Neonatal Jaundice Symptoms, Causes and Risk Factors in Newborns

Jaundice – the disease we associate with the yellowing of the skin, doesn’t just affect adults. It is one of the many conditions a newborn can suffer from. Studies reveal that 6 out of every 10 babies are affected by jaundice, out of which 8 out of 10 are born prematurely.

The condition when a baby’s skin and eyes develop a yellowish color is called newborn jaundice. This is a very common occurrence in babies and is because of a high level of bilirubin present, which is a yellow pigment that is produced during a normal breakdown of red blood cells.
The liver processes bilirubin in older babies and adults, however, this is not the case in a newborn as the liver is not mature enough to filter out the bilirubin.

The good side to it is, in most cases, jaundice fades away as the baby develops and starts to feed which is helpful for the bilirubin to pass through the body and hence can be a very mild event
Mostly the jaundice cures within 2 to 3 weeks. If jaundice persists any longer than 3 weeks, it most probably can be due to an underlying condition.
Some of the repercussions of high Bilirubin levels are deafness, cerebral palsy, and other forms of brain damage.

The four types of different neonatal jaundice are:

1. Pathologic jaundice
2. Physiologic jaundice
3. Breastmilk jaundice
4. Suboptimal intake jaundice

What reasons could there be, for jaundice in newborns?
Most healthy babies tend to be affected by normal jaundice. This is because newborns have more blood cells than an adult. Since these blood cells don’t live as long, more bilirubin is formed when these break down.

The risk for developing newborn jaundice is highest in: 

• Babies that are born before the 37 weeks gestation period (premature babies)
• Babies who aren’t getting enough breast milk or formula because either the mothers are not able to feed them or the mother’s milk is not produced yet. If a baby is diagnosed with this type of jaundice, also otherwise known as (breastfeeding jaundice) it’s recommended to feed more often. A lactation consultant can be consulted in these cases
• In cases where there the mother and the child’s blood type do not match.

In cases where the blood group of the newborn and the mother isn’t compatible, antibodies can develop in the baby that can destroy their red blood cells and hence lead to a sudden rise in the bilirubin levels.

Some other causes of neonatal jaundice include:

• A bruise at birth or internal bleeding.
• Liver problems
• A possible infection
• An enzyme deficiency
• An abnormality in the baby’s red blood cells (born with high red blood cells or a big bruise on the head.

What symptoms should be focussed on, in cases of newborn jaundice?

Look out for the whites of the eyes and the skin turning yellow. This usually appears between the second and the fourth-day post-birth. The yellowing begins to show up first on the face, followed by the chest and the legs. Babies with very high levels of bilirubin may be sleepy, fussy, and floppy. It is difficult to spot jaundice in darker complexioned babies, hence it is necessary to look out for other symptoms in this case.
To check if your baby has jaundice here is something you can try. Press lightly on your infant’s forehead or nose. If the skin looks yellowish on the area where you pressed, the baby likely has jaundice otherwise the skin color on that spot should look lighter than the normal color for a moment.
It is recommended to try doing this in good lighting conditions, during natural daylight.

Contact your doctor if:

• Your baby starts to look or act sick and develops a fever over 100°F.
• Is not eating well.
• Is sleepier than usual days
• has jaundice that gets worse
• makes high pitched cries
• have dark yellow pee
• have pale poo which is usually yellow or orange

What are the risk factors?

There are major risk factors for neonatal jaundice that can cause complications, they include but are not limited to.

• Premature birth of the baby. A baby born before 38 weeks of gestation might not be in the position to process bilirubin when compared to normal-born babies. Premature babies may have a smaller appetite, thus leading to lesser bowel movements, which results in less bilirubin being flushed through stool.
• Newborn bruise. A newborn who, during the time of being born gets bruised, may have higher levels of bilirubin due to the breakdown of more red blood cells.
• Breast-feeding. Breast-fed babies, particularly those who have difficulty in getting nursed and are only getting nutrition from breastfeeding, are at higher risk of jaundice. Dehydration or a low caloric intake may be a reason for jaundice. However, breastfeeding has its benefits. Hence, it’s important to make sure your baby is fed enough is adequately hydrated.
• Race. Studies have indicated how newborns of East Asian descent have a higher risk of developing jaundice due to their underlying genes.
• Acute bilirubin encephalopathy. Bilirubin is a condition that is said to be toxic to the brain cells of the newborn. In cases of severe jaundice, there are chances of bilirubin passing into the brain, and this is known as acute bilirubin encephalopathy. Early treatment may prevent significant damage.
• Kernicterus. It is a type of syndrome which arises when acute bilirubin encephalopathy causes permanent damage to the brain. It thus results in involuntary and uncontrolled movements, permanent upward gaze, hearing loss, and in some cases improper development of tooth enamel.

How is jaundice treated?

Do not wait to get in touch with the doctor. Call them right away, if jaundice doesn’t seem to subside. Babies who have had jaundice for beyond 2 weeks need to undergo more testing to rule out any underlying reasons causing jaundice. There could be any problems with the liver or their bile system, their metabolism, or even their genes. Certain treatments include –

• Treatment of the cause which may be infection or hypothyroidism
• Breastfeeding the baby between 8-12 times a day every day for at least a fortnight post-birth. Do not wait for your baby to cry for food, as this can interfere with effective bleeding
• Phototherapy
• Exchange transfusion
• Additional supplementation should be given only post consultation with your doctor.

Newborns need constant care and support and in this case, do not hesitate to get medical intervention, as a stitch in time, saves nine. In this case, it can save a life.

Also Read: Stomach Worms in Children

Disclaimer: The information included here is only for knowledge sharing purposes, and the blog is not intended to be a substitute for diagnosis, medical advice, or treatment by a healthcare professional. Because individual needs appropriate advice, the reader should consult their doctor to determine the appropriate disease depending on their situation.