What is jaundice?
Jaundice is a condition in which there is a yellowish discoloration of the skin due to an excess of bilirubin in the blood. Bilirubin occurs due to the breakdown of red blood cells.
Why do newborns get jaundice?
Babies usually have a high level of red blood cells as compared to adults. During pregnancy, the bilirubin is removed by the placenta. After birth, the baby’s red blood cells rupture and release bilirubin. Usually, this bilirubin must be removed from the body by the liver, however, as the baby’s liver functions are still immature, it cannot filter the increased load of bilirubin leading to jaundice in the baby.
Which babies are at risk for jaundice?
Almost 85% of newborns (term and preterm) get jaundice (physiological jaundice). Most babies do not require treatment. A few, however, develop severe jaundice requiring various forms of treatment such as phototherapy or sometimes exchange transfusion.
What increases the risk for jaundice in babies?
- Babies born preterm have a higher risk for jaundice
- Poor feeding
- Babies with different blood type than mother (ABO/RH incompatibility)
- Bruising/bleeding below the scalp during the delivery process
- A sibling who also had received treatment for jaundice in the newborn period
How is the baby tested for jaundice?
The baby needs to be taken to the doctor if he/she has a yellowish tinge on the eyes or has a yellowish color noted on the chest, abdomen, legs. Jaundice may be difficult to detect in babies with darker skin color. The doctor will examine the baby by pressing the skin against a bony surface to determine the extent of jaundice (less reliable). A blood test may be done to confirm the level of jaundice. The range of jaundice is dependent on the age of the baby (hours/days), gestation at the time of birth, blood group of baby and mother, presence of infection, etc. By plotting the level on the baby, it can be decided as to whether the baby needs hospitalization for treatment.
When should the baby be examined for jaundice?
All babies are examined for jaundice prior to discharge from the hospital. Depending on the presence of any risk factors, the doctor may ask the parents to come for a follow-up anytime between 2-5 days after discharge.
Does the diet of the mother have any effect on the baby’s jaundice?
No, jaundice in a baby is not related to the mother’s diet.
Instead, a breastfeeding mother must have a healthy and adequate diet with lots of liquids, fresh fruits, and vegetables, whole grains, legumes, lean proteins, etc.
Does sunlight help to reduce jaundice?
Sunlight emitting blue-green light is most effective for treating jaundice, however, the baby needs to be undressed with a maximum area of the body exposed to the sunlight.
Sunlight can be used to prevent jaundice in infants who are at risk before they present at the hospital. One has to take precautions to prevent sunburns/hyperthermia due to prolonged exposure of the skin to sunlight.
How can jaundice be treated?
Treatment varies depending on the cause and severity. A baby may need proper infant feeding supportive management along with phototherapy for it to be effective. An infant may be needed to be admitted to the hospital for treatment of jaundice.
Phototherapy is treatment with a special type of light with a specific wavelength that converts bilirubin into bilirubin byproducts which are excreted in stool and urine.
Exchange transfusion is a procedure where-in the damaged red cells are replaced with new donor blood cells. It may be needed in cases where the bilirubin reaches such high levels that brain damage may occur.
When does jaundice go away?
Physiological jaundice usually rises to a peak by 3-5 days in a full-term baby and gradually starts to fall thereafter. Preterm babies may have a higher range of jaundice than term babies. In most babies, jaundice may disappear by 2 weeks of age. Breastfeeding infants can have jaundice lasting ≥ 1 month. Any jaundice lasting longer than 3 weeks may need further evaluation by the doctor.
Writer details:
Dr. Neema completed her fellowship in Neonatology in 2017 and since then she has been working at the NICU at Grande International Hospital. She is a mother to two beautiful daughters. She has also served as a tutor for the Sydney Child health program in 2019-2020, helping medical graduates to become better child care advocates.
