Hyperbilirubinemia or Jaundice is a frequent and usually harmless condition in newborn babies that causes the skin and the whites of the eyes to look yellow. According to estimates, six out of 10 babies develop jaundice. For premature babies (those born before the 37th week of pregnancy), that statistic becomes 8 out of 10 babies.
Why does my baby have Jaundice?
Jaundice is caused by the build-up of bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells are broken down. Babies get jaundice when they have too much bilirubin in their blood.
In most cases, babies have what’s called physiologic jaundice. It occurs because their livers aren’t yet able to get rid of the excess bilirubin very well.
This type of jaundice usually appears about 24 hours after birth. It increases until the fourth or fifth day, and then it goes away in about a week.
In rare cases, jaundice may be caused by other conditions, such as an infection, a premature baby, a problem with the baby’s digestive system, or a problem with the mom’s and baby’s blood types. Your baby may have one of these problems if jaundice appears less than a day after birth or stays more than two weeks of life.
Is Jaundice harmful?
Most jaundice is not harmful to your baby. It usually shows up during the baby’s first three to seven days of life. Then it starts to disappear as the baby’s body learns to deal with bilirubin by accepting more and more breastfeeds every day.
In some situations, however, there is so much bilirubin in a baby’s blood that it may affect some of the baby’s brain cells. This may cause the baby to be less active.
The effects of this kind of jaundice may also lead to deafness, cerebral palsy and/or mental retardation. Fortunately, it can usually be prevented.
Doctors will most likely diagnose jaundice based on appearance alone. However, the severity of jaundice will be determined by measuring levels of bilirubin in the blood. Bilirubin levels can be checked via a serum bilirubin (SBR) blood test or a transcutaneous bilirubinometer device, which measures how much of a certain light shines through the skin.
If the infant’s jaundice persists for more than two weeks, doctors may perform further blood tests and urine tests to check for underlying disorders.
However, in breastfed babies who are otherwise healthy, feeding well and gaining weight appropriately, this can be normal. This is known as Breast Milk jaundice.
Treating a Newborn Jaundice
Most cases of jaundice in babies don’t need treatment as the symptoms normally pass within 10 to 14 days, although symptoms can last longer in a minority of cases.
Your baby will need treatment if the bilirubin level is above the normal range for newborns.
There are two main treatments that can be carried out in the hospital to quickly reduce your baby’s bilirubin levels. These are:
Phototherapy – a special type of blue light shines on the skin, which alters the bilirubin into a form that can be more easily broken down by the liver and the baby can get rid of it easily.
An exchange transfusion – a type of blood transfusion where your baby’s blood is removed and replaced with blood from a matching donor.
Don’t try to treat jaundice by placing your baby in the sun or near a window. Special lights and controlled surroundings are always needed to treat jaundice safely. Most babies respond well to treatment and can leave the hospital in few days.
How Can you help your baby?
If your baby has jaundice, you have an important role to play.
Look closely at your baby’s skin twice a day to make sure that the color is returning to normal. If your baby has dark skin, look at the white part of the eyes.
Take your baby for any follow-up tests your doctor recommends.
Call the doctor if the yellow color gets brighter (means getting worse) after your baby is three days old.
The best thing you can do to reduce jaundice is to make sure that your baby gets enough to eat (means adequate milk intake). That will help your baby’s body get rid of the extra bilirubin.
If you are breastfeeding, feed your baby about 8 to 12 times every 24 hours.
If you are feeding your baby with formula, give 1-2 ounces every 2-3 hours.
At Rosewalk Healthcare, we have a Paediatrician &Neonatologist available 24 hours
Laboratory and Blood bank that runs 24 hours & Advanced LED Phototherapy and Billi blanket for the treatment of newborn jaundice in our NICU.
By Dr. Atul Chopra
Head – Paediatrics & Neonatology
By Dr. Rahul Jain
Junior Consultant – Paediatrics & Neonatology