Jaundice in newborn babies

What happens?

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Jaundice in newborn babies is very common amongst both premature babies and those carried to term, although the former are more affected. It happens when there is too much of a substance called bilirubin in a baby’s blood, thus causing a yellowish discolouration of the baby’s skin and the whites of their eyes.

Bilirubin is a natural product of the breakdown of red blood cells in the body. Usually, the liver changes the bilirubin into a form the body can get rid of as waste. But sometimes, the liver isn’t able to handle all the bilirubin produced, either due to excessive breakdown of red cells or lack of the materials to change the bilirubin.

Jaundice in the newborn usually starts in the first few days after a baby is born. By the time babies are about 2 weeks old, they make less bilirubin and the jaundice clears up.

What are the symptoms?

In addition to the yellowish discolouration of the skin and whites of the eyes, babies with severe jaundice may also:

• Feed less

• Be less alert and harder to wake

• Have a high-pitched cry

• Seem limp.

What treatments work?

Most babies with jaundice won’t need any treatment, as their jaundice will go away on its own in a week or two. During this time, watchfulness is advised for any worsening of the yellowness or behaviour. The baby should also be well-fed and hydrated.

Breast milk is the best first food for most babies. But, sometimes, breastmilk itself may cause jaundice, and formula is instead recommended for a short while.

If the baby’s bilirubin level is especially high or increasing at a dangerous speed, treatment is advised. The main options are light treatment (phototherapy) and exchange blood transfusion (EBT).

Light treatment is quite simple and very effective. The baby is put in a cot with special kinds of lights over their body. This helps the body convert the bilirubin appropriately, and treatment usually lasts for a couple of days.

If the light treatment isn’t helpful, or the level of bilirubin in your baby’s blood is rising very rapidly, an EBT may become necessary. During this, some of the baby’s blood is taken out and replaced with blood from a donor.

What will happen to my baby?

If treatments don’t work and a baby’s bilirubin level gets too high, it can cause serious problems. Bilirubin is sometimes able to get into the brain and cause kernicterus, a problem that can lead to hearing loss, learning difficulties, and late development.