Monday, November 17, 2014

Why New Born Baby got jaundice? What is Treatment for jaundice?

Find out what causes jaundice in newborns, and what can you do to prevent/treat this condition that make the baby’s skin and eyes appear yellow.

Parents of newborns often get panicked when they find their baby has been diagnosed with jaundice. But actually there is nothing to worry about as nearly all newborns are jaundiced to some extent. In most cases, it will get better on its own within 1-2 weeks without causing any problems. Jaundice has even been found to have some protective benefits for newborns. Like for example, it protects the infant from harmful effects of oxygen free radicals. Still, you should not ignore jaundice completely, as in some severe cases, close monitoring and treatment is needed to prevent the condition from causing harm to the newborn. Read on to get some helpful information about neonatal jaundice, including its causes, symptoms, and treatment.

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What causes Jaundice in Newborns?

Jaundice is caused due to high level of bilirubin in the blood, which is a yellow pigment that’s produced when the body breaks down red blood cells. So what causes elevated biliburin levels in the blood of newborns?

While in the womb, babies require high levels of red blood cells so as to get oxygen from their mother’s blood. But once the baby gets out of the womb and starts breathing on their own, they don’t require these red blood cells containing fetal hemoglobin. Those extra cells must be broken down and removed from their bodies. Bilirubin is a by-product of red blood cell breakdown process, and normally it passes through the liver before being excreted through stool. During pregnancy, the mother’s liver process bilirubin for the fetus, but after birth, baby needs to do this on their own.
A newborn’s immature liver may find it difficult to process and excrete bilirubin from the body, resulting in build up of bilirubin. Hence jaundice develops, and when bilirubin levels rise above normal, it causes the yellowish tint to eyes and skin. This is especially common in premature babies. It typically appears 2-4 days after birth.Then as the baby’s liver matures and the breakdown of cells slows down, it will begin disappearing (generally, it goes away in about a week).
In some rare cases, jaundice may also be caused by other factors, such as:
  • Maternal-fetal blood type incompatibility: In such case, antibodies produced by mother will attack the fetus’s red blood cells and cause them to break down.
  • A problem with the baby’s digestive system
  • Polycythemia - a medical condition in which a child is born with an elevated red blood cell count.
  • Cephalohematoma - a pocket of blood is formed underneath the scalp during the delivery. After birth, when the baby’s body starts breaking down this clot of blood by natural process, a large amount of bilirubin will be released all at once. Such a sudden increase in bilirubin levels will eventually result in jaundice.
  • Sometimes during delivery the baby swallows blood. This swallowed blood is broken down in the intestines and there is a sharp increase in bilirubin level in blood.
  • An infant of a diabetic mother is more likely to develop neonatal jaundice.
  • Hereditary disorders like Crigler-Najjar syndrome and Lucey-Driscoll syndrome can also cause jaundice.
  • Bacterial infection acquired during or soon after birth.
  • Hypothyroidism - a condition in which the thyroid gland does not produce enough hormones.

Types of Newborn Jaundice

Depending on what is causing the increased bilirubin level in newborns, jaundice is classified into three types.
  • Physiological jaundice: This is the most common type of newborn jaundice, which affects up to 50-60 percent of full-term babies in their first week of birth. It is usually harmless, and it occurs when a baby’s young liver is incapable of processing and removing bilirubin from body. In most cases, this condition disappears within 1-2 weeks. Premature babies and babies who don’t feed enough in the first couple of days after birth, and who don’t stool often, are more likely to get this type of jaundice.
  • Blood group incompatibility jaundice: This serious type of jaundice usually appears at birth or within the first 24 hours after birth. It occurs when the mother produces antibodies that attack her infant’s red blood cells. In some cases, this condition can be avoided by treating the mother with a drug that would prevent the formation of these antibodies against her baby.
  • Breast milk jaundice: A very small percentage of babies (roughly 1-2 percent) develop jaundice because their mother’s milk has something in it that cause bilirubin levels to rise. This type of jaundice generally appears during the 2nd week of life and may reach its peak on around 10th day or later. However, what is important to remember is that nursing should be continued once the baby’s bilirubin level starts to decrease.

Signs and Symptoms:

Newborn with jaundice will have a yellowish tint on skin and the whites of the eyes. The yellow color will first appear in baby’s face and then it will move downwards to his chest, stomach and finally the legs. Babies with higher bilirubin levels are often sleepy and lazy nursers. They may be jittery, arch his/her back or have a high-pitched cry.

Since newborns usually develop jaundice after being discharged from the hospital, parents are highly recommended to keep an eye on their baby’s skin tone to detect jaundice. There’s a simple test parents can do to check for jaundice. Simply press your fingertip to baby’s nose or forehead. If the pressed area looks yellow, that means your baby may have jaundice and you should contact your doctor right away to check whether your baby needs treatment.

Treatment of jaundice in New born babies

Physiological jaundice

Normal or Physiological jaundice will resolve on its own once the baby’s liver gets matured and starts functioning at full speed.

However, there are some things you can do to prevent/treat it, like:
  • Feed your baby early and frequently: Colostrum (a thick yellow fluid produced right after birth) acts as a laxative. And, needless to say, increased bowel movements will eventually help lower bilirubin levels.
  • Avoid water supplements: Only about 2% of bilirubin is excreted through urine, while the remaining 98% of it is removed through stool. Colostrum and breast milk contain fat which stimulates bowel movements. On the other hand, water will simply fill your baby up, making them lose interest in nursing or feeding.
  • Encourage your baby to stay awake and feed after every 2 hours.
  • Supplement with your expressed milk: If your baby is sleepy and is not nursing well, consider expressing your milk after feedings. And give it to the baby using a dropper, syringe, cup or tube-feeding to ensure adequate supply. (Bottle feeding is not advisable for a few days old infant)
  • Expose baby to indirect sunlight: Undress baby completely, and place him/her in a room that gets a lot of natural light. Baby’s skin is thin and extremely sensitive - so never place them in direct sunlight.
  • Avoid taking medications like aspirin and sulfa drugs: Make sure to consult your doctor before taking any such drugs.
Breast milk jaundice

In some cases of this type, mothers are advised to stop breastfeeding for 1-2 days and express the milk regularly during this break. They can resume breastfeeding once the baby’s bilirubin level starts lowering down. However, in most cases, mothers are asked to breastfeed as usual because the health benefits of breast milk are far greater than the risks.

Jaundice with high bilirubin levels

Treatment is required if the bilirubin level is above the normal range or if it is rising too rapidly.
  • Phototherapy: It is the most common treatment used for treating jaundice in newborns. In this treatment, baby is placed under a special type of light. Nowadays, babies can even receive phototherapy at home with the help of “bili lights” or “bili blankets” provided by home health care providers. Usually, bilirubin levels starts decreasing rapidly as soon as phototherapy is initiated, and would return to normal levels with a day or two of therapy.
  • Blood transfusion: In severe cases of jaundice, when all other treatments including phototherapy fails to bring the bilirubin level to normal, the doctor may go for a blood transfusion. This involves replacing the baby’s blood with donated blood so as to bring the bilirubin level down more rapidly.


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