Jaundice in children
Jaundice is a common condition in newborns that causes yellowing of the skin and whites of the eyes. Mild jaundice occurs in about 60% of newborns and up to 80% of premature babies. You're most likely to notice it as early as the third day after birth. Jaundice is usually harmless and disappears within one to two weeks.
Common causes of jaundice in newborns
When red blood cells break down, a chemical called bilirubin is released, which makes the skin turn yellow. Newborns are born with (and need to break down) plenty of red blood cells, but their livers haven't developed enough to remove the bilirubin. This results in an excess of bilirubin, which leads to jaundice. By about the second week, your baby's liver is more developed and better at removing bilirubin from the blood.
Most newborns with jaundice have "breast milk jaundice." This occurs when a chemical in breast milk interferes with the removal of bilirubin. This type of jaundice usually clears up on its own without treatment after several weeks.
Rare causes of jaundice in newborns
A rare type of jaundice occurs when the mother and baby's blood types are incompatible (usually ABO or Rh incompatibility). This is not usually a problem during a first pregnancy because the mother's and baby's bloodstreams don't mix. However, during delivery, some of the baby's blood may mix with the mother's blood.
The mother then develops antibodies that become active during the next pregnancy and cross the placenta to attack the second baby's red blood cells. The destruction of the red blood cells releases more bilirubin into the second baby's bloodstream, resulting in jaundice. This type of jaundice typically appears within the first 24 hours after birth.
Biliary atresia is another rare cause of jaundice in infants. It occurs when the tiny tubes that carry bile from the liver to the intestine become scarred. Infants with this condition usually grow normally and appear well initially, but they will become seriously ill with serious liver disease if not diagnosed and treated early. Jaundice usually persists after they are two weeks old, and they may also have pale-looking stools.
Symptoms of jaundice
Jaundice in newborns causes the skin and whites of the eyes to turn yellow. It usually begins on the face and head. If bilirubin levels increase, the color spreads throughout the body. Babies may also feel sleepy and have difficulty feeding.
When to see your doctor
Jaundice is usually harmless, but a nurse or doctor should screen and monitor all cases of jaundice in newborns. Some babies develop severe jaundice, which can sometimes lead to deafness and even brain damage if not treated promptly.
You should take your child to the doctor if:
- Your child has been sick, feeding poorly, and not gaining enough weight.
- Your baby's stool becomes pale or dark in color
- Your baby develops jaundice in the first 48 hours after birth.
- Jaundice becomes more noticeable after a week.
- Jaundice not gone after 2 weeks
Jaundice tests
If your baby has jaundice that lasts for more than two weeks—especially if their stools are pale or dark in color—they will need a blood test to check the levels of conjugated bilirubin in their blood. They may then need further liver tests.
Natural treatment for jaundice
Treatment for jaundice in newborns depends on how severe the condition is and what is causing it.
Babies who develop jaundice several days after birth usually require close monitoring, sometimes with heel-prick blood tests, to check bilirubin levels in their blood. Treatment is simple—they just need plenty of fluids. If your baby has mild jaundice, make sure he or she is breastfed or formula-fed regularly.
If bilirubin levels are high, your baby may undergo phototherapy for a few days. This treatment uses ultraviolet light to help break down excess bilirubin. It involves placing your baby naked in a crib under a blue phototherapy lamp for 2 to 3 days. Your baby's eyes will be covered for protection.
Phototherapy has few side effects, although your child may experience a mild rash and watery stools for a few days. Some children experience minor fluid loss during phototherapy and may need additional feedings at this time. Most children tolerate phototherapy well.
If your baby has breast milk jaundice, there's no need to stop breastfeeding. This type of jaundice is usually mild and should improve on its own over time. Talk to your child and family health nurse or nurse if you're concerned about what to do.
Treatment of severe jaundice
Severe jaundice, in which bilirubin levels are very high, may require treatment with an exchange transfusion. This occurs when the baby's blood is replaced with fresh, compatible blood. This is not common.
prevention
Only "Rh-incompatible" jaundice can be prevented. If this type of jaundice is suspected, the mother will receive an anti-D injection after delivery. This can prevent complications in subsequent pregnancies.