Jaundice in Newborn Baby – Yellow Baby : Neonatal Jaundice

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Baby in violet photo treatment to treat jaundice.
A baby is having photo treatment to treat jaundice.

What Is Jaundice?

Jaundice is yellowish color that visible on the skin due to the increase of bilirubin level in blood. Jaundice in infants is a jaundice which occurred during the first month after baby is born.

What Is Bilirubin?

Bilirubin is a type of pigment produced by red blood cell fragmentation. It is then processed in the liver before being discharged out into faeces.

Does Jaundice Often Happened Among Babies?

Jaundice often occurs in infants. 50% babies will experience jaundice in their first week of life.

Type of Jaundice in Baby and Causes:

  1. Physiologic Jaundice
    Is the most often jaundice happened in infants and not dangerous. Jaundice started after 48 hours after birth and will slowly disappear by end of the first week. This type of jaundice happened due to red blood cells fragmentation and liver organ state which is not yet mature enough.
  2. Pathologic Jaundice
    This type of jaundice starts within two days after born. This is due to excessive red blood cells fragmentation because of:

    • Incompatible blood group between mother and baby. (When mother having Rhesus negative or blood group O).
    • G6PD deficiency in infants. The enzyme deficiency causes red blood cells to become unstable when exposed to certain substances. However not more than 5% of infants experiences this problem. Nowadays all babies will be checked for their G6PD status just after they are born. (Refer food list and drugs that should be avoided by G6PD deficiency sufferer).
    • Infection to the baby. Usually the baby will look weak and requires hospital treatment.

What Causes Prolonged Jaundice?

Jaundice is considered prolonged when the yellowish condition continues exceeding 14 days for a month old baby and 21 days for premature baby. It is due to:

  • Fully breast milk feeding (breast milk jaundice). This prolonged jaundice is not dangerous to infants as long as the mother does not take traditional medicines.
  • Clogged or blocked bile flow from liver to intestine which then eventually brought about pale faeces and concentrated urine. However this case seldom occurs.
  • Lack of thyroid hormone. This case is extremely rare, one in 4000 births. Through national screening program, all newborn infants will be screen test by using umbilical cord blood.

Should I Worry if My Baby Having Jaundice?

Your baby may be well if:

  • Your baby is a full nine month pregnancy and not risky to severe jaundice.
  • Jaundice happens 48 hours after birth and there is no severe increase of jaundice.
  • Your baby is healthy and active.

However please get doctor’s checkup for further assessment.

What Are The Danger Signs That Should I Be Aware Of?

You should get immediate doctor’s checkup if:

  • Jaundice happens in 24 hours time after birth.
  • Fast yellowish increase
  • Your baby experience G6PD deficiency
  • Your earlier child experienced severe jaundice
  • Your baby looks inactive and does not want to feed milk
  • Your baby faeces looks pale or her urine become thick

What Will The Doctor Do?

Your doctor will check your baby and do a blood test and give the suitable treatment. They also will give related advice.

What Problem Will Arise Because of Severe Jaundice?

High level of indirect bilirubin in newborn can achieve danger level and can cause:

  • Hearing disturbance where brain damage happened at the hearing control section.
  • Severe brain damage (kernicterus)

Therefore early intervention must be done to avoid severe complication.

What Treatment Will Be Given?

There are two types of treatments namely:

  1. Photo treatment
    Baby will be placed under certain blue lights component radiation until indirect bilirubin turned into non-hazardous material.
    Note: Do not expose your baby in morning sunlight directly because this endangers your baby.
  2. Blood exchange transfusion
    Bilirubin level which is considered dangerous for newborn is when it is more than 20 mg/dL (340 mmol/L). Blood exchange treatment is the last choice to avoid brain damage. Bilirubin level for this treatment depends on many factors including the baby’s age and the cause of jaundice itself.

Jaundice Prevention

It would be vital for us to detect and monitor baby with high risk to get severe jaundice.

Early action to detect jaundice can ensure suitable treatment and reduce complication.

What Should Be Done to Baby Who Experience Severe Jaundice?

All infants with bilirubin level of more than 20 mg/dL should get further treatment pediatrician clinic to monitor their development and hearing.

In case severe jaundice has resulted brain damage, the child should be referred to a group of expert for recovery.

Other Things

Food list, drugs that should be avoided by G6PD deficiency sufferer:

  • Food : broad bean
  • Certain Chinese herbs
  • Drugs (refer doctor for complete list)
    – Antibiotic such as sulfamethoxazole, nalidixic acid
  • Chemical
    – Mothballs (do not use in clothing.)
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