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Jaundice in New born babies (Neonatal Jaundice)

Dr.Madhura More
May 10, 2010

Neonatal Jaundice
A common condition in newborns, when a baby has jaundice, either too much bilirubin is being produced or the liver does not get rid of it quickly enough. A newborn baby's liver is not fully matured, so jaundice is common during a baby's first few days of life.


There are following kinds of jaundice:

1. Physiological Jaundice: It is common in newborn babies. It usually becomes noticeable during the baby's first three to five days of life. It disappears as the baby's liver matures. This type of jaundice is not harmful.

2. Pathological JaundiceIn some situations, however, there is so much bilirubin in a baby's blood that it can be harmful. This condition is called pathological jaundice. If the level of bilirubin becomes very high, it may affect some of the baby's brain cells. This may cause a baby to be less active. In rare cases, a baby may have seizures (convulsions).


Signs & Symptoms of Jaundice
The symptoms of jaundice are extreme weakness, headache, and fever, loss of appetite, severe constipation, nausea, and yellow discoloration of the eyes, tongue, skin, and urine.

The patient may also feel a dull pain in the liver region. Obstructive jaundice may be associated with intense itching.


Call your doctor if your baby shows any of the following symptoms:

  • Refuses breastfeeding or bottle feeding, or is sleepy all the time; 
  • Has lost a significant amount of weight 
  • If the baby is extremely jaundiced then baby's arms and legs are yellow. 
  • Baby sleeps for a longer time than usual.
  • The urine color is dark, while the stool appears normal.
  • High levels of bilirubin can cause high-pitched crying, Apnea (temporary stoppage of breathing), listlessness, Seizures and arched backs in the infants.
  • Extremely high levels of bilirubin (Hyperbilirubinemia) lead to Kernicterus, a condition where the brain is severely damaged.


Myths about Jaundice:


Myth: Breast milk should be stopped because the mother's milk is defective
Fact:A general impression that mother's milk is not suiting the child will do more harm than good since it shall disturb the vital breast milk supply to the newborn. Breast Milk Jaundice is a well defined medical entity and can be diagnosed only by the Pediatrician.


Myth: Keeping the child in sunlight can cure jaundice
Fact:It is true that Sunlight does help as a source of warmth, for vitamin D production but has no role in reducing Jaundice.


Myth: Keeping the child under a tube light at home is helpful
Fact:Phototherapy is specially designed set of tube lights of a specific radiation wavelength kept at a specified distance from the newborn and it is a specialized technique and a short cut of putting the child under a tube light at home is simply deceive oneself. If the baby  is in the need for Phototherapy then it has to be done under guidance of a specialized doctor in a Hospital.   


Myth: Mothers should avoid foods that contains fat
Fact:Again there is no scientific reason, because fats have no relation with fats


Myth: Mothers should not eat / drink / wear yellow things
Fact:There is No scientific reason which indicate that the mothers should not drink/eat/wear yellow things.


Diagnosis of Jaundice
Newborn jaundice can be diagnosed by visual examination, transcutaneous (through the skin) measurement, and blood testing.

Physical examination - The initial diagnosis of neonatal jaundice is based on a physical examination, which is done by placing the infant by a window and checking for signs in natural sunlight. At this stage the baby must be in the care of a health professional.

Visual examination - Visual examination is often used by healthcare providers to identify a newborn with jaundice. Visual examination is performed by quickly pressing and releasing the skin.


The diagnosis is made by recognition of the patient's appearance and accompanying symptoms.

  • A blood test will confirm the raised bilirubin level and other tests such as those for hepatitis and haemolysis are also done on the blood. 
  • Ultrasound is a good way to inspect the liver and bile ducts for signs of obstruction, and often can give useful information on the pancreas gland. 
  • CT scanning also helps diagnose obstructive jaundice accurately


Preventions of Jaundice
Although jaundice cannot be totally prevented but early recognition and treatment are important in preventing bilirubin levels from rising to dangerous levels. If your baby's color is turning more yellow, promptly call your baby's physician.

  • Feed babies frequently and don't let them become dehydrated.
  • With jaundice, the important thing to prevent is kernicterus -- toxic levels of bilirubin accumulating in the brain. Early identification and treatment of jaundice will usually prevent kernicterus, whatever the cause.


Treatment for Neonatal Jaundice
Most jaundice needs no treatment, but when it does, the given below treatments are possible:

  1. Phototherapy (light therapy) is considered very safe and effective. Placing your baby under blue "bililights" lights - naked in a bassinet, with his eyes covered - will often do the trick because ultraviolet light changes the bilirubin to a form that your baby can more easily dispose of in his urine. 
  2. Fiber Optic Blanket: Another option involves wrapping your baby in a fiber-optic blanket called a bili-blanket or bili-pad. With a prescription from your doctor, you may be able to rent one of these blankets to treat your baby at home.
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