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Wednesday, July 10, 2013

Newborn jaundice

Jaundice is a yellow coloring of the skin and the whites of the eyes. It is caused by a build-up in the blood of a substance called bilirubin. Jaundice occurs in about 60 percent of all newborns.

A baby’s skin usually starts to turn yellow a few days after birth. In most cases, jaundice is mild and does not harm the baby. Mild jaundice goes away without treatment. However, babies with severe jaundice can have high bilirubin levels, which can pose a risk of brain damage.
The American Academy of Pediatrics (AAP) recommends that all babies be checked for jaundice with a physical exam, skin test or blood test before they leave the hospital. Babies should be examined again by a doctor or nurse at 3 to 5 days of age because this is the time when bilirubin levels are highest. When necessary, a baby can be treated to prevent bilirubin levels from getting too high.

Jaundice occurs when bilirubin builds up in the blood. Each day some red blood cells in everyone’s body are recycled. Bilirubin forms as these cells break down in the recycling process. Normally, the liver removes bilirubin from the blood. The liver of a newborn may be too immature to keep up with bilirubin removal, causing bilirubin to build up in the blood. This build-up turns the skin and, sometimes, the white part of eyes yellow. Premature babies have especially immature livers, making jaundice more likely.
Breastfed babies are more likely than formula-fed infants to develop jaundice. However, jaundice occurs mainly in babies who are not nursing well. These babies may not get enough calories and may become dehydrated, both of which may contribute to jaundice. This should not be a reason to avoid breastfeeding, however, as breast milk is the ideal food for babies and provides many health benefits, including reducing the risk of infections. Breastfeeding mothers should nurse their babies at least 8 to 12 times a day for the first several days of life to help keep their baby’s bilirubin level down.

So what should new parents look for? Yellow coloring usually first appears on the face and in the whites of the eyes. You often can tell if your baby has jaundice by looking at your baby under natural daylight or in a room that has fluorescent lights. If you think there is a yellowish color, you should contact your baby’s health care provider.
Most babies with jaundice do not need treatment, but some do and it’s important to have the health care provider make that decision. Providers sometimes suggest steps you can take at home to help clear up mild jaundice. They may recommend increasing the number of feedings to encourage more bowel movements, which helps eliminate bilirubin.

If your baby has more severe jaundice, however, your provider may recommend treatment. Phototherapy is a treatment you may have seen in the hospital. The baby, wearing only a small diaper, is placed under special white or blue lights called bili-lights. He wears shields to protect the eyes. The lights help change bilirubin into a form that can be eliminated easily in urine. In more serious cases, a blood transfusion may be necessary.

For additional information about newborn jaundice contact the American Academy of Pediatrics (AAP) or the Centers for Disease Control and Prevention.

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