Jaundice in a baby: symptoms, cause and treatment

A yellow baby: how is that possible? Most newborn babies experience physiological jaundice to a greater or lesser extent, also known as ‘neonatal jaundice’. This phenomenon indicates the visible yellow discoloration of the skin and the whites of the eyes. The extent to which it occurs is often difficult to determine with the naked eye. The yellow color is caused by an excessive amount of bilirubin – a breakdown product of red blood cells – in the blood. Bilirubin is removed from the body through the liver. Neonatal jaundice is a normal and harmless phenomenon. However, one must be aware of the development of severe hyperbilirubinemia. Bilirubin in high concentrations causes toxicity and can cause damage in the brain. However, if an excessively high bilirubin level is discovered in time and treated adequately, it will have no consequences for the health and development of the child now or later in life.

Yellow baby: jaundice in babies

  • Physiological jaundice in infants
  • Cause of physiological jaundice in babies
  • Two important factors
  • Breastfed children have a higher risk of hyperbilirubinemia
  • What is hyperbilirubinemia?
  • Recognize in time
  • The possible consequences of hyperbilirubinemia
  • Treatment of jaundice in a baby
  • Wait and see policy
  • Phototherapy lamp
  • Prognosis

 

Jaundice in a baby / Source: Anastasiia Ylitko/Shutterstock.com

Physiological jaundice in infants

Many newborn babies look a bit yellowish after birth. This is because there are too many red blood cells in the baby’s blood. This phenomenon is known as ‘physiological jaundice’ or ‘neonatal jaundice’. Icterus means ‘jaundice’ and neonatorum means ‘newborn’. It begins about the second or third day of life and disappears by the seventh day. Neonatal jaundice is common and is a harmless phenomenon. This does not alter the fact that one should be aware of the development of severe hyperbilirubinemia. Bilirubin in high concentrations causes toxicity and can lead to kernicterus, a condition in which the newborn’s brain is damaged by high levels of bilirubin in the blood.

Cause of physiological jaundice in babies

Two important factors

In newborns, the following factors play a role in the development of jaundice: excess fetal hemoglobin and immaturity of the liver. The liver is not yet mature (especially if the baby is born prematurely) and the processing capacity for bilirubin is therefore still substandard. This substance therefore accumulates in the blood and subcutaneous fat, causing the skin to turn yellow.
Bruises, in which the body has to break down extra blood cells, also increase the risk of jaundice. Bruises can occur due to delivery with forceps or vacuum pump.

Breastfed children have a higher risk of hyperbilirubinemia

Physiological jaundice may last a little longer in breast-fed children due to slow passage of meconium (the first, often black and sticky stools that a newborn baby produces). In addition, increased jaundice during breastfeeding is often caused by inadequate initiation of breastfeeding. This results in a lower calorie intake during the first days of life. All in all, breastfed children have a higher risk of hyperbilirubinemia than bottle-fed children, but as long as the newborn drinks enough, urinates, defecates and does not get sick, there is no problem. Only 2-5% of newborn babies become too yellow, but maternity nurses and midwives can identify this in time and take measures.

What is hyperbilirubinemia?

Recognize in time

Hyperbilirubinemia means an excess of bilirubin in the blood. Timely recognition of (severe) hyperbilirubinemia (yellow vision) is a point of attention. Only a small proportion of infants develop some degree of hyperbilirubinemia.
This pathological jaundice can have several causes, such as:

  • prematurity (premature birth);
  • blood group and rhesus antagonism;
  • liver diseases;
  • infections; and
  • metabolic disorders.

 

The possible consequences of hyperbilirubinemia

Hyperbilirubinemia is not harmless. Bilirubin in high concentrations causes toxicity by releasing too much yellow dye into the brain. A severely increased amount of bilirubin in the blood of a newborn baby can lead to ‘kernicterus’, a form of brain damage. This manifests itself in lethargy, drowsiness, hypotonia (reduced muscle tone) and poor drinking.

Treatment of jaundice in a baby

Wait and see policy

Physiological jaundice is a normal phenomenon. If in doubt, a drop of blood will be taken from the child for examination. After all, one wants to ensure that the amount of bilirubin in the blood does not become too high (more than 210 micromole per liter of blood). Above a certain threshold value, bilirubin can cause damage to the brain with all its consequences, and this must be prevented.

Phototherapy lamp

If necessary, the baby’s body can be helped to break down increased bilirubin with the help of the phototherapy lamp, which emits ultraviolet light. This light ensures that the stored bilirubin in the skin is processed, making it easier for it to leave the body through the feces or urine. The Biliblanket, a luminous mat for the baby to lie on, is also used .
The lamp and the blanket are also used together.

Prognosis

Jaundice in a baby is usually harmless. In most cases, jaundice goes away within one to two weeks without treatment.

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