Jaundice is a common condition in newborn infants that is commonly noticed shortly after birth. In most cases, it goes away on its own. Hence it is also called physiological jaundice.
A baby has jaundice when bilirubin, a yellow pigment which is produced naturally by the body, builds up faster than the baby's liver can break it down and get rid of it in the baby's stool. Excessive bilirubin makes the baby's skin look yellow. The discolouration appears first on the face, then on the chest and stomach and, finally, on the legs. This happens because of one or more of the following reasons:
The baby's developing liver is not yet able to remove the bilirubin from the blood.
More bilirubin is being made than the liver can handle
Too much of the bilirubin is reabsorbed from the intestines before the baby gets rid of it in the stool.
What is bilirubin?
The red cells in the blood contain a red pigment called haemoglobin, a substance that helps transport oxygen in the blood. The red blood cells live for a short time and, as they die, the haemoglobin is changed to the yellow pigment called bilirubin. Normal newborns have more bilirubin because their liver is not efficient at removing it. Older babies, children, and adults get rid of this yellow blood product quickly, through the bile that passes from the liver to the intestines.
Is jaundice harmful to the baby's health?
Jaundice can be dangerous if the bilirubin level in the blood is very high. This danger level varies depending on the baby's age, whether the baby was premature, and if there are other medical conditions. High levels of bilirubin can affect the brain causing fits.
How is it diagnosed?
The yellow discolouration is first detected in the whites of the eyes. Later the skin may show the yellow colour. This must be seen in daylight or in a room that has fluorescent lights. A small sample of the baby's blood can be tested to measure the bilirubin level to confirm jaundice. If the jaundice persists beyond the period of normalcy, other tests may be needed to determine the cause.
How is it treated?
Mild to moderate levels of jaundice do not require any treatment particularly if the baby was born at full term. If high levels of jaundice do not clear up on their own, the baby may be treated with special lights or other treatments. These special lights help get rid of the bilirubin by altering it chemically so that the baby's liver may be able to get rid of it easily. This treatment is called phototherapy and may require the baby to stay in the hospital for a few days.
Rarely, babies may require treatment of their blood to remove bilirubin. In cases with very high bilirubin levels, a blood exchange is done to give the baby fresh blood and remove the bilirubin. Once the bilirubin level comes down, it is unlikely that it will increase again. However, if the child continues to look yellow after 3 weeks of life, the paediatrician should be consulted to determine if there is some other disease process causing jaundice.