Jaundice can be caused by prematurity, infection,
exposure to drugs during labor, or bruising at birth.
Different types of jaundice exist with physiological
version being the commonest form in newborns. It is
not a true disease, rather a symptom that affects
more than half of healthy newborns in the initial
days of life. As a rule if there is no underlying
cause to jaundice, it will subside without treatment
in the first week of life.
The
Cause
Jaundice is the result of a raised
level of bilirubin, a yellow pigment byproduct that
results when red blood cells breakdown. This process
occurs around the 2nd or 3rd day after baby is born.
Baby's immature liver is unable to clear the excess
buildup of bilirubin fast enough causing it to accumulate
in the blood. Instead of being directed to the bowel
for excretion, the overload spills into the system
and manifests itself in the skin and eyes.
What next
• Baby may develop a yellowish tinge to her
skin 2-3 days following birth. The whites of her
eyes will also turn yellowish. The doctor will examine
the jaundice situation by extracting blood from
a vein in baby's hand or heel and test the bilirubin
level.
• Physiological jaundice usually occurs around
day 2-3 and peaks at day 4-7. As baby's stay at
the hospital is very brief, parents will have to
monitor at home.
• Symptoms will start to subside around day
7 and disappear within 2 weeks.
• Frequent feeding is recommended; it is important
for newborns with jaundice to feed well and have
extra fluids.
• The extent of jaundice can be assessed by
observing the face and upper body in natural light
- a flushed, tanned parlor indicates jaundice. For
further proof, gently press your finger on her cheek,
release, and note the skin tone when you remove
your finger. If it is a deep yellow repeat this
action on her chest. You should take baby to hospital
for a review if the chest is also yellow.
• Apart from a yellowish parlor, if baby is
lethargic, slow to feed consult your doctor. An
appropriate treatment will be prescribed
Phototherapy
• Phototherapy is the usual form of treatment
prescribed if treatment is required. It uses the wavelength
of the blue spectrum of light to break down bilirubin
molecules thereby assisting the immature liver to
process the bilirubin faster.
• Once upon a time natural sunlight was a popular
therapy but these days doctors have their doubts on
the efficiency of this method due to depletion of
the ozone layer - the sun rays could prove to be too
strong for baby's sensitive skin doing more harm than
good in the long run.
• Phototherapy is performed in the hospital
premises under medical supervision.
• Treatment is usually given intermittently
e.g. for one hour in four.
• The baby is undressed and the eyes are well
protected with shields before being placed under blue
fluorescent lamps. The light breaks down the bilirubin
which the baby then excretes.
• Sometimes babies are placed on fiber optic
blankets to increase the amount of absorbed light.
• The treatment of jaundice with lights is easy
but if that fails drastic forms of treatment will
be taken, so it is important to maximize the time
under phototherapy.
Common Concerns explained
Eating ginger while breastfeeding will cause
baby to be jaundiced!
Jaundice is due to raised levels of bilirubin in baby's
bloodstream and an immature liver. There is no conclusive
evidence suggesting a link between the two, but do
remember that ginger is a herb and an excess of anything
may not be beneficial to you or your baby.
Eating carrots and papaya during pregnancy
will cause jaundice in my baby!
These foods contain beta carotenes which are not the
same as bilirubin. Eating excessive amounts of food
containing beta carotenes may cause your skin to have
a yellowish hue but that is not jaundice. Still, it
pays to eat a variety of foods and not zero in on
one particular type.
Breastfeeding aggravates jaundice in babies!
Breastfeeding does not cause physiological jaundice;
instead inadequate feeding may aggravate the jaundice.
There is a condition known as breast milk jaundice
which develops a week after birth and seems to occur
in exclusively breastfed babies. The exact cause is
unknown but there is no real necessity to stop breastfeeding.
Discuss your concerns with your doctor or lactation
consultant.
Feeding water to jaundiced baby is preferred!
It is important for jaundiced babies to be hydrated,
but a milk diet is preferred since it is packed with
water and nutrients and helps eliminate bilirubin
more effectively. Water on the other hand is just
plain fluid without the nutrients.
