Jaundice In Newborns

GENERAL INFORMATION:

What is jaundice in newborns? 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. This results in yellowing of the skin and whites of the eyes in a newborn baby.

What causes jaundice in newborns? Jaundice occurs when the body makes too much bilirubin or has problems removing it. These problems usually happen when the baby's liver is not yet well developed. It may take time for the liver to get used to its work of removing bilirubin. Jaundice usually appears after the first 24 hours of life in a healthy newborn. Jaundice in newborns may also be caused by problems in any of the following:

• Blood: Blood mismatch between the mother and baby, hemolytic anemia (RBC death), or polycythemia (increased RBC).
  
  
• Genetics: Lack or absence of certain enzymes, such as pyruvate kinase or glucose-6-phosphate, during birth.
  
  
• Infections: These may include infections caused by germs, such as bacteria or viruses.
  
  
• Liver: Liver diseases, such as biliary atresia (blocked or absent bile ducts) or hepatitis (swelling of the liver).
  
  
• Breast milk: Rarely, breast milk can cause jaundice in newborn babies. If this is the case your caregiver may have you stop breast feeding until the jaundice improves.

What are the signs and symptoms of jaundice in newborns? Jaundice makes your baby's skin and the whites of his eyes turn yellow in color. This yellow coloring usually starts on your baby's face and moves down to the chest. It then goes to the abdomen (belly), and spreads to the arms and legs. Depending on the cause, your baby's jaundice may appear at birth or anytime after. Your baby may feed poorly or become fussy or sleepy if the bilirubin level continues to increase. When the level stays very high, his brain and nerves may be affected. Your baby may develop fever and a high-pitched cry. Muscle spasms (stiffness) may also be present. When this happens, your baby may arch his neck and body backward.

How is jaundice in newborns diagnosed? Your baby's caregivers will check how much of your baby's body has jaundice. Blood tests will be done to learn how much bilirubin is in your baby's blood. Other tests may be done if your baby's caregiver thinks that other problems may be causing the jaundice. These may include blood tests to check the function of his liver, and ultrasonography (ultrasound).

How is jaundice in newborns treated? Treatment of jaundice depends on the amount of bilirubin present in your baby's blood. It will also depend on how long your baby was inside the womb (gestational age) and his condition now.

• If your baby is full term (at least 37 weeks inside womb) and has no health problems, watchful waiting may be all that is needed. Caregivers will watch your baby closely for a period of time. If this is the case, in 1 to 2 weeks the jaundice usually goes away on its own, as the baby’s liver matures. Ask your baby's caregiver if you need to make changes to how often you feed your baby.
  
  
• If your baby is premature (less than 37 weeks inside the womb) or has other health problems, he may need treatment. Caregivers may treat your baby with phototherapy. Phototherapy uses lights to help remove extra bilirubin from the body. If your baby's jaundice is very serious, caregivers may do a procedure called exchange transfusion. This is done by removing your baby's blood and replacing it with donated blood from the blood bank. Ask caregivers for more information if your baby needs an exchange transfusion.

What problems can jaundice in newborns cause? Jaundice is a common and often harmless problem in newborns, but may get worse if left untreated. The bilirubin level may become very high and cause problems in the brain. This may lead to hearing loss or brain damage, and may even be life-threatening. Jaundice usually does not cause any long-term harm if treatment begins as soon as jaundice is seen. Any of the following conditions may increase your baby's risk of having further problems with his jaundice:

• A brother or sister who had jaundice or received phototherapy in the past.
  
  
• A mother who is 25 years old or above at the time of the baby's birth.
  
  
• Born premature (before 37 weeks of gestation).
  
  
• Breast feeding only, especially if the baby is not getting enough milk or there are other problems. This is especially true if the baby loses too much weight.
  
  
• Bruising on the scalp (head) or body during birth, especially in premature babies.
  
  
• Jaundice present in the first 24 hours of life or just before leaving the hospital.
  
  
• Male babies are more likely to have jaundice than female babies.

Where can I find more information? Having a baby with jaundice may be hard for you and your family. You and those close to you may feel sad or frightened. These feelings are normal. Talk to your baby's caregivers, family, or friends about your feelings. Contact the following for more information:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village, IL 60007-1098
  Phone: 1-847-434-4000
  Web Address: http://www.aap.org
  

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.

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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