Because neonatal jaundice is a common and usually harmless disease, the skin and eyes of newborns may appear yellow. This usually happens to babies born before 38 weeks gestation and some breast-fed babies. Infant jaundice generally occurs because the baby’s liver is not mature enough to remove bilirubin in the bloodstream.
Too much bilirubin, a substance released by red blood cells during the normal breakdown process, causes jaundice. It may disappear spontaneously or the doctor may recommend phototherapy or other treatments to help get rid of it.
It causes jaundice when the baby’s liver is not well developed to get rid of bilirubin in the bloodstream. Jaundice for these normal neonatal conditions is known as physiological jaundice. It usually appears on the second or third day of life.
Infant jaundice can also be caused by certain neonatal underlying illnesses, such as:
- Sickle cell anemia
- Liver disease
- Sepsis-blood infection
- Bleeding under the scalp (cephalohematoma) – due to difficulty in delivery
- Red blood cell abnormalities in children
- More red blood cells – common in twins and small babies
- The blood types of the mother and the child are different, and the mother’s antibodies attack the red blood cells of the child, causing rhesus monkey or ABO incompatibility.
- Enzyme deficiency
- Obstructed bile duct or intestine
- Hypothyroidism (hypothyroidism)
- Viral or bacterial infections
- Hepatitis (liver inflammation)
- Hypoxia (hypoxia level_
- Infectious diseases such as rubella and syphilis
Causes of neonatal jaundice
Excessive bilirubin, a yellow pigment, causes infantile jaundice. Bilirubin is produced as a waste product when red blood cells are broken down. It is usually broken down in the liver and excreted in the intestines.
Bilirubin is a natural ingredient produced during the breakdown of “used” red blood cells.
Newborns produce more bilirubin than adults because they produce more red blood cells and break down faster in the first few days of life. Bilirubin is usually filtered from the bloodstream and released by the liver into the intestines. The baby’s immature liver is usually unable to eliminate bilirubin quickly enough, resulting in an excess of bilirubin. Physiological jaundice is a type of jaundice that occurs on the second or third day of life.
Breastfeeding can also cause infantile jaundice. In breast-fed newborns, it appears in two ways:
- Breastfeeding jaundice develops in the first week of life if the baby is not breastfeeding well or if it takes a long time for the milk to arrive.
- Breast milk jaundice is caused by chemicals in breast milk that interfere with the bilirubin-degrading process. It begins 7 days after birth and lasts 2-3 weeks.
Symptoms of neonatal jaundice
Yellow skin and yellow eyes on the baby’s skin are obvious signs of jaundice. It usually starts with the face. As the level of bilirubin in the blood rises, a shade of yellow spreads to the chest and stomach, then to the legs and arms. If you have a baby, talk to your doctor right away.
- Not properly fed
- The diaper is not wet
- Hard to wake up
- Weeping constantly or with high pitched cry.
- The spine is arched, dragging or stiff.
- I have abnormal eye movements
Infant jaundice can also cause the following symptoms:
- Mild greenish-yellow shades for breast-fed newborns and greenish mustard-colored stools for bottle-fed babies.
- Dark pee-newborn urine must be colorless
The following are symptoms of severe neonatal jaundice.
- Yellow abdomen or limbs
- Don’t gain weight
- Inadequate eating
Risk factors for neonatal jaundice
The main risk factors for jaundice are:
Premature birth– Newborns born before 38 weeks gestation may not be able to process bilirubin at the same rate as full term babies. Premature babies also have less stool and less food intake, which may result in less bilirubin being excreted in the stool.
Bruises during childbirth– Newborns injured during childbirth may have higher levels of bilirubin because more red blood cells are broken down.
blood type– If the mother’s blood type is different from the baby’s blood type, the baby may have been exposed to antibodies through the placenta, causing abnormally rapid red blood cell destruction.
Race– Studies show that babies of East Asian descent are at increased risk of jaundice.
Complications of neonatal jaundice
When untreated, high levels of bilirubin that cause acute jaundice can cause catastrophic problems.
Acute bilirubin encephalopathy (ABE)
Bilirubin is toxic to brain cells. A disorder known as acute bilirubin encephalopathy occurs when the newborn has severe jaundice and bilirubin enters the brain. Prompt treatment may help prevent long-term damage.
In infants with jaundice, the signs of acute bilirubin encephalopathy are:
- I have a problem with awakening
- Crying a lot
- Sucking or eating problems
- The neck and body are arched backwards.
Kernicterus is a syndrome that develops when acute bilirubin encephalopathy causes permanent brain damage. Kernicterus can lead to:
- Uncontrollable and involuntary movements (athetotic cerebral palsy)
- Constant upward appearance
- Deafness is a common problem.
- Inappropriate tooth enamel development
Diagnosis of neonatal jaundice
Doctors can usually determine if a newborn has jaundice just by looking at him. However, they will want to know how much bilirubin is in the baby’s blood to determine treatment strategies. They can:
- Your baby’s blood will be collected and submitted to the lab to test the level and type of bilirubin.
- The skin is tested using a device called a percutaneous viril binometer.It measures the reflection of special light illuminated through your skin
Other tests may be done if the doctor feels that the following conditions are causing jaundice in the baby:
- A urine sample was taken to check for infection.
- A complete blood count is used to determine the amount of red blood cells in the body.
- The reticulocyte count is used to determine if the amount of newly generated red blood cells is within the normal range.
- Blood typing is done to determine if the mother’s blood is incompatible with the baby’s blood.
- A Coombs test to detect if a baby’s red blood cells are destroyed by the immune system.
- Liver function test
Treatment of neonatal jaundice
Jaundice usually heals spontaneously in a week or two. The doctor chooses whether the child should wait or start treatment as follows:
Requires additional feeding: Increasing your baby’s milk and infant formula intake will help your baby defecate more often and help remove bilirubin from your body. If your baby has breastfeeding problems, your doctor may advise your mother to feed her milk in a bottle or supplement it with infant formula.
Phototherapy (phototherapy): The baby is placed under a special light that is shielded from UV rays by a plastic shield. Light changes the structure of bilirubin molecules, allowing them to leave the body.
Exchange blood transfusions: Remove blood from the newborn and replace (exchange) it with a blood donor on a regular basis. This treatment is only considered if phototherapy fails, as the baby must be in the neonatal intensive care unit (ICU).
Intravenous immunoglobulin (IVIg): In the case of rhesus monkeys or ABO incompatibility, newborns may receive intravenous immunoglobulin (IVIg) transfusion. It is a protein in the blood that lowers the levels of antibodies from the mother that attack the baby’s red blood cells.
Prevention of neonatal jaundice
There is no way to stop a newborn from getting jaundice. Pregnant mothers can test their blood type during pregnancy.
If necessary, the baby’s blood type is tested after birth to rule out blood group incompatibility that can cause neonatal jaundice. If your baby has jaundice, there are a few things you can do to prevent it from getting worse.
- Make sure your baby is getting enough nutrition from breast milk. Feeding your baby 8-12 times a day for the first few days will keep you hydrated and allow bilirubin to get out of the system faster.
- During the first 5 days after childbirth, watch for signs of jaundice, such as yellowing of the skin and eyes.
- If the mother finds that the baby is showing signs of jaundice, contact your doctor immediately.