Jaundice of the Newborn

Definition :
Jaundice refers to the yellow coloration of the skin and white of the eye. When it occurs in a newly born baby its called as Newborn jaundice.

What causes it:
It is caused by high amount of bilirubin ( a pigment formed as a result of the break down of the Red cells in the blood. Bilirubin is eliminated from the body by the liver. The Liver of the newborn usually takes some time to adjust to excrete all the billirubin and until then the bilirubin builds up in the body and produces jaundice.

Types of newborn jaundice :

Physiological jaundice:
Some degree of jaundice is evident in a lot of newborns usually on the 2^nd day of life. It peaks around the 4^th to 5^th day & the yellowness disappears by the end of the 1^st week.Technically speaking the bilirubin levels are between 10-16 mg%.

Pathological jaundice:
If the bilirubin builds up too high in the body that is more than 17mg% within the first week then it may be toxic to the brain and it can cause permanent brain damage. This can occur due to some infection to the baby, mismatch between the baby’s and mother’s blood group or due to some structural defects in the liver.

Jaundice of prematurity:
It occurs frequently in premature babies because the liver takes much more time to be able to handle the bilirubin levels.

Breast milk jaundice:
A particular compound in the mother’s milk can lead to jaundice in a few babies. It usually occurs the 4^th day onwards. However sometimes it can reach high levels be prolonged.
Stopping breast feeding & feeding only formula for 2 days subsides the jaundice and then breast feeding can be resumed .

Treatment:
In case of physiological jaundice no specific therapy is required. The infant should be watched for any complications or a sudden increase in the jaundice
Simply putting the baby in the sun for half an hour or so in the morning & evening is sufficient. Care though must be taken to avoid putting the baby in too strong a sunlight and for too long because then the baby can become dehydrated quickly and also can get sun burnt.

Phototherapy:
Fortunately the bilirubin is converted to a water soluble type by the fluorescent or natural light and this then can be easily excreted by the baby.
Eye patches one worn to protect the baby’s eyes.

Exchange transfusion :
In extreme cases of jaundice which is not controlled by phototherapy an exchange transfusion is performed this involves removing the blood containing high levels if bilirubin and replacing it with blood with very little bilirubin.