Neonatal (Newborn) Jaundice


Jaundice in newborn babies is common and is often not a serious medical problem. However, severe jaundice may lead to cerebral palsy, deafness and mental retardation. Fortunately, these complications are rare with the availability of effective treatment for babies who develop significant jaundice, and with close follow-up checks after discharge from the hospital.

In talking to parents, the same questions are often asked about jaundice.

1. Does my baby have jaundice?

This is one of the commonest questions asked by parents who have a newborn baby. Jaundice usually appears on the third day of life and tends to peak around the fifth day. Therefore, when babies are discharged on the third day, the doctor should review them a few days later. It is not advisable to delay the follow-up check by more than a week.

2. What is jaundice?

Jaundice is a yellowish discoloration of the skin caused by excessive bilirubin in the body. Bilirubin is a substance formed by the breakdown of red blood cells, and the liver gets rid of the bilirubin pigment via the stool. In newborn babies however, more bilirubin is produced compared to the amount excreted, resulting in the accumulation of bilirubin in the blood.

Although we can tell that a baby is jaundiced by looking at the skin, a blood test may be necessary to decide if treatment is necessary.

3. Why does my baby have jaundice? Will my baby develop jaundice?

Jaundice is more frequent in Chinese babies as compared to Caucasian babies. It is also common in babies who are born premature, have blood groups that are incompatible with their mothers’, suffer from excessive bruising, or those with G6PD (a type of enzyme normally present in red blood cells) deficiency.

It is not possible to predict which baby will develop jaundice. Therefore, it is important for the doctor to see the baby a few days after discharge.

4. How do I tell if my baby has jaundice?

Very often, parents look at their baby’s eyes for jaundice. However, it is difficult to tell if a baby is jaundiced by looking at the eyes because the baby’s eyes are often closed. Jaundice first appears around the nose and face, and progresses downwards to the rest of the body as it worsens.

5. What are the symptoms of jaundice?

“The baby looks yellow!” That is the most obvious and only symptom in almost all babies. They usually feed well and appear normal in behaviour.

6. What can I do to prevent jaundice?

Regular feeding with formula or breast milk helps with the excretion of jaundice in the stools. Water or glucose feeds does not help in reducing jaundice.

7. Is there any food I should avoid? Can I continue breastfeeding?

In general, there is no need to restrict the diet of nursing mothers. It is better to avoid herbal preparations. To be safe, you should seek the advice of a doctor or lactation consultant for possible side effects of prescribed medications. It is not necessary to stop breastfeeding in mild or moderate jaundice.

8. Is jaundice dangerous? Is treatment of jaundice really necessary?

Jaundice is dangerous at extremely high levels. Bilirubin (jaundice) is toxic to nerve cells in the developing brain. It can cause cerebral palsy, deafness, and mental retardation. Yes, treatment of jaundice is necessary to prevent it from reaching dangerously high levels.

9. How is jaundice treated? Can it be prevented with medicine? Does fluorescent and sunlight help?

Phototherapy (light treatment) is safe and effective. The baby has to be monitored closely during the treatment. Eye shields are used to protect the baby’s eyes during treatment. Blood exchange transfusion is only performed if the jaundice is very severe, and is not responding to phototherapy.

Medication to prevent jaundice exists, but it is not available for routine treatment yet.

Normal fluorescent lights at home is not effective treatment, and there is also no scientific proof to show that sunlight is effective in the treatment of jaundice.

10. Will the jaundice recur?

The short answer is no. In most babies, jaundice resolves after 1 or 2 weeks and does not recur. Breast fed babies may have jaundice that can persist for up to 10 weeks.

All babies need follow-up medical checks until the jaundice resolves. Persistent jaundice may be a sign of hepatitis or liver disease. Pale or beige coloured stools are abnormal and must be reviewed by the doctor as soon as possible.

And there you have it – all you ever wanted to know about jaundice!


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