KPJ News & Articles

Jaundice

Posted in Article on 05:20PM, 26 February, 2020



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WHAT IS NEWBORN JAUNDICE


What is newborn jaundice?

Newborn jaundice is a yellowing of a baby’s skin and eyes. Newborn jaundice is very
common and can occur when babies have a high level of bilirubin, a yellow pigment
produced during normal breakdown of red blood cells.

In older babies and adults, the liver processes bilirubin, which then passes it through the
intestinal tract. However, a newborn’s still-developing liver may not be mature enough to
remove bilirubin.


The good news is that in most cases, newborn jaundice goes away on its own as a baby’s liver develops and as the baby begins to feed, which helps bilirubin pass through the body.


What is the cause?
1. Physiological jaundice

This is the most common cause of newborn jaundice and occurs in more than 50% of babies. Because the baby has an immature liver, bilirubin is processed slower.


2) Breast-feeding jaundice

Breast-feeding jaundice may occur when your baby does not drink enough breast milk. It occurs in 5% to 10% of newborns.


3) Breast-milk jaundice

Breast-milk jaundice occurs in 1% to 2% of breast-fed babies. It is caused by a special substance that some mothers produce in their milk. This substance causes your baby's intestine to absorb more bilirubin back into his body than normal. This type of jaundice starts at 4 to 7 days of age. It may last 3 to 6 weeks. It also is not harmful.


Should parents panic?

  • It is normal for babies born at term to have at least some jaundice that affect their eyes and face, and this should not cause any problems. Therefore, it’s nothing to worry about.
  • This is typically seen on the baby’s second or third day of life, and it is called physiological jaundice.
  • Some breast-fed babies may have more jaundice than babies who are not breast-fed, but this should not be a reason to stop breast-feeding.
  • However, talk to your child’s doctor if you have concerns about jaundice and questions related to breast-feeding.
  • If the jaundice is apparent on the first day of a child’s life or it affects the chest or abdomen, it’s a sign the level of bilirubin may be higher than the norm. In this case, the infant should be evaluated by a paediatrician.

Prolonged jaundice ?

  • Other issues could include blood group incompatibility, infection in the blood stream, urine infection, abnormalities of certain enzymes and abnormalities of the red cell membrane.
  • If jaundice is prolonged beyond 2 weeks of life, then problems related to the liver that affect the flow of bile to the intestine will have to be considered. The most common of these is biliary atresia, a disorder that leads to blockage in the bile ducts – the tubes that drain bile from the liver to the intestine.
  • Often, an elevated bilirubin does not lead to any major health problems.
    So for prolonged jaundice we will do thyroid function test, urine test and also liver function
    test.

Treating jaundice

  • Most often, physiologic jaundice does not require treatment and will improve on its own. However, if the jaundice spreads to the chest or abdomen, a pediatrician will need to check the baby’s bilirubin level.
  • Placing the baby under light, called phototherapy, is the most common treatment to lower bilirubin levels – if considered high enough to be treated.

Can newborn jaundice be prevented?

  • Make sure your baby is getting enough nutrition through breast milk. Feeding your baby 8 to 12 times a day for the first several days ensures that your baby is not dehydrated, which helps bilirubin pass through their body more quickly.
  • If you are not breastfeeding feeding your baby formula, give your baby 1 to 2

ounces formula every 2 to 3 hours for the first week. Talk to your doctor if you are not concerned your baby is taking too little or too much formula or if they won’t wake to feed at least 8 times per 24 hours.


Dr Sum Wai Thean

PAEDIATRIC KPJ SEREMBAN SPECIAIST HOSPITAL

MBBS (Melaka Manipal), MRCPCH (UK), MEMBER OF ROYAL COLLEGE OF PAEDIATRICS AND CHILD HEALTH (UK)