Jaundice in newborns: Symptoms, causes, treatments and prevention

Stella Takyiwaa Okyere 09:47 - 27 May 2024

Babies with jaundice [NHS]

Jaundice in newborns, also known as neonatal jaundice, is a common condition that causes a yellowing of the skin and eyes.

It typically occurs due to an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells. While usually not serious, it's important to understand the causes and treatments to ensure proper care.

Causes of neonatal jaundice

1. Physiological jaundice

Definition: This is the most common type of jaundice in newborns, appearing 2-4 days after birth and usually resolving within 1-2 weeks.
Cause: Immature liver function in newborns is often unable to process bilirubin efficiently.

2. Breastfeeding jaundice

Definition: Occurs in breastfed babies, often due to insufficient intake of breast milk in the first few days of life.
Cause: Low-calorie intake and dehydration can lead to decreased bilirubin elimination.

Jaundice photo [Intermountain Healthcare]

3. Breast milk jaundice

Definition: Appears after the first week of life and can persist longer than physiological jaundice.
Cause: Substances in breast milk can interfere with bilirubin processing.

4. Blood group incompatibility

Definition: Conditions like Rh or ABO incompatibility where the mother and baby’s blood types are different.
Cause: Maternal antibodies attack the baby’s red blood cells, leading to increased bilirubin production.

5. Premature birth

Definition: Babies born before 37 weeks of gestation.
Cause: Premature babies have less developed livers and higher red blood cell turnover.

6. Hemolytic disorders

Definition: Disorders that cause increased breakdown of red blood cells.
Examples: G6PD deficiency, hereditary spherocytosis.

7. Infections

Definition: Infections in the newborn can sometimes lead to jaundice.
Examples: Sepsis, urinary tract infections.

8. Other causes

Examples: Bruising during birth, internal bleeding, certain enzyme deficiencies.

Treatment of neonatal jaundice

The treatment for neonatal jaundice depends on its severity and underlying cause. Here are common treatment methods:

1. Phototherapy

Definition: The most common treatment for significant jaundice.
Method: Babies are placed under a special type of light that helps break down bilirubin in the skin.
Types: Conventional phototherapy, fiber-optic blankets.

2. Exchange transfusion

Definition: A more intensive treatment used in severe cases.
Method: The baby's blood is replaced with donor blood to quickly lower bilirubin levels.

3. Intravenous immunoglobulin (IVIG)

Definition: Used for babies with blood group incompatibility.
Method: IVIG can reduce the need for exchange transfusion by lowering antibody levels.

4. Hydration and feeding

Method: Ensuring the baby is well-hydrated and fed frequently can help decrease bilirubin levels by promoting regular bowel movements and bilirubin excretion.

5. Treating underlying conditions

Examples: Addressing infections with antibiotics, treating hemolytic disorders.

Monitoring and follow-up

1. Bilirubin levels

Monitoring: Regular monitoring of bilirubin levels in the blood to determine the need for treatment.
Methods: Blood tests, transcutaneous bilirubinometer.

2. Physical examination

Checking Symptoms: Observing for yellowing of the skin and eyes, lethargy, poor feeding.

A baby is screened during a trial in a large-scale feasibility study using a smartphone-based screening for jaundice at Greater Accra Regional Hospital in Accra, Ghana in this undated handout photo from the University of Ghana

Physical examination

3. Follow-up appointments

Purpose: Ensuring jaundice resolves and monitoring for any potential complications.

Prevention

1. Early and frequent feeding

Breastfeeding: Encourages early and frequent breastfeeding to promote bilirubin excretion.
Formula Feeding: Ensuring adequate intake if breastfeeding is not possible.

2. Monitoring at risk babies

Premature Infants: Closer monitoring of bilirubin levels.
Blood Group Incompatibility: Testing and early intervention if necessary.

Jaundice in newborns is a common and usually manageable condition. Understanding the causes and appropriate treatments can help ensure that affected babies receive the care they need to prevent complications.

Regular monitoring and early intervention are key to managing neonatal jaundice effectively. If you have any concerns about jaundice in a newborn, it's important to seek advice from a healthcare professional.