Jaundice in Newborns: Symptoms, Causes, Treatment

What are the symptoms of jaundice in newborns?

Jaundice in newborns is characterized by the yellowing of the skin and the whites of the eyes. This yellow discoloration is due to high levels of bilirubin in the baby’s blood. Here are the common symptoms to look for:

1. Yellowing of the Skin: This usually starts on the face and forehead and can spread down to the chest, abdomen, legs, and soles of the feet.
2. Yellowing of the Whites of the Eyes (Sclera): This is often one of the first noticeable signs.
3. Dark Urine: The baby’s urine may appear yellow or brown, even though newborn urine is typically very light in color.
4. Pale Stools: The stools might appear lighter than usual if the baby is breastfed. Normally, newborn stools are yellow-green in color.
5. Lethargy: The baby may seem unusually tired or sluggish and may have difficulty waking up for feedings.
6. Poor Feeding: The baby may have difficulty breastfeeding or bottle-feeding and may not eat as much as usual.
7. Irritability: The baby may be more fussy or irritable than usual.

If you notice any signs of jaundice in your newborn, it is important to contact your healthcare provider promptly, as jaundice can sometimes indicate an underlying health issue that requires treatment.

What are the causes of jaundice in newborns?

Jaundice in newborns is primarily caused by an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells. Newborns are especially prone to jaundice due to several factors. Here are the common causes:

1. Physiological Jaundice: This is the most common type and occurs due to the immature liver’s inability to process bilirubin efficiently. It usually appears between the second and fourth day of life and resolves on its own within two weeks.
2. Breastfeeding Jaundice: This can occur in breastfeeding babies due to inadequate intake of breast milk, leading to dehydration and reduced excretion of bilirubin.
3. Breast Milk Jaundice: Some breastfed babies develop jaundice due to substances in the mother’s milk that increase the reabsorption of bilirubin in the intestines. This typically appears after the first week of life and can last for several weeks.
4. Hemolytic Disorders: Conditions like Rh incompatibility, ABO incompatibility, or other blood group incompatibilities can cause increased breakdown of red blood cells, leading to higher bilirubin levels.
5. Internal Bleeding (Hematoma): A cephalohematoma or other internal bleeding can lead to an increased breakdown of red blood cells, resulting in higher bilirubin levels.
6. Liver Disorders: Infections or other conditions affecting the liver can impair its ability to process bilirubin.
7. Infections: Infections such as sepsis or a urinary tract infection can contribute to jaundice.
8. Genetic Disorders: Conditions like Gilbert’s syndrome or Crigler-Najjar syndrome affect bilirubin processing and can cause jaundice.
9. Prematurity: Premature babies have less developed livers and may have difficulties processing bilirubin efficiently.
10. Polycythemia: An increased number of red blood cells can result in higher bilirubin production as these cells break down.

Understanding the specific cause of jaundice in a newborn is essential for proper management and treatment. If jaundice is observed, medical evaluation is important to determine the cause and appropriate intervention.

How is the diagnosis of jaundice newborns made?

Jaundice in newborns is typically diagnosed through a combination of physical examination, laboratory tests, and imaging studies. Here are the common methods used to diagnose jaundice in newborns:

1. Physical Examination: A healthcare provider will perform a physical examination on the newborn, paying attention to the skin, eyes, and sclera (the white part of the eye). Jaundice typically causes a yellowish discoloration of the skin and eyes.
2. Total Bilirubin Measurement: A blood test is performed to measure the total bilirubin level in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells. Elevated levels of bilirubin in the blood can cause jaundice.
3. Conjugated Bilirubin Measurement: In some cases, a conjugated bilirubin test may be performed to determine if the jaundice is due to liver dysfunction or blockage of the bile ducts. Conjugated bilirubin is a type of bilirubin that is not normally present in the blood.
4. Serum Bilirubin Levels: The healthcare provider will also measure the serum bilirubin levels, which indicate the amount of bilirubin in the blood.
5. Transcutaneous Bilirubin Meters: Some hospitals use transcutaneous bilirubin meters, which measure bilirubin levels through a handheld device that shines a light through the skin and measures how much light is absorbed by the bilirubin.
6. Ultrasonography: In some cases, ultrasound may be used to rule out other conditions that may be causing jaundice, such as gallstones or biliary atresia.
7. Liver Function Tests: Liver function tests (LFTs) may be performed to assess liver function and rule out liver dysfunction as a cause of jaundice.

The American Academy of Pediatrics (AAP) recommends that all newborns have their bilirubin levels measured at 24 hours of age and again at 48-72 hours of age. If the bilirubin levels are elevated, further testing and evaluation may be necessary to determine the cause and appropriate treatment.

It’s important to note that jaundice can be a sign of underlying conditions, such as infections, metabolic disorders, or liver dysfunction. Therefore, it’s essential to work with a healthcare provider to diagnose and treat jaundice in newborns promptly and effectively.