What is jaundice?
Yellowish discoloration of the skin and the whites of the eyes. It is very common in babies, is usually harmless and usually clears up on its own after 10–14 days and in some cases it will need treatment.
Why does it happen? Where does it come from?
Normally, it happens when there is excess bilirubin which is a substance produced by increased breakdown of red blood cells in neonates that physiologically occurs in all newborn infants. The liver removes bilirubin from the blood to intestine then it passes out of the body through stool. In case of jaundice, liver doesn’t remove bilirubin completely, the latter starts to increase in baby’s blood and appear in skin and eyes.
What are manifestations of jaundice?
Yellow color of skin and eyes. It usually starts in the face then spreads to involve the body with various degree. Sometimes it is difficult to assess the color especially in dark-skinned babies. If suspecting, press the baby’s skin of the nose and forehead then lift your finger, the skin will turn into yellow. It is better to be assessed in daylight.
When should you call the doctor?
If the baby looks:
*Deeply yellow or jaundice gets worse
*Unwell or sick
* Not crying, not feeding well
* Sleepy more than usual
* Clay colored stool
* Associated vomiting
*If baby remains jaundiced more than 2 weeks of life.
What are side effects?
Critical level of bilirubin can cause damage to brain cells.
What are the causes?
- Physiological: it means that most of babies will turn into yellow color 2-4 days after birth. This is common, considered normal usually clears up during the 1st 2 weeks of life and usually doesn’t require treatment.
** Baby doesn’t get enough breastfeeding especially during the 1st few days. In this case, it is recommended to feed the baby more frequently.
** Different blood groups and Rh-type:
- When the mother has blood group O and baby has type A or B blood group. This is called (ABO incompatibility)
-If the mother has Rh –ve and baby has Rh +ve type
** Disorder of red blood cells:
- Genetic e.g. G6PD deficiency
- Number: increased number of red blood cells (polycythemia)
How is jaundice diagnosed?
- All babies are routinely checked before being discharged from the hospital
- Routine follow up visit is recommended for all babies after discharge and parents should bring the baby for the visit to be checked.
-Bilirubin is routinely checked by a device that measures its level in blood through baby’s skin.
-Blood test is done based on the physician assessment and it is diagnostic.
- All readings are plotted on a chart to choose the best management for each baby individually.
How is it treated?
It is treated according to the cause
- If jaundice is mild it can be treated at home by proper feeding and follow up.
- If baby needs hospital admission, he will receive phototherapy. It is a special light designed to decrease bilirubin level in blood. The baby is put under this light wearing diaper and eye shield only.
- In severe cases, exchange transfusion can be done. It is removal of some baby blood containing this bilirubin and replace it with glucose.
American Academy of Pediatrics
KidsHealth from Nemours
Dr. Eman Mohamed I. Moawad