Jaundice In Newborns

WHAT YOU SHOULD KNOW:

• Jaundice is a condition where there is too much bilirubin in the blood. Jaundice can occur in newborn babies. Bilirubin is a yellow pigment (coloring) released during the normal breakdown of your baby's red blood cells (RBC). Blood carrying bilirubin goes to the liver, where it is prepared before removal by the intestines (bowels). Bilirubin then leaves your baby's body through his bowel movements (BM). When the body has problems removing bilirubin, it stays in the blood and builds up in the skin. These problems usually happen because the baby's liver is not yet well developed. Jaundice may also occur when the body makes too much bilirubin. It may also result from a blood mismatch between the mother and baby, infections, and other liver problems.
  
  
• Jaundice usually starts on your baby's face and moves down his body. Blood tests will be done to learn how much bilirubin is in your baby's blood. Liver function tests and ultrasonography may be done to check for other causes of his jaundice. Treatment will depend on the amount of bilirubin in the blood and your baby's health. Jaundice in a full term, healthy baby usually goes away on its own as the baby’s liver matures. Caregivers may treat your baby with phototherapy or exchange transfusion if his bilirubin is very high. When monitoring and treatment begin as soon as jaundice is diagnosed, jaundice usually goes away without causing further medical problems.

CARE AGREEMENT:

You have the right to help plan your baby's care. To help with this plan, you must learn about your baby's health condition and how it may be treated. You can then discuss treatment options with your baby's caregivers. Work with them to decide what care may be used to treat your baby.

RISKS:

Treatment for jaundice may cause unpleasant effects. During phototherapy treatment, your baby may become too cold or too warm, and more irritable or tired. He may get dehydrated (lose too much body fluid) if he becomes too warm. Your baby's skin may burn or his eyes may be damaged by phototherapy. Exchange transfusions may cause bleeding, allergic reactions, or infections. If left untreated, the bilirubin level may become very high and cause problems to the brain. Your baby could have hearing loss or brain damage, and could even die. Ask your baby's caregiver if you are worried or have questions about his jaundice, care, or treatment.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your child's health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your child's condition. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives your child's caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to your child. Before giving your consent, make sure all your questions have been answered so that you understand what may happen to your child.

IV: An IV is a tiny tube placed in your child's vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Diet: You may need to feed your baby more often, especially if you are breast feeding. Ask your baby's caregiver if you should feed your baby at least 8 to 12 times a day for the first few days. Ask your baby's caregiver if you should feed your baby milk formula as well as breast milk, or if you need to make other changes to your baby's diet. Ask caregivers for more information about feeding your baby.

Intake and output (I&O):

• Your child's caregiver may need to know how much liquid your child is getting and urinating. Caregivers may also want to know how much your child eats and if he had a bowel movement (BM).
  
  
• Your child may need to urinate into a container in bed or in the toilet. A caregiver will then measure the amount of urine. If your child wears diapers, save them so a caregiver can weigh them. Do not throw away diapers or flush urine down the toilet before asking your child's caregiver.

Tests: Tests may be done to monitor your baby's bilirubin level and to look for the cause of jaundice:

• Blood tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. Blood tests can give caregivers more information about your child's health condition. Your child may need to have blood drawn more than once.
  
  
• Imaging tests:
  
  
  • Abdominal ultrasound: An abdominal ultrasound is a test that looks inside of your baby's abdomen (belly). Sound waves are used to show pictures of his liver, gallbladder, and bile ducts on a TV-like screen.
    
    
  • Scintigraphy: This is a test to look at the flow or movement of blood through the liver and bile ducts. Your baby is given a small, safe amount of dye in an IV. Pictures are then taken of his abdominal organs and blood vessels.
  
  
• Liver biopsy: This test checks your baby's liver by taking a sample from it. Guided by an ultrasound, caregivers will put a needle through your baby's skin and into his liver. Tissue samples are taken and sent to a lab for tests.
  
  
• Urine tests: Caregivers may test your baby's urine for white blood cells, protein, sugar, blood, and bacteria (germs) that should not be there. A urine culture may also be done if your baby has an infection.

Treatment options: Your baby may need any of the following treatments if the bilirubin level in his blood becomes very high:

• Phototherapy: This treatment uses a type of light to help break down the bilirubin in your baby's body. Decreasing the bilirubin will take out his skin's yellow color. Your baby may lie under bright lights undressed or in a special diaper. Small eye masks will be placed over his eyes to keep them from being damaged. Caregivers will turn your baby frequently so different areas of the skin can be exposed to the lights. Depending on how high the bilirubin level is, phototherapy may be used all of the time, or only sometimes.
  
  
• Exchange transfusion: This is a procedure to remove and replace your baby's blood. Exchange transfusion may be done if your baby has too much jaundice. This may be needed especially if your baby's jaundice is caused by a mismatch with your blood types. During this procedure, caregivers replace some of your baby's blood with donor blood. Ask your baby's caregiver for more information if your baby needs an exchange transfusion.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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