As parents welcome their bundle of joy into the world, it's essential to be informed about various aspects of newborn health, including a common occurrence known as jaundice. Contrary to popular belief, jaundice is not a disease but a visible symptom of an underlying condition, hyperbilirubinemia.
Let's explore the complexities of jaundice in newborns to gain a better understanding of this phenomenon.
Understanding Jaundice
Jaundice is characterized by a yellowing of a newborn's skin and eyes due to high levels of bilirubin in their bloodstream. Bilirubin is a byproduct of the breakdown of old red blood cells in the body. Ordinarily, the liver processes and eliminates bilirubin from the blood but in some newborns this process works slowly. Jaundice can be classified into two main types: unconjugated and conjugated hyperbilirubinemia. Although most instances of jaundice are benign, there is a serious risk of Kernicterus, which can result in significant consequences such as brain damage, permanent harm, and, in severe cases, death.
Statistics and Risk Factors
Did you know that approximately 60% of term newborns and 80% of preterm babies develop jaundice? It's no wonder then that jaundice is the most common cause of readmission for infants in their first month of life. Physiologic jaundice, which affects around 60% of full-term infants, typically appears a couple of days post-birth and is often harmless. On the other hand, pathologic jaundice, is associated with many different risk factors like preterm birth, low birth weight, cephalohematoma, Pyloric Stenosis, ABO incompatibility, Infection, G6PD deficiency, Rh incompatibility, measles, inborn metabolism errors, congenital thyroid deficiency, intestinal obstruction, infections and various genetic conditions, requires closer monitoring and medical intervention.
The Role of Bilirubin
Bilirubin, albeit being an antioxidant, can be detrimental in excess. High levels of total serum bilirubin (TSB) within the first six days of life can signal a potential issue. Suboptimal intake jaundice, more common in breastfed babies but also occurs in formula feed infants, is exacerbated by insufficient feeding, dehydration, or low caloric intake. Breast milk jaundice is specific type of jaundice, usually starts after the first week of life. Your baby should be careful monitored to rule out any pathological causes. Infants generally feed well but may exhibit mild jaundice for 8 to 12 weeks, which is seldom harmful.
Signs of Jaundice in Newborns
Yellowing of the face, whites of the eyes, and abdomen.
The skin is becoming increasingly yellow, starting from the face and abdomen and spreading to the arms and legs.
Lethargy or difficulty waking your infant up to feed.
Inadequate feedings leading to slow or no weight gain.
Baby sleeps at the breast, then crying fitfully when removed from the breast.
Still losing weight despite being supplemented pumped milk or formula,
Baby is having difficulty completing supplemental feeding from a bottle, or if bottle-feedings are lasting 40 minutes or more.
Disorganized weak suck that leaves your breast engorged or feeling full after feedings.
High-pitched cries when baby is roused.
Inadequate wet or dirty diapers.
How to Care for Newborn with Jaundice.
Most infants born between 36 weeks’ gestation and full term need no treatment for jaundice—it typically resolves on its own if the infant received adequate calories and their liver matures. Your baby needs to eat regularly, 10-12 times a day to produce enough dirty diapers to push the excess bilirubin out of their body. This means waking your baby for scheduled feedings, not letting them sleep past 3 hours for a feeding even at night.
If bilirubin levels become high enough, supplementing your baby with pumped milk or formula after some or all feedings may be necessary until bilirubin levels decrease. As bilirubin levels decrease and the baby becomes more alert, the need for supplementation decreases until the baby can exclusively breast feed again. In some cases, phototherapy (exposing the baby to special lights) may be necessary to decrease bilirubin levels.
Keep in mind that newborn jaundice is typically harmless and temporary. However, if you ever feel worried, do not hesitate to contact your pediatrician. If your newborn is lethargic and having difficulty breastfeeding, seek assistance promptly. While still in the hospital, request the support of an IBCLC (board-certified lactation consultant). If feeding issues arise after discharge, seek out a board-certified lactation consultant in your area. Many lactation consultants provide home, office and telehealth visits.
Understanding jaundice in newborns is crucial for every parent. While most cases are harmless and resolve on their own, close monitoring is necessary to detect any underlying issues that may require medical attention. Remember, early intervention and proper management are key in ensuring your baby's well-being. By staying informed and observant, you can navigate through this common yet significant aspect of newborn health with confidence.
Knowledge is power when it comes to your infant's health.
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