skin becomes yellow on little pressure), yellowing of face, eyes and so many.
Bilirubin level increases continuously from face, trunk and then towards the extremities. Neonatal jaundice is common among newborns babies and it affects more than 50-60% of all the newborn babies in first week after birth. Bilirubin is an orange or red pigment in blood which generally produced by the normal breakdown of red blood cells however it gets abnormal due to some problems and starts depositing on fatty tissues under the skin which lead to yellowness of the skin.
Newborn babies have more chance to develop jaundice after birth as they produce more bilirubin than adults, they have immature liver which is not able to remove extra bilirubin from blood or bilirubin gets reabsorbed into the intestines before getting out of the body through stool.
Bilirubin Levels in Newborn Babies with Jaundice
Newborn babies having jaundice have their bilirubin level more than 85 μmol/l (5 mg/dL) which manifests clinical jaundice. Some babies have jaundice restricted to the face and trunk and have bilirubin less than 204 μmol/l (12 mg/dL) which is considered as the less dangerous level. However babies with yellow palms and soles have bilirubin more than 255 μmol/l (15 mg/dL) in the blood which is considered as more serious level.
Types of Jaundice in Babies
Jaundice among newborn babies may occur due to many reasons which help in categorizing the jaundice types, some of are mentioned below:
- Physiological or Normal Jaundice: It is the most common type of jaundice among babies and considered as mild jaundice which occurs 2 to 4 days after birth. It occurs because of the immature liver of baby which does slow processing of the bilirubin. Generally, it disappears in 1 to 2 weeks as liver gets matured.
- Prematurity: Premature babies are more prone to the neonatal jaundice as their liver is not ready to process or excrete bilirubin properly. Jaundice among premature babies needs careful attention by parents and required to be treated under good doctor to correct it immediately as well as avoid complications in later life.
- Breastfeeding Jaundice: Newborn babies not getting proper breastfeed are more prone to jaundice. As soon as baby gets his/her full nutrition, it starts getting settled down.
- Breast Milk Jaundice: Some babies, approximately 1% to 2%, get jaundice due to the special substance present in breast milk which causes bilirubin level to rise by slowing down the bilirubin excretion through intestine. It occurs 3 to 5 days later birth and continuously improves which needs proper treatment.
- Blood Group Incompatibility (Rh or ABO problems): Blood group incompatibility means blood group of a baby is different from the mother, for which the mother produces antibodies in her blood which destroys red blood cells of baby. It is considered as the most severe form of jaundice which can only be prevented with Rh immune globulin injection to mother within 72 hours after delivery. This injection prevents antibodies formation in mother.
Symptoms of Jaundice in Newborn Babies
Occurrence of jaundice among newborn babies shows some signs and symptoms which indicate that baby suffer from jaundice. Generally, it appears after 2 to 3 days of birth and progresses continuously if not recognized and treated immediately which cause complications in later life. Some of the signs and symptoms are mentioned below:
- Yellow skin of face
- Yellow skin of chest and stomach
- Yellow skin of hands and legs.
- Yellow of the whites of infant’s eyes
- Increased serum bilirubin level in blood test
- Baby develops fever more than 100°F (37.8°C)
- Baby looks very inactive and sick
- Baby is not getting proper feed
- Baby feels sleepier than usual
- Baby born before full term or premature
- Baby looks lethargic and drowsy
- Baby passes urine or stool dark yellow colour
- High-pitched crying
Causes of Jaundice in Newborn Babies
The causes of jaundice among newborn babies may be many reasons which sometimes affect healthy babies as well. Causes of jaundice among babies are not similar to the adult type jaundice and not necessarily due to the problems in liver. Any healthy or weak baby may develop jaundice in first week of the birth due to the excess bilirubin availability in their blood. Some of the causes are mentioned below:
- Babies have extra oxygen carrying red blood cells in comparison to the young and their liver is immature to metabolise excess bilirubin.
- Liver disease or maternal blood incompatibility is the main reason of severe jaundice among newborns which may cause damage to the nervous system.
- Babies born before full term or premature have more chance of jaundice due to the immaturity of their liver and high level of bilirubin.
- Mothers suffering from gestational diabetes may be the reason of jaundice in babies.
- Male babies are more prone to neonatal jaundice than female.
- Babies of mothers having blood group “O” are more prone to jaundice.
- Excess bilirubin (also called hyperbilirubinemia) is the main reason of jaundice.
- Immaturity or improper functioning of liver do not let liver to filter bilirubin from blood and release to intestinal tract which get reabsorbed in blood.
- Internal bleeding (or haemorrhage) in newborn babies.
- Infection (viral or bacterial infections).
- Incompatibility between mother and baby blood.
- Liver malfunction.
- Enzyme deficiency or lack of certain important proteins.
- Abnormality of red blood cells in babies which causes them to break.
- Abnormal red blood cell shapes.
- Mother suffering from rubella, syphilis or others.
- Low oxygen level (or hypoxia)
- Genetic or inherited disorders
Treatment of Jaundice in Newborn Babies
Identification, diagnosis and treatment of jaundice among newborn babies are very necessary as ignorance of such condition may lead to some severe complications in later life or even death. Parents must take care of their baby from the time of birth and notice for any signs or symptoms of jaundice to take immediate action. They must go to the doctor in early stages of the jaundice to get relief from it immediately.
Severe or high levels of jaundice may need phototherapy treatment under the careful watch of doctor. In phototherapy treatment, baby is given special lights which help him to get rid of excess bilirubin. Treatment of jaundice among babies needs proper diagnosis and identification to give proper and accurate treatment which should be done under by the doctor. As we have discussed above about all the causes of jaundice among babies, thus baby should be given treatment accordingly. Blood check up of a newborn baby is very necessary to get accurate serum bilirubin level and provide treatment according to that.
Parents should consult doctor properly in order to provide required care at home. Some of the tests like complete blood count, coomb’s test, reticulocyte count and etc are required to get diagnosis of jaundice. Baby needs treatment according to the severity of jaundice otherwise he generally needs proper care, well hydrated with breast milk or formula milk and etc advised by the doctor.
Protection of Newborn Babies from Jaundice
It is well said that prevention is better that cure which fits in all areas. Proper care of the mother getting pregnant or all through the pregnancy is the main thing we can prevent the occurrence of jaundice or other health disorders among babies after their birth. Proper and healthy diet, regular health check up, vitamins and folates intake, regular exercise, proper daily routine, physical and mental well being and etc are the main points of making our newborn happy and free of neonatal problems.
A woman must consider and go to check-up whether she is suffering from any disease and get proper treatment by the authorized medical practitioner till she become free of all the problems before getting pregnant. Parent’s responsibility is not only to give birth to a baby but keep him healthy (mentally, physically and intellectually) throughout the life.
Newborns suffering from jaundice should get proper care and treatment by the parents and doctor respectively. Careful monitoring of baby during jaundice is very necessary to avoid complications. Parents should deeply notice all the advice given by the doctor such as giving early morning sunlight to the baby, proper and timely feeding, proper follow up and etc.