Jaundice in Newborn BabiesKatlyn Joy |16, September 2013
Jaundice is a common condition in newborn babies, affecting about 60 percent, according to the March of Dimes. Jaundice refers to the yellow discoloration of baby's skin and eyes due to a build up of bilirubin. Bilirubin is a yellowish substance in the blood that occurs when the red blood cells are broken down. Sometimes, the liver cannot keep up with the bilirubin levels and the result is jaundice.
Types of Jaundice
Normal or physiological jaundice
This is the most common form of jaundice, and happens within the first few days following birth. It is due to the immaturity of the newborn's liver and requires just a couple weeks to correct, most often without treatment. Prior to birth, the mother's liver took care of this task for the baby, so the baby's liver just needs some time to catch on to the process.
Jaundice of prematurity
Another common cause of newborn jaundice, premature babies are less developed and mature so their livers are much more apt to be overwhelmed and prone to jaundice. Babies who are premature also require treatment for lower bilirubin levels than other babies. Premature babies also have fewer bowel movements, so the bilirubin does not get excreted as quickly.
This particular type of jaundice is mostly seen in babies who have trouble nursing at the onset, and don not get enough milk. This is perhaps because mother's milk hasn't come in yet and the baby is not getting enough milk yet. It is most often seen in baby's first week before nursing is well established.
Breast milk jaundice
This type happens most often around the second or third week of life and affects only 1 to 2 percent of breastfed babies. It is due to substances in the mother's milk which causes bilirubin levels to rise. It generally improves gradually over several weeks time.
Blood type mismatches
If you are Rh negative and baby is positive, the breakdown of red blood cells may be too fast for baby's liver to handle. This used to be a major cause of serious newborn jaundice but today it can be prevented with a shot of Rh immune globulin within the first 72 hours after birth.
A difficult labor can lead to blood leaking out of a blood vessel which can cause bruising. This bruising may increase bilirubin levels.
Small for gestational age babies and multiples
Babies with this birth background are more likely to have a higher number of red blood cells than other babies, leading to jaundice as a newborn.
Other issues that can contribute to newborn jaundice includes problems with abnormally-shaped blood cells, a lack of certain types of enzymes, having a blood infection or liver problems. However, these are rarer conditions.
Most hospitals test for jaundice within 24 hours after birth. Probes that make contact with the skin are used for this test, and should a high reading occur, blood tests will be conducted. Blood tests will consist of a complete blood count (CBC), Coombs test and a reticulocyte test. Babies will also be observed for any yellowing of the skin or eyes while in the hospital as well as at baby's first well visit with a pediatrician after birth.
The majority of infant jaundice cases require no treatment at all, other than watching for improvement. However, to determine whether this is a case requiring treatment, doctors will make note of the bilirubin level, how quickly it's rising, whether the baby was premature or not, and the believed cause of jaundice.
You will be encouraged to frequently feed the baby in order to achieve regular bowel movements, which will help expel the bilirubin from the body.
Your baby may need treatment at the hospital which may involve placing the baby in an enclosed bed with artificial light. Baby will wear special goggles to protect the eyes, and the bed will be kept warm. Phototherapy uses blue lights and baby will not be uncomfortable or need invasive procedures. Breastfeeding should continue as normal. Baby is usually done with the treatment within a day or two.
Some babies may get treatment at home by using a fiberoptic blanket containing very small but bright lights, or using a bed that has a light shining up from the mattress. You will be trained by a nurse before leaving the hospital on how to use the lights and will be instructed to feed the baby every few hours at least. A nurse will visit baby to check weight, skin appearance and bilirubin levels.
Serious cases are quite rare, and would involve a blood transfusion. If left untreated, jaundice could cause brain damage. However, diagnosis is simple and treatment easy so these worst-case scenarios are extremely unlikely.
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