Newborn Jaundice: Causes, Symptoms, and Treatments

Little ones could be born very healthy but may be affected by disorders. Birth Defects, Down syndrome, Fetal Alcohol Spectrum Disorders, Jaundice, and Cerebral Palsy are some. Pray for healthy births! Newborn jaundice manifests as a yellow sheen in the eyes and skin, also referred to as Hyperbilirubinemia. The cause is the high level of bilirubin. 

What is bilirubin? When old red blood cells undergo the natural breaking down process, it results in a yellow pigment called bilirubin. Bilirubin exits the body through urine and stool. An excess of that gives rise to the yellow appearance. A rather common ailment in newborns which is not at all serious, usually. 

Jaundice in new-borns or in adults

Jaundice affects both children and adults with yellow eye and skin along with loss of appetite, dark urination, exhaustion, and itching skin. The yellow-orange bile pigment that affects babies and adults differs. Adults require no treatment while babies may face severe dangers. Some of the many causes might involve tumors, gallstones and hepatitis. Autoimmune disorders, genetic metabolic effects and certain medicines are possibly other causes. 

Every liver produces bilirubin

A natural function of the liver that processes bilirubin in adults and babies, everyone, bilirubin exits through the intestinal passage.  During pregnancy, the mother’s body uses the placenta to get rid of the baby’s bilirubin. After birth, the new-born suffers and the weak baby liver cannot process the bilirubin well. The little one just entering the world from the safety of mama’s womb has a delicate little liver that is hardly equipped to remove bilirubin. The liver is yet to develop and will take up such functions a little later in life. 

What is a bilirubin blood test? 

The yellow pigment called bilirubin is found in everybody’s stool and blood. With a bilirubin blood test, the level of bilirubin in the body is known. If the liver cannot process the bilirubin, it may be due to liver inflammation, an obstruction or excessive bilirubin levels. Jaundice is the yellowing of the skin and eye whites due to the excess bilirubin. The test will indicate the cause of the yellowing.

Hemoglobin protein breaking down in old red blood cells is a normal process that results in bilirubin. Through the blood, bilirubin reaches the liver where it is processed and mixed with bile. Finally, it is stored in the gallbladder from where it reaches the small intestine to aid in the absorption of fats. At last, bilirubin exits the body with the stool. 

By direct or conjugated bilirubin is meant the bilirubin that attaches to the liver with glucuronic acid that is formed from glucose. Indirect bilirubin is the unattached bilirubin. Together, they are referred to as Total Bilirubin. Comprehensively, the blood test will reveal all three readings of the total, direct, and indirect bilirubin. 

The icing on the cake

For expectant mothers and couples just entering the parenthood phase, there is just no reason to panic. In an overwhelming majority of such cases, the baby liver that develops jaundice gets rid of the problem especially with more feeding for the baby. The food facilitates the passing of bilirubin from the body. With the jaundice vanishing within 2 or 3 weeks, it is certainly good riddance. However, if jaundice continues beyond 3 weeks, something may be really wrong. 

Physiologic jaundice

The increased levels of bilirubin new-borns produce is referred to as physiologic jaundice. Appearing as the yellowish coloring on the skin a few days after birth, physiologic jaundice is gone soon enough within a fortnight. 

Causes 

  • Prematurely born babies do not succeed in removing the bilirubin and require early treatment. New-born jaundice may escalate otherwise.
  • Baby is unable to receive enough breast milk during the first few days. That could happen due to difficulty with breastfeeding or insufficient milk. Feeding more frequently is the solution. A lactation consultant is needed. 
  • The breastfeeding problem. Breast milk prevents the quick removal of bilirubin after the first week. Over 3-12 weeks, bilirubin levels elevate gradually. 
  • Blood type mismatch of the mother and baby. The mother’s blood manufactures antibodies that attack the red blood cells of the baby. Mother being O and baby being A or B, or if Mother’s Rh factor is negative and baby’s Rh factor is positive, such a problem arises. 
  • In the baby’s health conditions like hereditary spherocytosis or G6PD deficiency, red blood cells are fragile and collapse easily. 
  • The baby may be born with polycythemia which means high blood cell count or cephalohematoma which is a bruise on the head. 
  • Additional blood and liver complications.
  • Baby’s weak digestive system.

Dangers in extreme cases

Kernicterus means the brain damage that might be the heavy price the newborn pays for high bilirubin. Cerebral palsy and deafness could be the consequence if not some other disturbing brain condition. 

No wonder it is recommended that newborns get checked for jaundice before leaving the health facility after birth and between 3 and 5 days. Don’t wait further. If such symptoms occur, consult the doctor without delay. 

Symptoms to watch out for 

  • The yellow tinge deepens, starting with the face and chest 
  • The baby behaves strangely and slows down 
  • Sucking the breast weakens
  • Baby utters shrill sounds
  • Baby arches the back

Diagnosis

The doctor first carries out a physical examination. Parents are required to answer queries about their health and the baby’s health. Testing with a device that touches the baby’s skin indicates the bilirubin level. A blood test too may be required to indicate the need for treatment. Complex cases would require further testing. Some health conditions may be raising bilirubin levels. 

The crucial question is if the parents and the baby have different blood types. That is a leading cause of jaundice in newborns. 

Some common treatment procedures

Diagnosed with bilirubin levels above the usual range, the doctor will prescribe appropriate treatment. 

  • Light treatment is the usual procedure with a special light. The skin when exposed to the light gets to absorb the light. It is called phototherapy. Light-therapy blankets may be used too. As a result, the bilirubin changes and is easily expelled by the body. 
  • Hospitals administer light treatments safely with specialized lighting in controlled environments. It cannot be done at home under sunlight. 
  • If phototherapy does not succeed in bringing bilirubin levels down, emergency blood transfusion is required. A donor’s blood replaces the baby’s blood to quickly bring down the bilirubin level. 
  • If the Rh incompatibility caused serious jaundice, a blood transfusion would be recommended. Intravenous immunoglobulin (IVIg) treatment is given through the vein that stops the antibodies and transfusion may not be needed.
  • Administration of fluids will get rid of dehydration in mild cases that cause bilirubin to rise.

Coping up successfully with new-born jaundice

The most important thing is to increase nutrition that will result in the bilirubin being processed and removed from the body faster. Carry out breastfeeding maybe around 9 to 12 times within a 24 hour period. Bottle feeding would be a little less frequent, perhaps 7 to 10 times during the 24 hour period. If hesitating about adequate milk, talk it over with a lactation consultant, doctor, or nurse. 

Keep a watch on the baby’s skin a few times a day. Is the intensity reducing in the yellow tint? The white of the eye would reveal the yellow tint even if the skin is dark. If the yellow is darkening after 3 days of life have passed, get in touch with the doctor. Keep up with the doctor’s appointments as advised for testing.

Farha Naaz

Farha Naaz is a mother of a 10-month old baby.