Approximately 60% of full-term babies and 80% of premature babies suffer from newborn jaundice within a week of birth. A high level of bilirubin in the blood causes a yellowish tint to the skin and eyes. Bilirubin is a waste product that occurs when red blood cells break down. Bilirubin is normally removed from the body by the liver via bile. During the first few days of life, the liver may not be fully developed or functioning, resulting in a buildup of bilirubin in the body.
Causes
Jaundice in newborns can be caused by several factors, including:
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In most cases, the newborn develops physiological jaundice, which results from the body's normal adaptation to life outside the womb. The baby may have more red blood cells than necessary, which break down faster and produce more bilirubin. The liver may also be immature and unable to process bilirubin efficiently. It usually appears on the second or third day of life and disappears within a week or two.
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Breastfed babies can develop this type of jaundice if they don't get enough milk or nurse frequently enough. It causes dehydration, weight loss, and increased levels of bilirubin in the body. This type of jaundice usually occurs on the fourth or fifth day of life and lasts for several weeks.
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A substance in the mother's milk inhibits the baby's ability to eliminate bilirubin, causing breast milk jaundice to occur in some breastfed babies. It usually appears on the seventh or eighth day of life and may last up to two months.
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An incompatibility between mother and baby's blood types, such as Rh factor or ABO incompatibility, can cause hemolytic jaundice. As a result, the mother's immune system attacks the baby's red blood cells, causing increased hemolysis and bilirubin production. This type of jaundice usually appears the first day of life, and may be severe and need to be treated immediately.
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Infections, liver diseases, metabolic disorders, genetic conditions, and medications that interfere with bilirubin metabolism are some less common causes of newborn jaundice.
Symptoms
The main symptom of newborn jaundice is a yellowish color of the skin and the whites of the eyes, which may vary in intensity depending on the level of bilirubin. Other symptoms include: Yellowness in the head, chest, abdomen, arms, and legs.
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Lethargy or sleepiness
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Feeding or sucking problems
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A tendency to be irritable or fussy
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Pale stools or dark urine
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Seizures or high-pitched crying (in severe cases)
Diagnosis
Newborn jaundice is diagnosed by examining the baby and asking about the symptoms, the mother’s pregnancy and delivery, the baby’s feeding and weight, and any family history of jaundice or blood disorders. To determine a baby’s bilirubin levels, the doctor will also perform a blood test. A normal range for bilirubin in a full-term baby is between 1 and 12 mg/dL, while a premature baby may have a higher level. If the level exceeds 20 mg/dL, there is a risk of complications, such as brain damage or kernicterus, which can cause permanent neurological damage.
Treatment
Some of the treatment options for newborn jaundice depend on the cause, severity, and duration of the condition.
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Using a special blue light to break down bilirubin and make it easier to excrete, phototherapy is one of the most effective treatments for newborn jaundice. For several hours a day, the baby may be placed under a phototherapy lamp or wrapped in a phototherapy blanket until the bilirubin level drops below a safe level. A baby's eyes will be covered to protect them from the light, and his or her temperature, hydration, and weight will be closely monitored.
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Newborn jaundice can be treated with exchange transfusion, which involves replacing the baby's blood with fresh donor blood with a lower bilirubin level. In hospital, under close supervision and with careful screening of the donor blood, this procedure can be used to prevent or reverse severe jaundice, such as brain damage or kernicterus.
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Depending on the cause of the jaundice, the baby may also require other treatments, such as antibiotics for infections, intravenous fluids for dehydration, or medications for liver disease.
Prevention
While newborn jaundice cannot be prevented, there are some ways to reduce its risk or severity:
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Assuring adequate and frequent breastfeeding or formula feeding, keeping the baby hydrated, and stimulating bowel movements to eliminate bilirubin.
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Keep an eye on the baby's weight, urine output, and stool color for signs of dehydration, weight loss, or jaundice.
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Whenever a baby develops jaundice, especially if it occurs on the first day of life, is severe or worsening, or is accompanied by other symptoms, such as fever, lethargy, or poor feeding, seek medical attention immediately.
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Follow the doctor's advice and instructions regarding the treatment and follow-up of jaundice, such as phototherapy, blood tests, or exchange transfusions.
