Jaundice in Newborn Babies

Jaundice is usually a harmless condition that affects over 50% of all newborn babies. Sometimes referred to as neonatal jaundice, a baby may have a yellowing of their skin and the whites of their eyes that can develop up to a week after birth and can last for up to three weeks.

Most cases of jaundice will be noticed by your midwife or Health Visitor although if you notice that your baby has jaundice, it is advisable to inform your medical team.

What causes Jaundice?
Jaundice may occur if you baby has too much bilirubin in their blood. Bilirubin is a yellow chemical substance which is produced during the breakdown of red blood cells. Usually the liver will take the bilirubin which is produced and transfers it into a waste product that can be passed out through your stools. However, sometimes a newborn baby’s liver is too immature to be able to cope with this function and the process takes much longer and the bilirubin builds up too quickly for the liver to filter it out.

The excess bilirubin will turn your baby’s skin yellow in colour starting with her head and moving down the body. It does not matter how yellow your baby becomes, she will return to her normal colour in time.

Other symptoms of jaundice include very dark urine and very pale stools.

What shall I do if my Baby has jaundice?
Inform your midwife or health visitor or doctor that your baby has jaundice. They will advise you if your baby requires treatment for their jaundice. Most cases of jaundice clear up on its own within a few weeks. Some parents are advised to place their baby in natural sunlight to help the process of breaking down the bilirubin. If you are breastfeeding your baby, continue to do so at regular intervals as this will also help your baby’s jaundice to improve. Some babies may need medical help with their jaundice.

There is normally no need for concern if your baby requires medical assistance to clear up their jaundice. Phototherapy is normally used.

Phototherapy is treatment using light and usually carried out within the hospital setting. Phototherapy lowers the bilirubin levels by adding extra oxygen, which helps the bilirubin to break down into water and makes it easier for your baby’s liver to break-down the bilirubin and remove it from their body.

There are two types of phototherapy which may be used:

  • Conventional Phototherapy: this is where your baby will be placed under an ultraviolet light. This light helps to break down the excess bilirubin in order to help the liver get rid of it. In some hospitals, your baby will have to go to the Special Care Baby Unitto receive this treatment although in some hospitals they may use portable cots for this procedure. This kind of phototherapy means that your baby will need to be left alone for the process, although phototherapy will be stopped every few hours to allow you to feed your baby. This is the preferred method of phototherapy used for most babies.
  • Fibre-optic phototherapy: this is where your baby is wrapped inside a special blanket which contains fibre optics. These shine small lights directly onto your baby’s skin. Using this method allows the baby to cuddled and fed whilst receiving treatment.  This method is often used first on babies who are born prematurely.

Whilst your baby is receiving treatment, their bilirubin levels will be checked and assessed every 4-6 hours. Most courses of phototherapy take 24-48 hours to complete.

If your baby is receiving a course of phototherapy, they may become very dehydrated and may need to receive intravenous hydration. (This is where fluid is given to your baby through a drip directly into a vein.)

In very extreme cases of jaundice, your baby may require an Exchange Blood Transfusion. This is only carried out if your baby has hyperbilirubinaemia which is extremely high levels of bilirubin in the blood and phototherapy has been tried but was unsuccessful. Exchange transfusions are very effective: some of your baby’s blood will be removed and replaced with suitable, matching blood. This new blood will not contain bilirubin and therefore your baby will have less bilirubin for their lungs to remove. There are very rarely any problems with this medical procedure although your baby will be monitored closely throughout.

There is a small chance that Jaundice in new-born babies may be caused by another underlying health condition. Although this is very rare, your midwife or health visitor will want to continue their checks on your baby throughout these early days.

If you are worried or concerned about your baby’s jaundice at any time, it is advisable to seek medical help and advice.

by Jenny, mum to William and James

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