PEDIATRIC CARE: JAUNDICE IN NEW-BORNS

Jaundice is a yellowish decolourisation of the skin, mucous membranes and of the white of the eyes caused by high levels of the bilirubin in the blood (hyperbilirubinemia). Bilirubin is the yellow coloured substance that the body creates when it replaces old red blood cells and gets flushed out through urine and stool.

Mostly, jaundice in new-borns appears during the first five days after the baby is born. The jaundice in new borns is generally very mild and it goes off on its own within a week or two. However, jaundice in new borns calls for immediate medical attention. In some cases the jaundice is prolonged as bilirubin level stays high, if the condition is not treated medically, this can lead to kernicterus (brain damage).

What are causes of Jaundice in new-borns?

During pregnancy the bilirubin from the baby’s body is removed through placenta. After birth, the baby’s body should adapt in a way which enables to remove bilirubin by its own. So, it’s alright if the babies have a slightly elevated level of bilirubin. In most of the cases, the jaundice in new-borns is termed as Physiologic Jaundice caused as their organs are not adjusted to flush out excess amount of bilirubin.  The Physiologic Jaundice usually appears after 24 hours of birth and goes on its own in a week or two.

In exceptional cases, jaundice in new-borns may also be caused due medical conditions such as an infection, issues with baby’s digestive system or a problem with regard to baby’s and mother’s Rh type. Furthermore, due to certain substance in the breast milk, the breakdown of bilirubin is carried out properly which can lead to jaundice. Other medical conditions that may lead to jaundice in new-borns include rubella, syphilis, cystic fibrosis or hepatitis, hypoxia or different genetic or inherited disorders.

Treatment

The treatment usually depends on the level of bilirubin, how fast the level has been rising and also the number of days since the baby is born.

The most important point is to avoid dehydration. The baby needs to be kept well hydrated with breast milk. Feed the baby often to stimulate frequent bowel movements and thus help remove excess bilirubin through stools. In severe cases, the baby might require IV line to deliver the fluids.

Phototherapy may be recommended for babies with very high level of bilirubin. This treatment is performed by keeping the baby under a florescent light which helps in breaking down of bilirubin in the skin.

During extreme severe cases of jaundice, such as Rh incompatibility, the babies may have to undergo blood transfusion. Administering intravenous immunoglobulin to babies with such severe conditions may also reduce the level of bilirubin.

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