Jaundice

What is this mythical creature that turns newborn’s skins and eyes yellow? What causes it and how can it be avoided? Many new parents worry about the short and long term effects of jaundice on their newborn. Here I lay out the causes, treatments, and steps you can take to avoid it.

What is Jaundice

At the end of their life cycle red cells break down.  This is absolutely normal.  One of the products created when red blood cells break down is called bilirubin.  Jaundice is then caused when there is an excess amount of bilirubin in the blood.  It causes the skin and eyes to appear yellow and this is because bilirubin is yellow tinged.

What causes high levels of bilirubin in newborns?

During pregnancy, the placenta does the job of removing bilirubin from the growing baby’s body. But after birth, this is a job the liver must take over. It may take time for the liver to do the efficiently. This is why infants are routinely tested for jaundice. In addition, there are several genetic or congenital risk factors that may lead to higher levels of bilirubin. If you’re:

  • Preterm
  • Asian or Mediterranean descent
  • Mother with chronic diabetes or gestational diabetes
  • 35+ years of age

Males, exclusively breastfed babies, and newborns with bruising to the head during childbirth also suffer from jaundice more frequently.  In addition, mother/baby blood incompatibility increases your risk.

Signs, symptoms, and diagnosing jaundice

In addition to a yellow tinge to the skin, a baby with Jaundice may become sleepier than usual. As levels of bilirubin rise, he or she may begin to feed poorly, levels rise more and the cycle begins if not diagnosed and treated.  Mother’s with a healthy pregnancy and uneventful delivery will have their baby’s checked for jaundice at approximately 48 hours of life. Since certain risk factors put babies at a greater risk, routine testing for jaundice will begin much earlier and require more testing.

The initial test for jaundice is not invasive and can be done while baby’s asleep with a device that resembles a thermometer. If the initial test comes back elevated, a more accurate blood sample will be needed.  It is important to treat elevated levels of bilirubin, as jaundice can lead to long term brain damage.

Treatments

Treatment will depend on the cause, how fast the bilirubin level is rising, and how high it is.  The body removes bilirubin through bowel movements.   If levels are not too high your doctor may recommend to increase feedings to help the process. This is extremely important for baby’s that are exclusively breastfed.  Breastfed babies if not fed frequently can easily suffer from dehydration which causes the ratio of bilirubin in the blood to be much higher. This is one of the many reasons pacifiers are discouraged in the first few weeks of breastfeeding. Whenever a baby wants to suck, they should be at the breast hydrating and receiving nutritional value.  Indirect sunlight from a window for about 15 minutes is also another method of helping the body remove bilirubin.

If levels are higher or rising rapidly phototherapy may be prescribed.  Using artificial blue lights and possibly a phototherapy blanket, an infant is usually placed in an isolette, undressed, in only a diaper, and mask to protect their eyes.  They will be fed every three hours to help them more rapidly remove bilirubin.  Usually this treatment is enough to bring down bilirubin levels within a day or so.

If levels are extremely high due to disease or sometimes mother/baby blood incompatibility, a transfusion may be necessary.

 

 

Jaundice

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