Jaundice In Newborns – Everything You Need To Know


Jaundice is a common condition in newborns that manifests as a yellowing of the skin and eyes. This condition, medically known as neonatal jaundice, affects nearly 60% of full-term and 80% of preterm infants in the first week of life. While jaundice in newborns is usually harmless and resolves on its own, it can sometimes indicate underlying health issues that require medical attention. This blog aims to provide a comprehensive overview of neonatal jaundice, including its causes, symptoms, diagnosis, treatment, and prevention.

What is Neonatal Jaundice?

Neonatal jaundice occurs when there is a high level of bilirubin in the baby’s blood. Bilirubin is a yellow pigment that is produced during the normal breakdown of red blood cells. The liver processes bilirubin, which is then excreted in stool. However, in newborns, especially preterm infants, the liver is not fully developed and may not be able to remove bilirubin efficiently, leading to its buildup and subsequent jaundice.

Types of Neonatal Jaundice

There are several types of neonatal jaundice, each with different causes and implications:

  1. Physiological Jaundice: This is the most common type, usually appearing between the second and fourth days of life. It results from the baby’s immature liver and typically resolves without treatment within two weeks.
  2. Breastfeeding Jaundice: Occurs in breastfed babies due to insufficient breast milk intake, which leads to dehydration and decreased bilirubin excretion. Ensuring adequate feeding usually resolves this type of jaundice.
  3. Breast Milk Jaundice: This type appears after the first week of life and can persist for a month or more. It is thought to be caused by substances in the mother’s milk that can increase bilirubin levels. Despite its persistence, it is usually harmless.
  4. Pathological Jaundice: This is caused by underlying medical conditions such as blood group incompatibility, infections, or enzyme deficiencies. Pathological jaundice appears within the first 24 hours of life and requires prompt medical attention.
  5. Prematurity Jaundice: Preterm babies are more prone to jaundice because their livers are even less developed than those of full-term babies. They need closer monitoring and sometimes treatment to manage bilirubin levels.

Causes of Neonatal Jaundice

Several factors can contribute to the development of jaundice in newborns:

  1. Immature Liver: The primary cause of neonatal jaundice is the baby’s immature liver, which is not yet efficient at processing bilirubin.
  2. High Red Blood Cell Turnover: Newborns have a higher turnover of red blood cells compared to adults, leading to increased production of bilirubin.
  3. Breastfeeding: Inadequate intake of breast milk can lead to dehydration and less frequent bowel movements, causing bilirubin to accumulate.
  4. Blood Type Incompatibility: If the mother’s blood type is different from the baby’s, it can lead to the breakdown of the baby’s red blood cells, increasing bilirubin levels.
  5. Bruising During Birth: Birth injuries such as bruising can cause an increased breakdown of red blood cells, leading to higher bilirubin levels.
  6. Genetic Disorders: Conditions such as Gilbert’s syndrome or G6PD deficiency can affect bilirubin metabolism, leading to jaundice.
Jaundice In Newborns

Symptoms of Neonatal Jaundice

The primary symptom of jaundice in newborns is a yellowing of the skin and the whites of the eyes. This yellowing usually starts on the face and then spreads to the chest, abdomen, arms, and legs. Other symptoms can include:

  • Lethargy: A jaundiced baby may appear unusually sleepy or lethargic.
  • Poor Feeding: Difficulty in feeding or refusal to feed.
  • Dark Urine: Urine may appear darker than normal.
  • Pale Stools: Stools may be lighter in color, which is a sign of severe jaundice.
Jaundice In Newborns

Diagnosing Neonatal Jaundice

Diagnosing jaundice in newborns involves both physical examination and laboratory tests:

  1. Physical Examination: Doctors will look for yellowing of the skin and eyes and assess the extent and severity of jaundice.
  2. Blood Tests: The level of bilirubin in the blood is measured to determine the severity of jaundice. This test, called a serum bilirubin test, helps in deciding the course of treatment.
  3. Transcutaneous Bilirubinometry: A device is placed on the baby’s skin to measure bilirubin levels without drawing blood. If the levels are high, a blood test will be conducted to confirm the results.
  4. Additional Tests: If pathological jaundice is suspected, additional tests such as blood type tests, Coombs test, and tests for enzyme deficiencies or infections may be conducted.

Treatment of Jaundice In Newborns

The treatment for neonatal jaundice depends on the severity and underlying cause. Common treatment options include:

  1. Phototherapy: The most common treatment for jaundice. The baby is placed under special blue lights that help break down bilirubin in the skin. This treatment is safe and effective.
  2. Intravenous Immunoglobulin (IVIg): Used if jaundice is due to blood group incompatibility. IVIg reduces the need for an exchange transfusion.
  3. Exchange Transfusion: In severe cases, the baby’s blood is replaced with donor blood to quickly reduce bilirubin levels. This procedure is done in a neonatal intensive care unit (NICU).
  4. Enhanced Feeding: Increasing the frequency of feedings, whether breast milk or formula, can help reduce bilirubin levels by promoting bowel movements and excretion of bilirubin.
  5. Treating Underlying Conditions: If jaundice is caused by an infection or a genetic disorder, treating the underlying condition is crucial to managing jaundice.
Jaundice In Newborns

Prevention of Jaundice In Newborns

While not all cases of neonatal jaundice can be prevented, certain measures can reduce the risk:

  1. Adequate Feeding: Ensuring that the baby is well-fed, particularly in the first few days of life, helps to prevent dehydration and promote the excretion of bilirubin.
  2. Monitoring: Babies at higher risk, such as preterm infants or those with a family history of jaundice, should be closely monitored in the first few days after birth.
  3. Early Detection: Parents should be educated on the signs of jaundice and encouraged to seek medical advice if they notice yellowing of the skin or eyes.
  4. Blood Type Screening: Blood type screening of both mother and baby can help identify potential blood group incompatibilities that might lead to jaundice.
Jaundice In Newborns

When to Seek Medical Attention

While mild jaundice is common and often resolves without treatment, it is essential to seek medical attention if:

  • Jaundice appears within the first 24 hours of life.
  • The baby is extremely sleepy, difficult to wake, or refuses to feed.
  • The baby has a high-pitched cry or shows signs of irritability.
  • The baby’s skin appears yellow below the chest or on the legs.
  • The baby’s urine is dark or stools are pale.

Early medical intervention can prevent severe complications such as kernicterus, a form of brain damage that can result from very high levels of bilirubin. Joining support groups may also assist.


Jaundice In Newborns Conclusion

Neonatal jaundice is a common and typically manageable condition in newborns. Understanding the causes, symptoms, and treatment options is crucial for parents and caregivers. By ensuring adequate feeding, monitoring for signs of jaundice, and seeking timely medical intervention when necessary, the risks associated with jaundice can be minimized, ensuring the healthy development of the newborn.

Early detection and treatment are key to preventing complications. With proper care and attention, most babies with jaundice recover fully without any long-term effects. If you have any concerns about your newborn’s health, always consult with a healthcare professional to ensure the best possible care for your baby.

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