Neonatal jaundice occurs when a newborn baby has high level of bilirubin in blood. Yellowish discoloration of the white part of the eyes and skin are the common visible symptoms of neonatal jaundice.
Bilirubin is a yellow substance created in the body for the purpose of aiding in the digestion of fats in the intestine. After its job is done, liver helps in breaking down the bilirubin and is eliminated via stool.
Generally, all newborns have higher levels of bilirubin in their blood soon after their birth. This is called physiological jaundice. While in the womb, the bilirubin produced by the baby is removed via the placenta. After birth, the baby’s own liver takes up this job and until the liver does the job efficiently, the levels remain high in the blood. Physiological jaundice is noticeable when the baby is about 2 days old and subsides within next two weeks.
Breastfeeding infants are found to have jaundice during the first week of life. This may be due to low supply of milk from the mother, leading to dehydration. Infants who are breastfed also may get jaundice after about 7 days of their life. This can be due to how the substances present in the breastmilk influence the breaking down of the bilirubin in the liver. Breastmilk jaundice is caused by the milk while breastfeeding jaundice is caused by lack of milk.
Conditions that are known to cause jaundice in newborns include:
- Premature birth
- Sickle cell anemia
- Rh incompatibility or ABO incompatibility
- Bleeding under the scalp due to birth injury
- Higher than usual levels of red blood cells
- Lack of enzymes
- Certain medicines taken by mother during pregnancy or administered to the baby
- Infections like rubella, syphilis, etc during birth
- Liver diseases like cystic fibrosis or hepatitis
- Low oxygen levels during birth
- Genetic or inherited disorders
Symptoms of neonatal jaundice:
Yellowing of skin and the white part of the eyes is the main symptom. Skin color can be checked by gently pressing the forehead of the baby. If the skin appears yellow, the baby is likely to have mild jaundice. If the skin turns slightly lighter, then jaundice is not there.
Presence of the following symptoms indicates immediate medical help:
- Baby’s skin turns more and more yellow. This can be in the abdomen, arms or legs.
- White parts of the eye looks yellow
- Baby seems difficult to awaken and appears sick
- Baby is not feeding well and not gaining weight
- Cries of the baby is high-pitched
Complications of neonatal jaundice:
High levels of bilirubin resulting in severe jaundice can cause problems if not treated.
- Acute bilirubin encephalopathy: High levels of bilirubin in blood leads to passing of bilirubin into the brain and this is very toxic to the brain. Acute bilirubin encephalopathy needs to be treated promptly otherwise may lead to permanent damage to certain parts of the brain. The symptoms include difficulty waking up, listlessness, high-pitched crying, poor feeding, fever and backward arching of the neck and body.
- Kernicterus: This is a condition that occurs if acute bilirubin encephalopathy causes permanent damage to the brain. Involuntary and uncontrolled movements, hearing loss, permanent upward gaze and improper development of the tooth enamel are the symptoms of Kernicterus.
Preventing neonatal jaundice is easy if the infant is fed properly. Breast-fed infants must have 8-12 feeds per day during the first few days of life. Formula-fed infants can be given about 1-2 ounces or 30-60 milliliters of the formula, every 2-3 hour during the first week. This helps in discarding the excess bilirubin through stools and keeps the newborn baby healthy.