Newborn jaundice

Skin | Dermatology | Newborn jaundice (Disease)


Description

Jaundice is a yellow discoloration of the skin and the white part (the sclera) of the eyes. It results from having too much of a substance called bilirubin in the blood. Bilirubin is formed when the body breaks down old red blood cells. The liver usually processes and removes the bilirubin from the blood.

Two types of jaundice may occur in newborns who are breast fed. Both types are usually harmless. (1) Breastfeeding jaundice is seen in breastfed babies during the first week of life, especially in babies who do not nurse well or if the mothers milk is slow to come in; (2) Breast milk jaundice may appear in some healthy, breastfed babies after day 7 of life. It usually peaks during weeks 2 and 3. It may last at low levels for a month or more. It may be due to how substances in the breast milk affect how bilirubin breaks down in the liver. Breast milk jaundice is different than breastfeeding jaundice.

Causes and Risk factors

Jaundice in babies usually occurs because of a normal increase in red blood cell breakdown and the fact that their immature livers are not efficient at removing bilirubin from the bloodstream.

Jaundice in newborns most commonly occurs because their livers are not mature enough to remove bilirubin from the blood. Jaundice may also be caused by a number of other medical conditions. It is normal for a babys bilirubin level to be a bit higher after birth.

When the baby is growing in the mothers womb, the placenta removes bilirubin from the babys body. The placenta is the organ that grows during pregnancy to feed the baby. After birth, the babys liver starts doing this job. This can take a while.

Most newborns have some yellowing of the skin, or jaundice. This is called physiological jaundice. It is harmless, and usually is worst when the baby is 2 - 4 days old. It goes away within 2 weeks and doesnt usually cause a problem.

Diagnosis and Treatment

Most babies do not need specific treatment but their bilirubin levels will be measured to ensure they are decreasing. The most common treatment is phototherapy with the use of special lights to help the baby remove the bilirubin through the urine. If there is a blood type difference between mother and baby and the bilirubin level is high intravenous immunoglobulin may be necessary. Severe cases that do respond to other treatments may require an exchange blood transfusion. ...