Jaundice in Newborns
What Is Jaundice?
Jaundice is a yellowing of the skin, and is caused by a buildup of the chemical bilirubin within the blood; bilirubin is formed during the body’s natural breakdown of red blood cells. This condition is a normal occurrence in newborns, affecting nearly 70 percent of term infants, and nearly all of preterm infants. Jaundice is often the result of an immature liver that has not efficiently removed bilirubin from the child’s bloodstream. While this condition is typically not a serious one, jaundice must be treated and monitored so that the bilirubin is not able to reach dangerous levels. Jaundice will first appear on the face and then the chest and abdomen, followed by the arms and legs in some instances. Some babies with jaundice will also exhibit a yellowing of the whites of the eyes.
Jaundice can sometimes be an indication of a more serious condition or dangerous levels of bilirubin within the baby’s bloodstream. Jaundice that accompanies the following factors or conditions should be carefully monitored to ensure the baby does not become seriously ill:
- Babies born early (anything greater than two weeks prior to the due date)
- When jaundice presents within the first 24 hours following birth
- Babies that are not breastfeeding well
- Babies with considerable bruising and bleeding under the scalp, associated with labor and delivery
- Babies that have parents or siblings who underwent treatment for high bilirubin levels
Prolonged or severe jaundice can result in kernicterus, which can include fever and seizures. This condition is unfortunate because it so easily preventable, and is almost always the result of leaving jaundice and bilirubin toxicity untreated. In addition to kernicterus, jaundice that is left untreated can lead to damage to the nervous system or even in some cases brain damage. This condition tends to be more common in newborns that breastfeed, specifically those that are not nursing well. Under normal circumstances, this condition typically lasts about two weeks in infants that are fed formula, and can last for several weeks in those that are breastfed.
Should a doctor determine that bilirubin levels are too high, they will typically treat jaundice by placing the baby under a special light while undressed, known as phototherapy. Phototherapy can be applied either in the hospital or at home, depending on the severity of the condition. When phototherapy is applied as an overhead light, babies wear special coverage while undergoing treatment in order to protect their eyes. Phototherapy can also be applied with a device known as a Biliblanket that sits under the baby’s clothing close to their skin.
In more severe cases of jaundice doctors can perform an exchange transfusion, which is a procedure that counteracts the effects of jaundice by slowly removing the baby’s blood and replacing it with fresh donor blood. This procedure is typically done in cycles by placing one or more catheters into the baby’s blood vessels. Each cycle typically lasts a few minutes.