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Neonatal jaundice

  • One of the most common conditions in newborns is neonatal jaundice. Neonatal jaundice is the yellow discolouration of the skin and the eyes of a newborn baby. It is seen in 50-60% of normal newborns in the first week of life. This is not caused by the usual diseases that occur in adults and therefore, it’s called physiological jaundice, meaning it is jaundice not caused by disease.
  • Physiological jaundice usually appears after the first 24 hours, it peaks by day 3 of life and disappears by day 5. Most often, jaundice completely disappears by the second to third week of life, except in preterms which may last up to 4 weeks. Most babies do not need any specific treatment. However, contrary to popular belief, just exposing jaundiced babies to sunlight may not be enough. Medical attention should not be delayed. Here are some common questions about newborn jaundice and its treatments:

What causes jaundice?

  • Normally, red blood cells are broken down and the yellow pigment called bilirubin released is processed further in the liver and is passed in the stools and urine. The liver of a newborn baby usually takes a week or two to mature enough to be able to process the bilirubin. Though newborn jaundice is generally harmless, there are other more dangerous conditions that can cause worsening of the conditions. Sometimes, an increase in the breakdown of red blood cells (blood group incompatibility) or liver disease can be the reason.
    As it is not possible for you as a parent to know the difference between physiological jaundice and something more serious, it is always advised that your baby be assessed by the doctor so that necessary tests can be run.

Is jaundice harmful to my baby?

  • Largely moderate levels of jaundice, which usually occurs in normal babies, are not harmful. Sometimes, it exceeds the threshold level and such cases need intervention. However, various graphs are available which help us identify the level of jaundice that actually needs intervention.

When does my baby need to be seen by a healthcare provider?

  • Bring your baby to the hospital in the following situations: Jaundiced skin appears within the first 24 hours
    When it spreads throughout the body
    If the baby is not feeding well or is sleepy or unwell
    If the baby passes dark urine or pale stools
    If the jaundice persists for more than 2 to 3 weeks

How is jaundice treated?

  • There are various ways in which newborn jaundice can be treated. The most common treatment/intervention is phototherapy. Exchange transfusion is another option that is available. Sometimes, certain drugs like Phenobarbitone have been used for the treatment of jaundice. Regular feeding is important as it helps the baby pass the waste product in the stools.

What is phototherapy and how does it work?

  • Phototherapy is a special bright light that shines on your baby’s skin, changing the chemical structure of bilirubin so that it is passed in the stools and urine. It is usually administered through an overhead light or by a special mat or pad. The baby is placed with its skin exposed, wearing only an eye-pad and a nappy/diaper.

Are there any side effects of phototherapy?

  • Yes, there are minimal side effects to phototherapy such as the baby developing skin redness, increased water loss from the body leading to weight loss, and retinal damage (to avoid this is why their eyes are covered).

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