21 Jul Jaundice in new born babies
After nine months of hard work, your baby finally gets to see the light of the world. Isn’t it our responsibility to ensure that the baby is born fully healthy and ailment-free? Jaundice in newborn babies (neonatal jaundice) is a common incidence in today’s times. A senior pediatrician tells you what could you do to avoid this condition.
What is Jaundice? Why do newborn babies often have Jaundice at birth?
Jaundice is the name given to yellow discoloration of the skin and sclera (white colored area) of the eyes and is very common in newborn babies. It is usually harmless and clears up in most babies after 10-14 days. It occurs in almost 60% of term babies and 80% of preterm babies. There are two types of jaundice in newborn babies:
Physiological caused by natural processes and is the most common.
Pathological caused by underlying health disorders.
This is caused from increased breakdown of excess red blood cells in newborn which produces yellow pigment called Bilirubin.
The newborn liver is not mature enough to breakdown this excess bilirubin and hence the yellow discoloration of skin appears. It presents when new born is 2 or 3 days old and begins to disappear towards the end of the first week and resolves usually by 10th day.
Yellowish discoloration starts from the face and proceeds downwards. The bilirubin level usually is not very high. However, the bilirubin level may increase if the baby is premature or if there is increased red cell breakdown – example- extensive bruising, cephalohaematoma, underlying blood disorders.
This is due to an underlying liver disorder, congenital infections, maternal diseases or blood group incompatibilities (ABO & Rh). This might lead to early onset of Jaundice (within 24 hours) or, prolonged Jaundice (after 14 days of birth).
The risk of developing significant neonatal jaundice is increased in cases of:
- Low birth weight: premature and small for dates.
- Exclusively Breast-fed babies.
- A previous sibling with neonatal jaundice requiring phototherapy.
- Infants of mothers who have diabetes.
- Blood group incompatibilities between mother and baby
How can Jaundice be harmful to your baby?
In most cases jaundice is mild, and does not cause harm to the baby. If bilirubin levels are very high and jaundice is left untreated, it may affect the brain and cause:
- Seizures and muscle spasms (e.g. back arching)
- Delays in development
- Physical and intellectual disability
To prevent bilirubin rising to a dangerous level, treatment of moderate levels of jaundice is recommended to avoid possible health disorders.
When should you contact your doctor?
You should contact your doctor if you notice your baby has:
- Yellowing of the skin, particularly within the first 24 hours after birth
- Jaundice that re-appears after initial treatment (usually called rebound jaundice)
- Skin yellowing that is spreading further over their body
- Jaundice that is still there 14 days after birth
- Pale chalky-colored stools
- Dark yellow urine or lack of urine
- Poor feeding
- Lethargy or listlessness
What is the treatment for jaundice?
Mild jaundice often goes away without treatment; however, babies with high levels of bilirubin or severe jaundice may need treatment. Treatment depends on the level of bilirubin in your baby’s body and the cause of the jaundice. The level of bilirubin can be tested by a simple blood test. Based on the reports, the doctor can decide to start the treatment, the most common treatment for jaundice is phototherapy.
How does phototherapy help?
Phototherapy is treatment with artificial lights that are usually blue. The light helps your baby’s body break down the bilirubin so that it can be easily removed through bowel movements. This helps tackle jaundice in an effective way. The phototherapy is provided in the hospital under close supervision by the NICU staff. The baby’s vitals are monitored. They may suggest feeding your baby more often.
Follow up post phototherapy
If your baby has had jaundice or has been treated for jaundice, you should arrange to have a follow up visit with the doctor within 1-3 days after the baby has been discharged from the hospital. At the follow-up visit, your baby’s jaundice will be assessed along with their weight, feeding, urine and bowel movements. If your baby is showing signs of jaundice, they may need further treatment in hospital.
Precautions you need to take to avoid neonatal jaundice
1. Take care of yourself during your pregnancy and talk to your obstetrician about prenatal risk factors.
2. Be aware of your blood group and child’s father’s blood group.
3. Rh negative mothers should follow their Obstetrician advice and get counseled with regular follow ups (If the mother is Rh negative and the father is Rh positive, the mother can potentially carry a Rh positive baby. This causes antibodies in the mother to fight the Rh factor in the baby. The mother will require treatment with a product containing Rh immune globulin to prevent serious complications for the newborn, including jaundice.)
4. Antenatal screening during visits is extremely important.
5. Eat a well balanced diet and take prenatal vitamins throughout your term.
6. Get plenty of rest, especially in the third trimester. Excess activity and fatigue may cause you to go into labor early. One risk factor for jaundice is premature birth.
Post natal care:
1. Get the baby assessed for jaundice by your doctor if yellow discoloration is noticed.
2. Follow a regular feeding schedule and feed the baby every 2-3 hours, this improves bowel movement and removes bilirubin from body.
3. Follow the doctor’s advice and cooperate in treatment.
4. Ensure regular visits as per advice of your doctor.
– By Dr. Savita Chaudhary