Infant jaundice is a yellow discoloration of the skin and eyes of a newborn infant. Infant jaundice is caused by an excess of bilirubin, a yellow pigment found in red blood cells.
Infant jaundice is a frequent disorder, especially in newborns born before 38 weeks of pregnancy (preterm babies) and in certain breast-fed babies. Infant jaundice develops when a baby's liver isn't developed enough to eliminate bilirubin from the circulation. Infant jaundice can be caused by an underlying condition in certain neonates.
Most infants delivered between 35 weeks and full term do not require jaundice therapy. Rarely, an abnormally high bilirubin level in the blood might put a baby at danger of brain injury, especially if specific risk factors for severe jaundice are present.
WHAT ARE THE SYMPTOMS OF INFANT JAUNDICE?
The predominant indication of baby jaundice is yellowing of the skin and whites of the eyes, which arises between the second and fourth day after delivery.
Gently push on your baby's forehead or nose to check for neonatal jaundice. If the skin where you pushed appears yellow, your infant most likely has mild jaundice. If your baby does not have jaundice, the skin tone should appear slightly lighter than normal for a brief period of time.
Examine your infant in bright light, ideally in natural daylight.
When should you see a doctor?
Most hospitals have a policy of checking neonates for jaundice before releasing them. The American Academy of Pediatrics advises that infants be checked for jaundice during routine medical exams and every eight to twelve hours while in the hospital.
Between the third and seventh days after delivery, when bilirubin levels often peak, your infant should be checked for jaundice. If your infant is released earlier than 72 hours after delivery, schedule a follow-up appointment within two days to check for jaundice.
The signs and symptoms listed below may suggest severe jaundice or consequences from high bilirubin. Consult your doctor if:
- Your baby's skin turns more yellow.
- The skin on your baby's abdomen, arms, and legs appears yellow.
- Your baby's eye whites appear yellow.
- Your kid isn't gaining weight or isn't eating well.
- Your baby's cries are high-pitched.
- Your infant appears sleepy, ill, or difficult to wake up.
- Your infant develops any other signs or symptoms that bother you.
WHAT ARE THE CAUSES OF INFANT JAUNDICE?
The most common cause of jaundice is an excess of bilirubin (hyperbilirubinemia). Bilirubin, the yellow pigment responsible for jaundice, is a natural component of the pigment produced by the breakdown of "used" red blood cells.
Because of the increased creation and quicker breakdown of red blood cells in the first few days of life, newborns generate more bilirubin than adults. The liver normally filters bilirubin from the circulation and discharges it into the intestine. The young liver of a baby frequently cannot eliminate bilirubin rapidly enough, resulting in an excess of bilirubin. Physiologic jaundice is caused by these common neonatal circumstances and usually emerges on the second or third day of life.
Other causes
Infant jaundice can be caused by an underlying illness. Jaundice typically emerges significantly earlier or later in these circumstances than in the more usual form of baby jaundice. The following diseases or conditions can produce jaundice:
- Internal bleeding (hemorrhage)
- A blood infection in your infant (sepsis)
- Other bacterial or viral illnesses
- An enzyme deficit
- A problem with the liver
- A blood incompatibility between the mother's and the baby's blood
- A problem with your baby's red blood cells that causes them to break down quickly.
- Biliary atresia, a condition that occurs when the baby's bile ducts become clogged or damaged.
WHAT ARE THE RISK FACTORS FOR INFANT JAUNDICE?
The following are major risk factors for jaundice, particularly severe jaundice that can lead to complications:
- Premature delivery: A baby born before 38 weeks may not be able to metabolize bilirubin as fast as a full-term newborn. Premature newborns may also consume less and have fewer bowel movements, resulting in less bilirubin excreted in the stool.
- Blood type: If the mother's blood type differs from that of her newborn, the infant may have absorbed antibodies through the placenta that induce unusually fast red blood cell destruction.
- Breast-feeding: Breast-fed newborns are more likely to develop jaundice, especially if they have problems breastfeeding or obtaining enough nourishment from breast-feeding. Jaundice may be exacerbated by dehydration or a low calorie intake. Breast-feeding is still recommended by professionals due to the benefits. It is critical that your kid receives enough to eat and stays hydrated.
- Race: According to research, newborns of East Asian origin are more likely to suffer jaundice.
- Significant bruising during delivery: Newborns that are wounded during birth may have greater levels of bilirubin as a result of the breakdown of more red blood cells.
WHAT ARE THE COMPLICATIONS OF INFANT JAUNDICE?
High bilirubin levels, which produce acute jaundice, can lead to catastrophic problems if not handled.
Acute bilirubin encephalopathy
Bilirubin is harmful to brain cells. A infant with extreme jaundice is at danger of bilirubin entering the brain, a disease known as acute bilirubin encephalopathy. Prompt treatment may avert long-term harm.
A infant with jaundice may exhibit the following symptoms of acute bilirubin encephalopathy:
- Listlessness
- Difficulties waking up
- High-pitched crying
- Inadequate sucking or feeding
- Backward neck and body arching
- Fever
Kernicterus
Kernicterus is a sickness that arises when acute bilirubin encephalopathy produces irreversible brain damage. Kernicterus can lead to:
- Uncontrollable and involuntary motions (athetoid cerebral palsy)
- Constant upward stare
- Loss of hearing
- Tooth enamel development problems
HOW IS INFANT JAUNDICE DIAGNOSED?
Your doctor will most likely diagnose newborn jaundice based on how your baby seems. However, the level of bilirubin in your baby's blood must still be measured. The severity of jaundice will be determined by the level of bilirubin. The following tests are used to identify jaundice and quantify bilirubin:
- A physical examination
- A laboratory test of a blood sample from your infant
- A skin test using a transcutaneous bilirubinometer, which detects the reflection of a specific light flashed through the skin.
If there is indication that your baby's jaundice is caused by an underlying condition, your doctor may conduct additional blood or urine tests.
WHAT ARE THE TREATMENTS FOR INFANT JAUNDICE?
Mild newborn jaundice usually resolves on its own after two or three weeks. If your baby has moderate or severe jaundice, he or she may need to stay in the newborn nursery longer or be readmitted to the hospital.
Treatments for lowering bilirubin levels in your baby's blood may include:
- Improved nutrition: To avoid weight loss, your doctor may prescribe more frequent feedings or supplements to ensure that your baby receives appropriate nutrients.
- Light therapy (phototherapy): Your infant may be placed under a special lamp that emits blue-green light. The light alters the shape and structure of bilirubin molecules, allowing them to be eliminated in both urine and stool. During therapy, your infant will only be wearing a diaper and eye patches. Light treatment can be enhanced by using a light-emitting pad or mattress.
- Exchange transfusion: When alternative therapies fail to cure acute jaundice, a newborn may require a blood exchange transfusion. This includes extracting tiny volumes of blood and replacing it with donor blood, diluting the bilirubin and maternal antibodies – a process done in a neonatal critical care unit.
- Intravenous immunoglobulin (IVIg): Jaundice might be caused by blood type discrepancies between the mother and the newborn. As a result of this disorder, the baby inherits antibodies from his or her mother, which contribute to the fast disintegration of the newborn's red blood cells. Although the results are not definitive, intravenous immunoglobulin — a blood protein that can lower antibody levels — may alleviate jaundice and reduce the need for an exchange transfusion.
HOME REMEDIES FOR INFANT JAUNDICE
When newborn jaundice is not severe, your doctor may propose adjustments in feeding patterns to minimize bilirubin levels. If you have any questions or concerns about how much or how often your baby is eating, or if you're experiencing difficulty breast-feeding, consult your doctor. Jaundice can be reduced by doing the following steps:
- More-frequent feedings: Feeding your infant more frequently will supply more milk and result in more bowel movements, increasing the quantity of bilirubin removed in your baby's stool. Breast-fed newborns should have eight to twelve feedings each day for the first few days of life. For the first week, formula-fed newborns should consume 1 to 2 ounces (approximately 30 to 60 milliliters) of formula every two to three hours.
- Supplemental feedings: If your infant is having difficulty breast-feeding, losing weight, or is dehydrated, your doctor may advise you to supplement breast-feeding with formula or expressed milk. In other circumstances, your doctor may advise you to use formula only for a few days before returning to breast-feeding. Inquire with your doctor about the best feeding alternatives for your infant.
HOW CAN INFANT JAUNDICE BE PREVENTED?
Adequate feeding is the most effective way to avoid baby jaundice. Breast-fed newborns should have eight to twelve feedings each day for the first few days of life. For the first week, formula-fed newborns should consume 1 to 2 ounces (approximately 30 to 60 milliliters) of formula every two to three hours.