Approximately 60% of full-term babies and 80% of premature babies suffer from newborn jaundice within a week of birth. It is a waste product that occurs when red blood cells break down that causes a yellowish tint to the skin and eyes. Bilirubin is normally eliminated by the liver through bile. The liver may not function properly during the first few days of life, resulting in a buildup of bilirubin in the body.
Causes
There are several factors that can cause jaundice in newborns, 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. There may be a surplus of red blood cells, leading to the production of more bilirubin, and an immature liver, which does not process bilirubin efficiently. It usually occurs on the second or third day of life, and it usually goes away within a week or two.
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A baby who is breastfed is at risk of developing this type of jaundice if he or she does not receive enough milk or nurses enough. This type of jaundice usually occurs on the fourth or fifth day of life and lasts for several weeks. It causes dehydration, weight loss, and an increased level of bilirubin in the body.
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Breast milk jaundice occurs in some breastfed babies when a substance in the milk inhibits the baby's ability to eliminate bilirubin. It usually appears on the seventh or eighth day of life and may last for up to two months.
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It is possible to get hemolytic jaundice when the mother's blood type and the baby's blood type are incompatible, such as Rh factor or ABO incompatibility. Consequently, the mother's immune system attacks the baby's red blood cells, causing hemolysis and bilirubin production. It usually appears on the first day of life, and can be severe.
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Among the less common causes of newborn jaundice are infections, liver diseases, metabolic disorders, genetic conditions, and medications that interfere with bilirubin metabolism.
Symptoms
Newborn jaundice is characterized by yellowish skin and whites of the eyes, which may vary in intensity depending on bilirubin levels. Other symptoms include yellowness in the head, chest, abdomen, arms, and legs.
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Sleepiness or lethargy
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Problems with feeding or sucking
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An irritable or fussy disposition
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Dark urine or pale stools
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A seizure or high-pitched crying (in severe cases)
Diagnosis
Jaundice in newborns can be diagnosed by examining the baby and asking about its symptoms, the mother's pregnancy and delivery, the baby's feeding and weight, and any family history of jaundice or blood disorders. In addition to a blood test, the doctor will also assess a baby's bilirubin levels. A normal level for bilirubin in a full-term baby is between 1 and 12 mg/dL, while a premature baby may have a higher level. There is a risk of complications such as brain damage or kernicterus, which can cause permanent neurological damage if the level exceeds 20 mg/dL.
Treatment
Newborn jaundice can be treated in several ways, depending on its cause, severity, and duration.
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One of the most effective treatments for newborn jaundice is phototherapy, which breaks down bilirubin and makes it easier to excrete using a special blue light. Until the baby's bilirubin level drops below a safe level, the baby may be placed under a phototherapy lamp or wrapped in a phototherapy blanket several hours a day. The baby's eyes will be covered to protect them from the light, and his or her temperature, hydration, and weight will be monitored closely.
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The treatment for newborn jaundice is exchange transfusion, which involves replacing the baby's blood with fresh donor blood that has a lower level of bilirubin. It is possible to use this procedure to prevent or reverse severe jaundice, such as brain damage or kernicterus, in a hospital setting under close supervision and careful screening of the donor blood.
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Jaundice may also require other treatments, such as antibiotics for infections, intravenous fluids for dehydration, or medications for liver disease.
Prevention
Despite the fact that newborn jaundice cannot be prevented, there are some ways to reduce its severity or risk:
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Breastfeeding or formula feeding regularly, keeping the baby hydrated, and stimulating bowel movements to eliminate bilirubin.
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Observe 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 on the first day of life, is severe or worsening, or has other symptoms such as fever, lethargy, or poor feeding, seek medical attention immediately.
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If you experience jaundice, follow your doctor's advice regarding treatment and follow-up, such as phototherapy, blood tests, or exchange transfusions.
