While holding your newborn, all of a sudden, a yellowish tinge of the skin (one of Signs of Jaundice in a Newborn) of your newborn has shocked you. This is called jaundice and happens in 50 to 60 percent of newborns during the first week. Here is all the information you need to know about jaundice in newborns including signs of jaundice in newborns:
So, what is jaundice?
When the level of bilirubin (a yellow-orange pigment formed by the breakdown of RBCs) surpasses a certain limit it begins to accumulate in the skin, mucous membranes, and sclera of the eye. This is called jaundice.
In a newborn, jaundice can appear as early as the third day of life. However, if the baby is born full-term i.e. after 40 weeks of pregnancy, there is nothing to worry about. This jaundice is a normal physiological change and disappears spontaneously within a week as the body begins its normal functioning.
However, if the baby is born pre-term i.e. before 37 weeks of pregnancy, jaundice can be a worrisome issue. In some serious cases, jaundice can cause brain damage and can be fatal.
Causes and signs of jaundice in newborns
To understand what causes jaundice, you need to understand a bit of normal body functioning. Our RBCs are recycled daily (the life span of an RBC is 3 months) and as they degrade they produce bilirubin as a waste product. This happens in the liver and the bilirubin produced is secreted from the body in stools.
As the baby is born a large number of RBCs are broken down producing a huge amount of bilirubin and to add to it the liver of the newborn is under-functioning as well. This affects the proper excretion of the bilirubin which starts accumulating in the skin, mucous membranes, and sclera as a result.
As the liver develops, it cleans up the remaining bilirubin and jaundice starts clearing slowly. However, certain conditions can aggravate the situation and delay the clearing process of jaundice. These include:
· Breast milk jaundice – as it contains certain substances which interfere with the clearing process of bilirubin
- Liver disease – liver is not able to clear bilirubin
- Sickle cell disease – causing increased production of bilirubin due to increased breakdown of RBCs
- Cephalohematoma
- Sepsis
- ABO incompatibility/ Rhesus incompatibility
- Hepatitis
- Enzyme deficiency
- Bile duct obstruction
What puts your baby at risk for neonatal jaundice?
Jaundice doesn’t happen to every child. Similarly, it is not a worrisome condition in every newborn. So, what puts your baby at an increased risk of jaundice in his early life? These include:
- Premature birth
- Breast-feeding
- ABO-incompatibility
- Difficult delivery leading to a lot of bruising
Signs of jaundice in newborn
Jaundice is a sign of something wrong going on with your newborn and it will elicit in the form of several different symptoms. This brief description of signs of jaundice in newborns will not only help you diagnose your newborn with jaundice at home but will also help you understand the severity of this disease.
Although a clear yellow tinge of the skin and sclera speaks for itself you will also find these symptoms and signs in your newborn:
- Poor feeding along with nausea, vomiting, and abdominal pain
- Fever and irritability
- Depending on the severity, the baby can be confused, drowsy or unconscious
- Pale-colored stools due to the absence of bilirubin in the stools.
- Dark-colored urine due to bilirubin appearing in the urine.
- Itching
- Legs or abdomen may be swollen
Diagnosis
The signs of jaundice in newborns given above are clear to diagnose jaundice. However, if your doctor finds these signs in your newborn he will admit the newborn to the hospital to determine the severity and cause of jaundice.
The testing for jaundice involves blood workup to determine the level of bilirubin and the functioning of the liver. Modalities like; ultrasound, CT-scan, MRI, and HIDA –scan can help in ruling out any cause associated with liver disease. However, these testing are avoided for the first week as most newborns recover on their own.
Treatment
Usually, no treatment is required for the initial week or two especially when there is no risk factor involved and jaundice is showing a resolving pattern. However, for non-resolving jaundice treatment options include:
Phototherapy reduces the Signs of Jaundice in Newborn
Surprised, how a light can treat the jaundice of your newborn? It interferes with the stricture of the bilirubin and makes it more soluble so that it can be excreted out of the body. The baby is placed in a specialized chamber wrapped in a plastic shield. It filters all the harmful Ultraviolet rays and allows white light to penetrate the body of the newborn and disrupt the molecular structure of the newborn.
Exchange and blood transfusion
Since the bilirubin is present in the blood in the highest amount, it is logical to remove that blood from the body of the newborn and replace it with fresh blood. However, this process has a lot of risks and should only be considered if phototherapy has failed.
Intravenous Immunoglobulin
In specific cases of jaundice like ABO incompatibility, IVIG is transfused into the blood of the newborn soon after the birth. It destroys the antibodies from the mother that are trying to kill RBCs in the newborn. This lowers the burden on the liver.
Lastly, the cause of jaundice is treated with specific drugs or surgical procedures.
Complications
Resolving jaundice is benign; however, non-resolving jaundice can produce serious complications and even death. The complications of jaundice include:
Encephalopathy along with the signs of Jaundice in Newborn
As long as the bilirubin is outside the brain it is not a serious issue. But this doesn’t stay like this for a long time. If the jaundice is left untreated bilirubin penetrates the brain and damages the brain tissue causing; sluggishness, unconsciousness, poor sucking, arching of the body, and neck. All these are signs of acute encephalopathy which means no time to waste anymore. Because once the damage is permanent it becomes a fatal syndrome called kernicterus.
So what you can do to prevent it?
- Keep the baby well-fed
- Hydration
- Consider consultation if the jaundice is not resolving.