Over the years, you may have seen or heard of newborn babies being diagnosed with jaundice on the 3rd or 4th day of their life, which turns out to be a great concern for most parents.
At this point, most parents have these questions - Was it this common in the olden days? Are doctors over-diagnosing it? Why are they unnecessarily keeping the newborn in the newborn intensive care unit (NICU) for so long?
This article tries to answer these questions and share more details to help you understand neonatal jaundice (jaundice in newborns) better.
Facts
Jaundice is a universal phenomenon i.e., it can happen to any newborn.
The normal trend is that jaundice starts from day 2 or 3 after birth, peaks on the 7th day and decreases gradually by the 14th day of life. It is often self-limiting unless the bilirubin levels are too high, which is when it needs medical intervention.
Sunlight cannot decrease jaundice. There is enough scientific data to back this up. The wavelength of sunlight is not enough to decrease jaundice. However, exposure to sunlight can increase a baby's vitamin D3 levels, a fat-soluble vitamin that has various functions from improving immunity to calcium metabolism.
What Parents Must Know
Do not panic. It is very normal for babies to have jaundice and it is easily treatable if the bilirubin levels go beyond a certain level.
It is unpredictable. The severity or degree of jaundice cannot be predicted at birth.
It is treatable. As the treatment is simple and the risks are high if untreated, it is always better to start the treatment as early as possible.
Trust the doctor. It is very important to trust and have faith in your doctor as they are the ones working continuously towards the betterment of your baby’s health while you are in the hospital.
What Causes Newborn Jaundice
Newborn jaundice is the yellowing of a baby’s skin and eyes during the first 1 to 2 weeks of their life. This is due to high levels of a yellow pigment called bilirubin. It is released as a result of the normal breakdown of red blood cells in the body.
In older babies and adults, the developed liver processes bilirubin, which then passes through the intestinal tract where a percentage of it is reabsorbed and the remaining is flushed out of the body.
Generally, newborn jaundice disappears within 2 to 3 weeks of life as the newborn begins to feed, which in turn helps in the development of their gut and liver. If jaundice persists longer than that, it could be concerning for the newborn's life due to some underlying condition.
High levels of bilirubin for a longer duration can put your baby at risk for kernicterus, cerebral palsy, deafness, etc. It is recommended that all newborns be thoroughly examined (especially for jaundice) right before their discharge and between 3 to 5 days of life.
What is The Treatment of Jaundice?
Phototherapy remains the gold-standard treatment for jaundice in newborns. However, in severe or rare cases, exchange transfusion is done.
1. Phototherapy: Special wavelength light, given to babies from a particular distance, breaks down the bilirubin accumulated in the skin and reduces its levels.
The baby is placed under the light in a warm and enclosed bed while a constant temperature is maintained and the baby is continuously fed (10 to 12 feeds per day).
It is usually given continuously and interrupted only during feeding time. The bilirubin levels are serially monitored, once every 12 to 24 hours.
It usually takes around 48 hours for the bilirubin to respond to the treatment. Each baby is different and the time taken for the bilirubin levels to decrease is very variable.
2. Exchange Transfusion: In this procedure, the baby’s blood is withdrawn gradually over a few hours and replaced (exchanged) with the donor's blood (cross-matched blood from the blood bank).
It is only considered when the baby is unresponsive to phototherapy.
3. Intravenous Immunoglobulin (IVIg): In cases of neonatal jaundice due to Rh or ABO incompatibility, the baby might need both exchange transfusion and IVIg transfusion.
Immunoglobulin is a protein that lowers the levels of antibodies (from the mother) that are attacking the baby’s red blood cells.
What Else Should You Know
Reach out to the treating paediatrician/child specialist if your baby has persistent jaundice (longer than 2 weeks) as the doctor will need to order a panel of tests to find out the underlying cause of jaundice. The list of causes can include infections, metabolic disorders, enzyme deficiencies, genetic factors, malfunctioning of the liver, etc.
Be vigilant and observe for signs. Do not be worried and remember to ACT (assess, care and treat).
Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.