What is Jaundice?
- Jaundice is the yellow coloring of the babies skin and eyes. This happens when there is too much bilirubin in the babies blood.
- Bilirubin is a yellow substance that comes from the breakdown of red blood cells. Think about when you have a bruise, sometimes you’ll see that it turned yellow during the healing process. This is from the bilirubin.
- Bilirubin is processed through the liver and then removed from the body through the bowels then out through the stools.
- Babies have more red blood cells than adults do and those cells don’t live as long, so they are being broken down more frequently. Also, infants livers do not function the same way as adults which causes a build up of bilirubin that the liver can’t process fast enough.
Risk Factors for Jaundice
- Babies who are premature are more likely to be diagnosed with jaundice because their livers are even more immature than a term infant.
- Babies who aren’t feeding well are also more at risk for jaundice because they aren’t excreting the bilirubin because they are not stooling as often. Breastfeeding more frequently and making sure baby is eating enough can help. If you need help with breastfeeding a lactation consultant can help. This type of bilirubin is usually seen within 2-4 days of life.
- Breastmilk jaundice happens because breastmilk prevents the liver from processing the bilirubin fast enough. This is seen in the first week of life.
- If a baby has a different blood type than the mother than the mothers blood cells attack the babies causing an increase of red blood cell breakdown.
- Also, if the baby has a large bruise from delivery or a cephalohematoma (blood trapped between the scalp and the skull), can increase the amount of bilirubin in the blood.
- Another cause of jaundice is an increase in red blood cells called polycythemia or genetic disorders that causered blood cells to break down faster.
- Babies of East Asian decent are also at an increased risk for jaundice. If a baby has a sibling that was treated with jaundice, they are also more at risk.
How is Jaundice Diagnosed and Treated?
- Babies are screened for jaundice at 24 hours of life in the hospital or at birth if they have any of the risk factors listed above.
- If the jaundice screening was high then a blood test will be done to diagnose jaundice and identify the severity. Depending on the severity of jaundice, your baby may be treated under a blue light called phototherapy, this can also be a blanket with a light. (which helps break down bilirubin so it can be excreted).
- Sunlight can help as well if the jaundice is less severe.
- If the baby is dehydrated doctors may recommend supplementation with expressed breastmilk or formula.
- IV fluids are also sometimes necessary.
- In very serious cases, babies may have to have blood transfusions.
Jaundice is very common in a newborn. But it can cause serious health problems, so treatment is very important. Bilirubin is toxic to the brain and an excessive build up of jaundice can cause permanent damage if not treated.
Signs of Jaundice, besides the yellowing of the skin and eyes, are sleepiness, lethargy, and difficult eating. If you notice thee in your baby, call your pediatrician.
References:
- American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114:297.