What Is Jaundice In Newborns
Jaundice in newborns is common. It gives the baby’s skin a golden tan appearance and turns the whites of their eyes yellow.
Mild jaundice occurs in approximately fifty per cent of full-term newborns and is more common in approximately eighty-five per cent of premature babies. You will likely notice it from birth if severe or the third day after birth if mild.
Jaundice is usually harmless in newborns and fades away in two weeks. All cases of jaundice in newborn babies should be checked by a doctor, qualified midwife, or paediatric nurse.
In adults, jaundice is the first sign of having contracted one of the Hepatitis family and or problems with the liver that need to be assessed, diagnosed, and treated promptly.
What Is The Common Causes Of Jaundice In Newborns
A chemical called ‘bilirubin’ is released when red blood cells break down. Large amounts of bilirubin cause the skin to turn yellow.
Newborn babies are born with numerous red blood cells their body needs to break down, but their liver isn’t quite developed enough to process large amounts of bilirubin. This results in a bilirubin overload, leading to jaundice. By about two weeks, your baby’s liver has developed and will be better at removing bilirubin, leaving the yellow shade to fade away like a cheap spray tan.
What Is Breast Milk Jaundice
Most newborns with jaundice will have breast milk jaundice. After several weeks, this type of jaundice usually sorts itself out without treatment. You do not need to stop breastfeeding.
Breast milk jaundice most often occurs in the second or later weeks of life and can continue for several weeks. While the exact mechanism leading to breast milk jaundice is unknown, it is believed that substances in the mother’s milk inhibit the ability of the infant’s liver to process bilirubin.
Rare Causes Of Jaundice In Newborns
One rare type of jaundice occurs when the mother’s and the baby’s blood groups are incompatible due to an ABO or Rhesus factor incompatibility. This isn’t typically a problem during a first pregnancy because the two different bloodstreams don’t mix. But during birth, some of the baby’s blood might mix with the mother’s blood.
The mother develops antibodies that activate during the next pregnancy crossing the placenta to attack a second baby’s red blood cells. The destruction of the red blood cells causes more bilirubin to be released into your second baby’s bloodstream, leading to jaundice. This type of jaundice is usually seen in the first 24 hours after birth.
The antibodies can also induce a miscarriage in some pregnancies.
An Rh immunoglobulin shot is given to pregnant women who have Rh-negative blood.
You may have Rh-negative blood, and your baby may have Rh-positive blood. If the two types of blood mix, your body will make antibodies. This is called Rh sensitisation. Most of the time, this is not a problem the first time you’re pregnant. But it could cause problems in future pregnancies.
Biliary atresia is another rare cause of jaundice in babies. It happens when the tiny tubes that carry bile from the liver to the intestine are scarred. Babies with this condition usually grow normally and look well at first, but they will get very ill with serious liver disease if they aren’t diagnosed and treated early. Their jaundice will usually go on after they are two weeks of age, and they might also have pale-looking stools.
What Are The Symptoms Of Jaundice In Newborns
Jaundice in a newborn will cause their skin and the whites of their eyes to go a yellow colour. It typically starts on the face and head. If the level of bilirubin increases, the colour will spread down to the body. Some babies might also be drowsy and have difficulty feeding.
A rare few are born completely jaundiced, but it happens from time to time that a newborn emerges from the womb looking like they have returned from an Ibiza vacation with an all-over tan.
Jaundice In Babies When To Worry
Jaundice is usually harmless, but a nurse or doctor should check and monitor all cases of jaundice in newborn babies. You should take your baby to the doctor if:
- Your baby’s poo becomes pale, or their wee becomes dark
- Your baby develops jaundice in the first 48 hours after birth
- The jaundice becomes more noticeable after a week
- The jaundice hasn’t gone away after two weeks
- Your baby is unwell, feeding poorly and not gaining enough weight
When To Tests For Jaundice In Babies
- If your baby has jaundice lasting more than two weeks
- Especially if their stools are pale or their urine is dark
- They are not feeding well and not gaining weight
A blood sample will be drawn to check the ‘conjugated bilirubin’ levels in their blood. They might also run LFT tests on their liver to check their liver health and rule out hepatitis as a cause of the jaundice.
How Do You Treat Jaundice In Newborns
Treatment for jaundice in newborns depends on the severity and cause.
If your baby has mild jaundice, the treatment is to ensure they are breast or formula fed regularly and receive enough fluids each day.
Babies who develop jaundice several days after birth usually need careful monitoring, sometimes with heel prick blood tests, to check the bilirubin levels in their blood.
If the bilirubin levels are high, your baby might need phototherapy treatment.
Phototherapy is a treatment with a special kind of blue light that helps your baby’s liver to break down the bilirubin more easily. This treatment is easy to access and safe.
Sometimes your baby is treated with phototherapy wrapped in a special blanket or sometimes in a cot with blue lights and their eyes covered for protection.
Phototherapy has minimal side effects. Sometimes your baby might have a mild rash and runny poo for a few days. Some babies might need extra feeds during this time. Most babies tolerate phototherapy treatment well.
In some cases, phototherapy is only needed for 24 hours or less. In other cases, it may be required for a few days.
If your baby has breast milk jaundice, you do not need to stop breastfeeding. This type of jaundice is usually mild and should improve with time. Talk to your child’s health nurse or doctor if you’re worried about what to do.
How To Treat Serious Jaundice In Newborns
Severe jaundice, in which bilirubin levels are very high, might need treatment with an exchange blood transfusion. This is when a baby’s blood is replaced with compatible fresh blood. This procedure is rare and the last resort.
Severe jaundice can, in rare cases, lead to deafness and even brain damage if not treated promptly.
