The World of Pregnancy

Jaundice – Symptoms, Diagnosis & Treatment

Jaundice, also known as icterus, is a normal medical condition of newborn babies which refers to the yellow color of the skin caused from the excess of bilirubin from blood.

About Bilirubin

Bilirubin, known in the past as haematoidin, is produced by the normal breakdown of the red blood cells. Typically, bilirubin passes through the liver and is excreted via bile after passing through the intestines. Jaundice appears when bilirubin is secreted in larger amounts than those that the newborn`s liver is able to destroy. The reasons may be:

  • Newborn babies secret more bilirubin than adults, since they have more red blood cells.
  • The infant`s liver, still being in development, may not be able to eliminate the proper quantity of bilirubin from his body.
  • A larger quantity of bilirubin is reabsorbed through the intestines before it can be eliminated from the infant`s body.

The increased levels of bilirubin, usually over 25mg, can cause cerebral palsy to some babies, as well as deafness and other forms of brain damage. In rare situations, infant jaundice can indicate the presence of other medical conditions, such as an infection or a thyroid related issue. Also, doctors advise that all babies should be tested for the level of bilirubin in the first days of their life.

Types of Jaundice

  • Physiologic jaundice (normal type) appears to the majority newborn babies. This small form of icterus is caused by the immaturity of the baby`s liver, which leads to a slow processing of bilirubin. It usually appears after 2 to 4 days after birth and disappears after 1 or 2 weeks.
  • Jaundice of in the premature babies appears often to babies born prematurely because they are generally unprepared to excrete bilirubin. To avoid complications, this type of icterus needs to be treated at a lower level of bilirubin than at babies born by normal birth.
  • Jaundice caused by breastfeeding can appear when a child that is breastfed doesn`t get enough milk because of difficulties at sucking or because mothers don`t have milk yet. However, it isn`t caused by an issue with the mother`s milk, but because the infant isn`t able to suck the milk properly.
  • Jaundice caused by the mother`s milk can appear at 1% to 2% from the breastfed babies and is caused by the substances found in the milk, which can increase the level of bilirubin. These substances can prevent the excretion of bilirubin from blood. It usually appears after 3 to 5 days after birth and disappears after 3 to 12 weeks.
  • Blood group incompatibility (or RH) – if the infant has a different blood type than his mother, she can produce antibodies that can destroy the baby`s red blood cells. This reaction will lead to the immediate increase of level of bilirubin in the baby`s blood. Baby jaundice coming from the blood group incompatibility can appear since the first day of the infant`s life. In the past this was the most serious type of icterus, but now  this can be prevented with a simple infection in the first 72 hours after birth. This injection, which contains the mother`s RH immune globulin, will prevent the forming of antibodies that can put the baby`s health in jeopardy.

Symptoms & Diagnosis

Jaundice can appear the 2nd or 3rd day of life. It will first appear on the head and then will progress to the rest of the body, the infant`s skin affected by icterus appearing to be yellow. Also, the white parts of his eyes can become yellow.

Since nowadays babies are released from the hospital after 2 days since birth, is best if the infant will be seen by a doctor to be checked for jaundice after a few days of being released. Parents should also pay attention for any signs of icterus. If you notice your baby`s skin turning yellow, get in touch with your baby`s pediatrician to check if your baby doesn`t have a severe form of jaundice.

A small sample of blood can be tested at a clinic or hospital to check the level of bilirubin. Some doctors use measurements based on the intensity of light and only after use a blood sample. The gravity of icterus will very much depend on the number of hours of the baby`s life as well as other symptoms.

When Do We Call the Doctor?

The doctor should be called immediately if:

  • Jaundice appears in the first 24 hours of the infant`s life
  • If/when the baby appears to be sick
  • Jaundice spreads or becomes too intense
  • If the baby develops a fever. The temperature needs to be measured rectally and should be higher than 37.8 Celsius degrees
  • The yellow color intensifies
  • If the infant isn`t feeding properly
  • If you notice the baby to be more sleepy than usually.

It`s rather hard to notice how serious a type of jaundice can be by just by looking at the baby, so if the infant has a yellow skin, he should immediately be seen by a pediatrician.

Treatments

If jaundice is not serious, until 1 or 2 weeks the baby`s organism will take care of the level of bilirubin on its own. For a more serious baby jaundice, phototherapy can be a good treatment, which involves exposing the infant to a special light which in turn will help the baby`s liver to eliminate bilirubin.icterus

More frequent feedings can help eliminate bilirubin naturally. In more rare situations, a blood transfer can be recommended to offer the baby fresh blood so he can eliminate bilirubin naturally.

If the baby has icterus that seems to be from the substances the mother`s milk produces, the doctor can advise for a temporary interruption of breastfeeding. During this time, the mother can use a milking pump to maintain the milk production and then she can breastfeed again after the medical condition disappears.

If the quantity of bilirubin is large, the baby can be send back to the hospital for treatment. Once the level of bilirubin decreases and the treatment is interrupted, it`s unlikely for the treatment to be resumed.

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