Jaundice in Newborns

Jaundice, also called hyperbilirubinemia, is extremely common in newborns, both full term and premature. Bilirubin is a byproduct of the breakdown of red blood cells. All human beings have a certain amount of bilirubin that they must eliminate every day. Newborn babies, especially premature babies, have difficulty in removing bilirubin from their bodies in urine and stool. As the bilirubin accumulates, it can cause a yellow discoloration of the skin and the whites of the eyes. Most of the time this is not harmful and requires no treatment.

However, we start prevention treatment with elevated levels, because very high levels of bilirubin can cause brain injury. Bilirubin levels can be monitored either by blood tests or by a device that reads the bilirubin level through the skin.

Treatments for Jaundice in Newborns

The treatment for an elevated bilirubin consists of the use of bright lights shining on the baby’s skin. The amount of skin that is lit up will have the greatest effect on lowering the bilirubin level. Therefore we remove all of the baby’s clothes, but cover the eyes to protect them. Blood tests are done periodically while this light therapy is being used to monitor bilirubin levels. Usually by the end of the first week jaundice has gone away in almost all babies.

Phototherapy
We use phototherapy which involves shining bright fluorescent lights onto newborns to treat jaundice. Most babies require light therapy for one to four days.

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What Is Jaundice?

Jaundice, also called icterus, is yellowing of the skin and whites of the eyes. It’s a very common condition in newborns. Jaundice usually gets better by itself and disappears in a few days.

What Causes Jaundice?

A substance called bilirubin can build up in the blood. Bilirubin forms when red blood cells break down. The body usually gets rid of bilirubin through the liver. Because the liver in newborns is immature, sometimes bilirubin builds up faster than the body can get rid of it. Jaundice is the result. Very high levels of bilirubin can hurt the baby’s nervous system. This condition is called kernicterus. Premature babies are more likely to get jaundice than are full-term babies.

Other causes include infection, a blood type conflict between mother and baby, and breast milk. Sometimes, breast milk interferes with the ability of a baby’s liver to process bilirubin. This type of jaundice develops later than the others and can last for several weeks.

What Are the Symptoms of Jaundice?

The most common symptom is yellowing of the skin and whites of the eyes. Other symptoms, with very high bilirubin levels, are being drowsy and not eating well.

How Is Jaundice Diagnosed?

The health care provider will do a simple blood test to check the bilirubin level.

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How Is Jaundice Treated?

Many babies don’t need treatment.

When treatment is needed, the best is phototherapy. The baby lies naked under fluorescent lights. The baby has eye patches to protect the eyes during the treatment. The lights help break down excess bilirubin so it can be removed more easily. An “ultraviolet blanket” can also be used. Bilirubin blood levels are checked regularly. Phototherapy usually lowers bilirubin levels in 2 days. Sometimes, the bilirubin level goes up after phototherapy, but only temporarily. The yellow color may last for a few days or even a week or two, even with low bilirubin blood levels.

In rare cases of extremely high bilirubin levels that can’t be lowered by phototherapy, exchange transfusion may be done. This treatment involves removing blood with high levels of bilirubin and replacing it with different blood.

DOs and DON’Ts in Managing Jaundice:
  • DO feed your baby often. This helps the baby pass more stool, which reduces the amount of bilirubin that the intestines absorb.
  • DO see your health care provider right away if your baby seems to be getting jaundice again, because it can mean that there’s a different problem. Once newborn jaundice clears up, it usually doesn’t come back.
  • DON’T panic. Most babies recover completely without treatment.
FOR MORE INFORMATION

Contact the following source:

  • American Academy of Pediatrics
    Tel: (847) 434-4000
    Website: http://www.aap.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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