Jaundice in Newborn Babies

JAUNDICE IN NEWBORN BABIES

CONTENT

What is Jaundice

How is jaundice diagnosed

Symptoms

Physiologic Jaundice

Breastfeeding Jaundice

Blood Type Jaundice

Treatment

Remember….

WHAT IS JAUNDICE

1.Jaundice is a common and usually harmless condition in newborn infants.

2.In most babies jaundice occurs because the liver is not yet fully mature or fully functional. This is especially true for the sick or premature baby.

3.All during our life, new red blood cells are being made and old ones are destroyed. As the old red blood cells are broken down (destroyed) a substance in the cells known as hemoglobin is changed by the liver into a yellowish substance called bilirubin.

4.It is the liver’s job to rid the body of the bilirubin. It does this by transporting the bilirubin to the baby’s urine and stool.

5.Until the baby’s liver begins to function fully, bilirubin tends to build up in the bloodstream causing a yellowish appearance to the eyes and the skin.

6.In many cases jaundice is so mild that it will disappear without treatment.

1. If the jaundice is more severe, is present at birth or appears during the first 24 hours of life, treatment probably will be necessary
2. If left untreated jaundice may cause brain damage.

7.There are several types of jaundice:

1. Physiologic Jaundice
2. Breastfeeding Jaundice
3. Blood Type Jaundice.

HOW IS JAUNDICE DIAGNOSED

1. Jaundice is usually diagnosed by measuring the bilirubin level in the baby’s blood.

1. Normal bilirubin levels are based on the baby’s weight and age (in other words the level varies from baby to baby.)

1. When the bilirubin level rises above the normal level for your baby we call this jaundice.

1. We will continue to monitor your baby’s bilirubin level every day until it has returned to your baby’s normal level.

1. If your baby is diagnosed with jaundice the doctor will talk with you about it and explain what treatment(s) he has ordered.

SYMPTOMS

In general, the most common symptoms of jaundice are:

1. Yellowish appearance to the eyes and the skin.

1. Decrease in the baby’s activity.

1. Irritable cry.

1. Feeding problems.

1. Unstable temperature.

PHYSIOLOGIC JAUNDICE

1. Physiologic or normal jaundice usually appears on the 2nd or 3rd day of life in healthy babies born after a full-length pregnancy.

1. It often disappears in one week
2. In many cases it may be very mild
3. We will, however, continue to monitor your baby.

1. Physiologic jaundice may appear later and last longer in the sick or premature infant.

1. It usually appears between the 4th and 7th days of life and may last a month or longer.

1. Physiologic jaundice may disappear without treatment.

1. In some instances, the doctor may suggest giving the baby extra fluids, such as water or sugar water to dilute the bilirubin.

BREASTFEEDING JAUNDICE

1. Sometimes breastfed babies develop jaundice.

1. The reason for this is not always clear but it is thought there may be a substance in the breast milk that either:

1. Interferes with the liver transporting the bilirubin to the urine and stool
2. Increases re-circulation of the bilirubin resulting in reabsorbing the bilirubin.

1. Breastfeeding jaundice usually appears between the 5th to 7th day of life.

1. Breastfeeding jaundice may last for a month or longer.

1. Breastfeeding jaundice may not require treatment but sometimes the baby’s doctor may suggest that breastfeeding be interrupted for a short time.

1. If breastfeeding is interrupted the doctor will talk with you about when to start breastfeeding again.

1. You should maintain your milk supply by emptying your breasts with an electric pump or by hand expression.

BLOOD TYPE JAUNDICE

1. A more serious type of jaundice occurs when the baby’s blood type is different from the mother’s blood type.

1. Two types of jaundice in this group are:

1. ABO incompatibility: a difference in the blood type between the mother and the baby.

• Jaundice may be present at birth.

1. Rh incompatibility: a difference in the Rh factor between the mother and the baby. This occurs when the mother has Rh-negative blood and the baby has Rh-positive blood.

• This type is the more severe.

1. If either of these types of jaundice occurs in your baby, the doctor or nurse practitioner will talk with you about it.

1. These two types of jaundice almost always appear in the 1st 24 hours of life.

TREATMENT

1. Whether or not babies receive treatment for jaundice depends on the baby’s age, weight, and the type of jaundice.

a.Remember that treatment varies from baby to baby.

1. When a baby’s jaundice does require treatment, the baby is placed under a special light called phototherapy. This helps to speed up the removal of bilirubin from the baby’s body.

1. Phototherapy is a special, high-intensity light that appears white or blue. This is done using either a “bili blanket” or a “bililight.”

1. The baby’s doctor or nurse practitioner will talk with you about phototherapy.

1. During Phototherapy:

1. All the baby’s clothes are removed

1. Special eye patches are used to cover and protect his/her eyes from the bililight

1. Baby is kept warm in an isolette

1. Phototherapy iscontinued until the amount of bilirubin in the baby’s blood reaches and stays at or near the baby’s normal level.

1. The bilirubin level is checked regularly by testing a small sample of blood.

1. Some babies may need to stay in the hospital for a day or two after the phototherapy is finished. This is to make sure the bilirubin level doesn’t rise again.

1. Babies with severe ABO or Rh incompatibility may need different and more rapid treatment. The most common and effective is an “Exchange Transfusion.”

1. Exchange transfusions are safe and successful in lowering the baby’s bilirubin
2. Usually an exchange transfusion will result in a sudden and rapid fall (return to normal level) in the bilirubin
3. If an exchange transfusion is needed the baby’s doctor or nurse practitioner will talk with you about it.

REMEMBER….

1. Don’t be alarmed if your baby has jaundice.

1. Jaundice in newborn babies is very common, especially in premature or sick infants
2. In the majority of instances, the condition is normal, harmless and temporary
3. When treatment is necessary, the methods are safe and effective.

1. If you have any questions about jaundice and your baby’s condition, please talk with your baby’s nurse, the nurse practitioner or the doctor.

Reviewed/Revised: 02/9………06/13

Jaundice 1