Jaundice is yellow discoloration of the skin and the white of the eyes. Newborns frequently get jaundice.  More than half of all newborns will develop some jaundice, but the degree varies. Severe jaundice is less common.

Extent of Jaundice (icterus) with Baby

What cause jaundice?

Usually, jaundice appears around day 3 to 5 of life, and disappears gradually over the next few days. Think of it as part of your baby’s adaptation to life outside the womb. In the womb, because the baby has to take oxygen from the mother, the baby has a lot of blood so that this process of extracting oxygen from mummy is more efficient. Once baby is born, however, baby doesn’t need as much blood to be able to take oxygen into his body directly from the air he breathes. Therefore, the body breaks down the excess blood. This produces a yellow colour, called bilirubin.

Bilirubin will colour the skin and eyes of your newborn yellowish. This is jaundice. This kind of jaundice is usually mild.

There are some other causes of jaundice that are not so harmless, like some enzyme deficiencies, such as G6PD deficiency. Infections can also cause jaundice. Other causes are liver and biliary tree problems, lactose intolerance and incompatibility between baby’s and mum’s blood. One particular cause of troublesome newborn jaundice is Rhesus incompatibility. This can be fatal to a baby in the womb, and in the newborn period as well, due to how quickly jaundice increases. Alert your midwife if you are Rhesus negative so they can plan properly for your pregnancy, delivery and care of your newborn.

How do we treat newborn jaundice?

How we treat newborn jaundice depends on the cause. It also depends on the level of bilirubin. We get this by doing a blood test on your baby. If the jaundice is very mild, your baby’s doctor may adopt a wait-and-see approach. However, your baby may be admitted for phototherapy, which is treatment by putting baby under special lights. If your baby has an infection, the doctor will treat it. In rare cases, baby may need an exchange transfusion. In this process, the doctor will remove your baby’s blood in small amounts. He will replace it with donor blood which does not contain bilirubin. Even more rarely, a baby may need special feeds or surgery.

Is newborn jaundice serious?

Newborn jaundice can damage your baby’s brain, if it is severe. This may result in death or disability. We call this kernicterus.

Newborn jaundice and cultural practices

Some cultures keep a newborn baby indoors till the baby is outdoored, usually after a week of life. In the not-so-bright light of bedrooms, you may not be able to identify jaundice in your baby. This can lead to reporting late to hospital. It is important that as a new mum, you see your baby in bright sunlight at least once a day. If you think your baby has jaundice, or if you are unsure, please report to your baby’s doctor. Moth balls can also cause jaundice in G6PD deficient babies.

Newborn jaundice is mostly easily treatable once picked up early. Early recognition and treatment save lives. It should be looked for in the newborn, and reported early.

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