Know How Jaundice can be Fatal for a Newborn?

In newborn babies, jaundice is usually common and harmless. It causes the skin and the white of the eyes to turn yellow. Neonatal jaundice is the medical term for jaundice in babies. In black or brown skin, the yellowing of the skin can be more difficult to see. It might be easier to see on the soles of the feet or the palms of the hands. Newborn jaundice has some other symptoms like pale-coloured poo and yellow, dark urine. 

Two days after the baby’s birth, the symptoms of newborn jaundice appear and by the time the baby is about two weeks old, they start getting better without treatment. While jaundice is not normally a cause for concern, it’s important to ascertain whether your baby needs treatment.

As part of the newborn physical examination, your baby will be examined for signs of jaundice within 72 hours of the birth. Reach out to your paediatrician for advice if your baby develops signs of jaundice after this time. If the baby becomes very reluctant to feed or the symptoms quickly get worse, then it is crucial to seek immediate medical attention.

What is Jaundice in Newborns?

When a baby has a high level of bilirubin in the blood, it leads to newborn jaundice. Bilirubin is a yellow substance that the body creates when the old red blood cells are replaced by it. A baby’s skin and the whites of the eyes look yellow with a high level of bilirubin. This is called jaundice. 

The liver of a newborn baby does not remove bilirubin as well as an adult’s does. When the bilirubin builds up faster than the liver can break it down and pass it from the body, then it results in jaundice. Only some babies need treatment to lower bilirubin levels as for most, the jaundice goes away on its own.

What Causes Jaundice in Newborns?

Too much bilirubin in the blood (also known as hyperbilirubinaemia) causes jaundice. When red blood cells, which carry oxygen around the body, are broken down, then a yellow substance is produced called bilirubin. 

Bilirubin travels in the bloodstream to the liver. The liver changes bilirubin’s form so that it can be passed out of the body in poo. The excess bilirubin causes jaundice if there is too much bilirubin in the blood or the liver cannot get rid of it. A newborn baby’s liver is less effective at processing bilirubin and removing it from the blood as it is not fully developed. 

Breastfeeding

The chances of developing jaundice can also increase during breastfeeding. The symptoms normally pass in a few weeks, so there is no need to stop breastfeeding if your baby develops conditions of jaundice. 

However, the potential risks associated with breastfeeding are outweighed by its benefits. The baby may need more frequent feeds and extra fluids during treatment if they need to be treated for jaundice. Few breastfed babies can have jaundice for as long as twelve weeks, however, this must be checked by a GP or a health visitor so that other more serious causes of jaundice can be ruled out.

Sometimes jaundice may be caused by another health problem, known as pathological jaundice. Some causes of pathological jaundice are:

• Hypothyroidism (an underactive thyroid gland), where sufficient hormones are not produced by the thyroid gland
• Blood group incompatibility, where the baby and mother have different blood types, which are mixed during the birth or pregnancy 
• Rhesus disease is a condition which can occur if the baby has rhesus-positive blood and the mother has rhesus-negative blood
• UTI (a urinary tract infection)
• Crigler-Najjar syndrome, an inherited condition which affects the enzyme responsible for processing bilirubin
• A problem or blockage in the gallbladder and the bile ducts (gallbladder stores bile, which is transported by the bile ducts to the gut)
• G6PD (glucose 6 phosphate dehydrogenase), an inherited enzyme deficiency can also lead to jaundice 

Also Read: Born too soon: Premature births are not a Taboo

How to Prevent Jaundice in Newborns?

As mentioned before, some degree of jaundice is normal and probably not preventable in newborns. Feeding babies at least eight to twelve times a day for the first several days and carefully monitoring infants at a higher risk, can considerably reduce the risk for serious jaundice. 

Testing for unusual antibodies and blood type should be done for all pregnant women. Follow-up testing on the infant’s cord is recommended if the mother is Rh-negative. This can also be done if the mother’s blood type is O positive.

Most complications of jaundice can be prevented by carefully monitoring all babies during the first 5 days of life. This includes:

• Checking the bilirubin level on the first day or so
• Considering a baby’s risk for jaundice
• Scheduling one follow-up visit at least in the first week of life for babies sent home from the hospital in seventy-two hours

How to Cure Jaundice in a Newborn?

The level of bilirubin in the blood of most babies with jaundice is found to be low, so they do not need treatment. The condition normally gets better within ten to fourteen days and will not cause any harm to your baby in these cases. 

Subsequently, if your baby’s jaundice does not improve over time, then they need to be treated with an exchange transfusion or phototherapy to reduce the risk of a serious complication like kernicterus, which can severely damage brain development. 

Phototherapy

It is a treatment with a special type of light (not sunlight). The baby’s skin is exposed to as much light as possible in an incubator or cot with their eyes covered. It makes it easier for the baby’s liver to break down and remove the bilirubin from the baby’s blood. In a day or two usually, the bilirubin levels fall to a safe level and then the phototherapy is stopped. 

Exchange Transfusion

If the phototherapy has not been effective, then they may need a complete blood transfusion called an exchange transfusion. During this process, the baby’s blood will be removed through a thin plastic tube placed in the blood vessels of the legs, arms or umbilical cord. The blood is then replaced with blood from a donor with the same blood group.

Other Treatments

IVIG (intravenous immunoglobulin) may be used if the jaundice is caused by rhesus disease (when the baby has rhesus-positive blood and the mother has rhesus-negative blood) 

Conclusion

Jaundice is quite common in most newborns, causing their eyes and skin to turn yellow. Normally the jaundice goes away on its own in some time but if it doesn’t or the bilirubin levels are still high, then it is always advisable to seek medical help from an experienced pediatrician. Timely care and help can ensure the gradual stabilisation of the bilirubin levels in your baby.

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to consult a paediatrician doctor, do reach out to us, or book a direct appointment with Dr. Virendra Sekhon the CK Birla Hospital. (Booking Link)

FAQ’s

Is Jaundice Dangerous for Newborn Babies?

Jaundice is usually harmless in most cases and the baby gets better on their own in about two weeks. Treatment is only required in cases when the baby still has jaundice after two weeks or the bilirubin levels are still high and in rare cases like kernicterus.

How Long does Jaundice Last in a Baby?

The baby’s condition usually gets better within ten to fourteen days. Recovery can take longer than two weeks if the baby is solely breastfed or was born prematurely.

Do Jaundice Babies Sleep more?

Babies with jaundice may be sleepier than usual because their body is fatigued from resisting the condition.