Has your newborn baby just been diagnosed with jaundice? While it is normal for you to be worried and stressed out, Jaundice, or hyperbilirubinemia, is a common condition that many newborn babies develop. Although it is usually benign, jaundice can cause serious complications in newborns if left untreated. So, read our post below and learn how to deal with Jaundice in newborns.
When neonates have too much bilirubin in their blood, it causes the skin and sclerae (whites of the eye) to turn yellow in color. Bilirubin is a byproduct that forms when the body breaks down old red blood cells. This is a normal and healthy process. Bilirubin usually circulates in the blood before reaching the liver and making its way into the gallbladder through the bile duct. When the body digests fats, the gallbladder releases bilirubin in small quantities into the small intestine. After stimulating the digestion of fats, bilirubin is excreted from the body in the stool (feces). Your baby gets jaundice when the body produces more bilirubin than the liver can metabolize and excrete out of the body.
There are many reasons your newborn infant has a higher buildup of bilirubin. Some of these include:
Jaundice in infants are treatable and usually is not a cause for concern. The neonatologist will check your baby a few days after birth for jaundice. Remember if the jaundice is severe, i.e. the bilirubin count is more than 25 mg, and you don’t get your infant treated, it could result in deafness, cerebral palsy or brain damage. In some infants, jaundice is indicative of an underlying health problem, like thyroid disorder or an infection.
Jaundice is more common among newborns than you can imagine. Estimates reveal 6 out of 10 babies develop jaundice after birth, and 8 out of 10 premature babies develop the condition. A premature birth is when your baby is born before the 37th week of your pregnancy. However, just one in 20 babies require treatment due to a high buildup of bilirubin in the blood.
Doctors still haven’t been able to find out why breastfeeding increases a newborn baby’s chances of developing jaundice. But in most cases, the benefits of breastfeeding outweigh the disadvantages. So, you should always breastfeed your newborn infant even though the fear of jaundice may be lurking at the back of your mind.
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It is natural as a mother you will want to know why your newborn infant develops jaundice. There are many causes of jaundice in newborn babies. If you know more about them, it will help ease the stress you are experiencing and help you pay more attention to caring for and nurturing your infant.
Also known as normal jaundice, physiological jaundice develops because your baby’s liver is still growing and maturing and does not have the ability to function optimally. The form of jaundice appears two to four days after birth and is usually mild. It disappears after your baby is a week or two weeks old.
When newborn babies don’t get sufficient breast milk due to problems associated with breastfeeding or your body is unable to produce milk, it could result in your baby developing jaundice. You should not feel guilty because this has nothing to do with you. Breastfeeding jaundice also doesn’t develop because of a problem with your breast milk. If your baby develops this type of jaundice, your OB/GYN and the neonatologist will recommend involving a lactation consultant.
Breast milk jaundice is different from breastfeeding jaundice. So, don’t get the two mixed up. In rare cases, in about 1 to 2 out of 100 babies, substances in the breast milk cause your baby’s bilirubin levels to spike. These substances prevent the body from excreting the bilirubin. The characteristic yellow skin coloration manifests after three to five days of birth but improves slowly over a period of three to 12 weeks.
Usually, you and your baby have the same blood types. In instances, where your baby has a different blood type from you, your body will produce antibodies as it perceives your baby’s red blood cells as a threat. This results in a buildup of bilirubin in your baby’s blood, leading to in-vitro jaundice. Previously, Rh-related issues used to result in severe jaundice in babies. However, with the advent of Rh immune globulin injections, these issues are preventable.
Babies born prematurely, or before 37 weeks of pregnancy, have a high risk of developing jaundice. A premature baby’s liver is not completely developed to excrete bilirubin. This causes a buildup of bilirubin in the blood, resulting in jaundice. If your baby is premature, don’t worry. The doctor will commence treatment even if bilirubin levels are low to avoid complications.
If your newborn baby develops jaundice, you will notice the skin and whites of the eyes turning yellow. This yellowish color develops anytime between the second and fourth day after the birth of your baby and is the most characteristic sign of jaundice.
In case, you notice a yellowish hue on your baby’s skin, switch on the lights in the room or allow ample natural light to filter in so that you can clearly see your baby’s skin. Then gently press your baby’s nose or forehead. If the skin appears yellow at the place you pressed, your baby may have a mild case of jaundice. On the other hand, if the skin doesn’t have a yellow hue after pressing, you have no reason to worry. Your baby’s skin is just lighter than what is should be, and in due course, the skin will get its normal color.
Sometimes, it can be tough to spot changes in your baby’s skin color. This happens if the skin tone is dark. If this is the case, look for the yellow color in other places, like:
If your newborn baby has jaundice, you also will notice many other symptoms like:
If your baby has severe jaundice, consult the neonatologist immediately. Severe jaundice is life-threatening and can result in complications. Some of the symptoms associated with severe jaundice include:
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If your baby has a mild case of jaundice, it will disappear on its own within two to three weeks. On the other hand, if your baby has moderate to severe newborn jaundice, he will require treatment to bring down his bilirubin levels.
Babies with moderate jaundice are given phototherapy. As the name suggests, this treatment uses light to lower bilirubin levels. The light results in photo-oxidation, which adds oxygen to bilirubin so that it dissolves in water. This allows the liver to metabolize the bilirubin present in the blood and excrete it from the body.
The doctor will recommend one of the two types of phototherapy:
Here, your baby is placed under a fluorescent or halogen lamp. During the treatment session, your baby’s delicate eyes are covered.
This is a unique treatment where you baby is enveloped in a blanked called biliblanket. The blanket contains fiber-optic cables through which light travels and bathes your baby in it. The treatment lasts for about one to two days. During the treatment, you would have to feed the baby every two to three hours to prevent dehydration. Biliblanket usually is used to treat premature babies.
Each phototherapy session lasts for three to four hours followed by a 30-minute break that lets you feed, change and cuddle with your baby. Then the treatment session resumes. On the other hand, if the doctor deems fit to recommend continuous multiple phototherapies, there are no breaks. You would have to pump out your breast milk, which your baby receives intravenously or through a stomach tube.
Once phototherapy starts, your baby’s bilirubin levels will be tested every four to six hours. As the levels start falling, the levels will be checked every six to 12 hours. The treatment ceases once bilirubin comes down to safe levels.
Phototherapy lasts for a day or two and is relatively safe. Your baby may develop a temporary tan or rash, but will not experience any other side effect.
If your baby’s bilirubin levels are high, or phototherapy doesn’t bring down the levels, doctors will perform a type of blood transfusion known as exchange transfusion. Here, a small amount of your infant’s blood is removed and is replaced with matching donor blood. The logic behind this treatment is that the donor blood contains no bilirubin. Hence, your baby’s bilirubin levels will come down quickly after the transfusion.
Exchange transfusion is a lengthy process. During the transfusion, your baby will be carefully monitored to ensure no problem or complication occurs. If it does, doctors can treat your baby quickly.
Two hours after the transfusion, your infant will have a blood test to find out whether the treatment was successful. The doctor may repeat the procedure if bilirubin levels don’t come down.
If the newborn jaundice is due to an underlying health problem, like an infection, doctors will treat the source of the problem to bring bilirubin count down.
Sometimes, you and your baby may have different blood groups. So, your baby may be carrying antibodies, which result in bilirubin spike. Under such circumstances, your little one receives IVIG, or intravenous immunoglobulin, to stop the continuous rise of bilirubin.
If there is mild jaundice in newborns, the doctor may recommend changes in the feeding patterns. You may have to breastfeed your baby more often to facilitate bowel movement. This helps in increasing the amount of bilirubin excreted out of the body through the stool. You may have to breastfeed your baby eight to 12 times a day.
If your neonate is on formula, the doctor will recommend feeding 1 to 2 ounces every two to three hours.
You cannot prevent your newborn baby from contracting jaundice. The good news is if your baby does develop newborn jaundice, there are many different treatments available to ensure the condition doesn’t take a turn for the worse.
Make sure your baby stays well-hydrated first few days after birth. This helps to flush out excessive bilirubin from the body quickly. You can ensure optimal hydration by breastfeeding your infant eight to 12 times a day or giving 1 to 2 ounces of formula every two to three hours.
Also, keep a close eye on your baby for the first five days after birth. If you notice your baby’s skin and eyes turning yellow, contact your doctor immediately.
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Article written by K. Masthoff
