Jaundice refers to the “yellow discoloration” of skin and the white of the eyes caused by excessive bilirubin in the blood. This bilirubin is produced by the breakdown of the red cells in the blood.
Normally, bilirubin passes through liver and is excreted as “bile” through the intestines but it occurs in all newborns as it accumulates faster than it can be excreted. Reasons for this are-
- Newborns make more bilirubin than adults as the life span of their red blood cells is less so there turnover is more than adults.
- A newborn’s liver is still immature at birth to excrete this bilirubin faster.
- Larger than normal amount of bilirubin is reabsorbed from intestines before baby gets rid of it via stool
Jaundice which appears within 24 hours of birth is always “abnormal” and suffering child should always be immediately shown to his pediatrician who should get it thoroughly investigated and treated. High levels of serum bilirubin in newborn babies can cause serious complications like deafness, cerebral palsy and even death.
Levels above 20 mg/dl are considered abnormal and sometimes, exchange transfusion, is done in such cases to prevent mentioned complications. The risk is further accentuated in pre-term, low birth weight and infected babies. Intervention is required at much lower levels of serum bilirubin in such babies.
Physiological Jaundice is the name given to jaundice seen in most newborns between 48 to 72 hours of age. It usually completely disappears by 2 weeks of age. It mainly occurs due to immaturity of liver.
Breastfeeding jaundice occurs in newborns not getting enough breast milk to feed and not due to breast milk itself.
Breastmilk Jaundice is a diagnosis made by excluding all other causes. It is caused by substances present in breast milk itself. It may take 3-12 weeks to resolve itself but is usually “benign”.
Blood Group incompatibility between baby and mother, usually seen in mothers having Rh-ve or O blood group, is another serious cause of jaundice in newborns due to antibodies produced by the mother against baby’s blood group. It usually appears within 1st 24 hours after birth.