Neonatal Jaundice is a commonly seen disease condition. Ironically, it is seen more in baby boys than baby girls. As many as 50% of all infants are prone to this condition. In an infant born at full term without any major health issues, neonatal jaundice is not a cause to panic. Having said that it does not mean that this condition can be taken lightly as an untreated neonatal condition can cause brain impairment and even death. So if a baby is suspected to be affected with neonatal jaundice seeking a professional opinion is always better.
Neonatal jaundice or infant jaundice occurs when the level of bilirubin in the baby’s blood is more than the required level. Bilirubin is it is a waste product formed by breaking down the red blood cells.
Excessive presence of bilirubin accounts for yellowish tinge of the baby’s skin and whites of the eyes. This is called neonatal jaundice.
The most apparent sign of infant jaundice is yellow skin. It is generally noticed on the head and spreads out to other organs such as chest, arms, legs, stomach etc. Other than this, the baby may appear drowsy, show inability to gain weight, feeding and sucking will be poor, urine will be dark in colour (ideally newborns’ produce colourless urine), may get cranky for a prolonged period of time, show pale face.
In rare cases neonatal jaundice could be a manifestation of liver disease, sickle cell anemia, blood infection, blocked up bowel or bile duct, underactive thyroid gland (hypothyroidism), liver inflammation (hepatitis), low levels of oxygen (hypoxia), syphilis or rubella.
There is nothing to be alarmed if the baby’s bilirubin after birth is a little bit on the higher side. It is the duty of the placenta to flush out excessive bilirubin when the baby is growing in the mother’s womb. It is through placenta the baby is fed during pregnancy, but after birth the liver of the baby takes over that responsibility. As we take a little bit of time to get accustomed to a new place, sometimes the liver also takes time to discharge the new task flawlessly. It leads to build up of bilirubin beyond the normal level in the bloodstream which liver may not be able to send to the intestine to eliminate.
It is not uncommon to see yellow skin in babies. It becomes all the more apparent when the baby is two to four days old. Most often it goes away on its own without any significant issues.
Following are the usually found risk factors for neonatal jaundice
Preterm birth – Premature babies liver may not be fully developed and their bowel motions are fewer, this means filtering of bilirubin is not taking place at the required pace and bilirubin excretion from the body is also challenged.
Breast-feeding – If newborn babies are not getting sufficient nutrients and calories from breast milk they are at risk of developing this condition.
ABO incompatibility – If the blood type of mother and baby are different, there are chances of mother’s antibodies go across the placenta and attack the red blood cells
Bruising during delivery – It accelerates the speed with which red blood cells are broken down, thereby pushing up the level of bilirubin.
Breast-feeding newborns are usually affected with two types of neonatal jaundice
Breast-feeding jaundice – As the name indicates this happens due to poor feeding or the milk is not sufficient enough to satisfy the baby. It appears in the early days of life.
Breast milk jaundice – This occurs due to the substances that are in the milk hamper the bilirubin being broken down. It generally occurs after a week of the newborns birth and reaches a crescendo at two to three weeks.
Usually it is not imperative to treat neonatal jaundice as it is not a very severe condition. In the unlikely event, if the newborn is affected with severe jaundice immediate treatment is required to bring down the levels of bilirubin in the blood. Some treatment modalities for severe neonatal jaundice are:
Photo Therapy or Light Therapy – As the name indicates light rays are used to treat the condition. The baby is kept under a light specially made for this purpose. Here a plastic shield is used to cut out harmful ultraviolet light. In this form of treatment, bilirubin is excreted from the body system as the light manipulates the very structure of bilirubin.
Exchange Blood Transfusion – It is an invasive treatment where the baby’s blood is drawn out repeatedly in order to be replaced with donor blood. This is not a first-line treatment modality and is only used when the light therapy does not yield the required benefit and the newborn is in the neonatal ICU.
Intravenous immunoglobulin (IVIg) – It is a form of treatment where immunoglobulin is transferred. Immunoglobulin is a protein seen in the bloodstream that brings down the antibody levels that are attacking the red blood cells.
If the cause of the jaundice is something other than the usual ones, more severe and stringent forms of treatment like drugs and at times surgery may be required.
Medical science has grown leaps and bounds, so the condition can be reversed provided proper treatment modality is in place.
Though we cannot do away with neonatal jaundice completely the best way to reduce chances of a newborn getting affected with this condition is to keep the baby well-fed. Preferably, breast-feeding babies eight to twelve times for the first week of life is a good step in the fight against neonatal jaundice. If the baby is formula-fed, make sure you give one to two ounce of formula every two to three hours.
Parents and health care professionals need to be properly educated and trained regarding the possible peril of hyperbilirubinemia. Only through a holistic approach we can keep this disease at bay.
For any questions related to Jaundice in Newborns, please drop a message to www.KJKHospital.com/contact or call 9447452568