Neonatal jaundice

Neonatal jaundice, also known as hyperbilirubinemia, is a common condition in newborn infants characterized by yellow discoloration of the skin and whites of the eyes. It occurs due to the accumulation of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells.

Jaundice phototherapy

Causes

• Neonatal jaundice can have various causes, including:
• Physiological Jaundice: This is the most common form of neonatal jaundice, occurring in approximately 60% of full-term newborns and 80% of preterm infants. It typically appears within the first few days of life and resolves on its own within one to two weeks. Physiological jaundice is usually due to the immaturity of the baby's liver, which is not yet efficient at processing and eliminating bilirubin.
• Breast Milk Jaundice: Breast milk jaundice is a relatively uncommon type of jaundice that occurs in some breastfed infants. It is thought to be caused by substances in breast milk that can interfere with bilirubin metabolism, leading to its accumulation. Breast milk jaundice tends to persist for a longer period, with bilirubin levels peaking at around two weeks of age and gradually resolving over several weeks or months.
• Breastfeeding Jaundice: Breastfeeding jaundice is usually caused by inadequate milk intake, resulting in dehydration and reduced elimination of bilirubin. It typically appears in the first week of life and can be resolved by ensuring adequate breastfeeding and hydration.
• Pathological Jaundice: Pathological jaundice occurs when jaundice is present within the first 24 hours of life or is severe and prolonged. It may be caused by underlying medical conditions, such as blood type incompatibility between the mother and baby (Rh or ABO incompatibility), genetic disorders (e.g., Gilbert syndrome, Crigler-Najjar syndrome), or infections.

Signs and Symptoms

• The main sign of neonatal jaundice is yellowing of the skin and eyes, starting from the head and progressing downward. Other signs and symptoms may include:
• Yellowing of the palms and soles
• Poor feeding or sucking
• Drowsiness or lethargy
• Decreased urine output or dark-colored urine
• Pale stools
• Irritability or fussiness (in severe cases)

Evaluation and Treatment

• Neonatal jaundice is typically assessed by measuring bilirubin levels in the blood. The severity of jaundice is determined by evaluating the bilirubin level in relation to the infant's age, risk factors, and clinical signs.
• In most cases of physiological jaundice, treatment is not required, as the condition resolves on its own. However, if bilirubin levels reach a certain threshold or if there are concerns about the underlying cause, further evaluation and treatment may be necessary. Phototherapy is a common treatment method for neonatal jaundice, which involves exposing the baby's skin to special blue lights that help break down bilirubin and facilitate its elimination. In severe cases or when phototherapy is not sufficient, exchange transfusion may be performed to replace the baby's blood with donor blood, removing the excessive bilirubin.
• For breastfeeding-related jaundice, ensuring proper breastfeeding techniques, adequate milk intake, and hydration are essential. In cases of pathological jaundice, the underlying cause will be addressed and managed accordingly.

Complications and Follow-up

In most cases, neonatal jaundice is a temporary and benign condition that resolves without complications. However, in rare cases, high levels of bilirubin can lead to a condition called kernicterus, which is characterized by brain damage due to bilirubin toxicity. This is why monitoring and managing neonatal jaundice is important to prevent its progression to dangerous levels. Regular follow-up with healthcare providers and appropriate monitoring of bilirubin levels are typically recommended for at-risk infants.

Conclusion

Neonatal jaundice is a common condition characterized by yellowing of the skin and eyes due to the accumulation of bilirubin. While physiological jaundice is the most common and typically resolves on its own, other causes, such as breast milk jaundice or pathological jaundice, may require further evaluation and treatment. Close monitoring and appropriate management of neonatal jaundice are crucial to ensure the well-being of the newborn and prevent complications.

See Also

• Bilirubin
• Phototherapy
• Newborn Care
• Pediatrics

References

Neonatal jaundice Resources
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