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- Jaundice definition
- Jaundice in newborns (neonatal jaundice)
- What causes jaundice in newborns?
- Physiologic jaundice
- Maternal-fetal blood group incompatibility (Rh, ABO)
- Breast milk jaundice
- Breastfeeding jaundice
- Cephalohematoma (a collection of blood under the scalp)
- Red blood cell enzyme defects
- Red blood cell membrane defects
- What are the symptoms of jaundice in newborns?
- What are the risk factors for jaundice in newborns?
- How is jaundice in newborns diagnosed?
- What is the treatment for jaundice in newborns?
- What are the complications of jaundice in newborns?
- Can jaundice in newborns be prevented?
- What is the prognosis of jaundice in newborns?
What are the risk factors for jaundice in newborns?
Approximately 60% of all newborns develop jaundice; however newborns with certain risk factors are at higher risk for developing neonatal jaundice. Risks factors include the following:
- Having siblings who have had neonatal jaundice
- Having parents of East Asian or Mediterranean descent
- Preterm babies
- Newborns with feeding difficulties/poor feeding
- Mother with diabetes
- Newborns with bruising/cephalohematoma
- Blood type incompatibility
- Congenital infection
How is jaundice in newborns diagnosed?
Neonatal jaundice can be diagnosed by examining the newborn and obtaining a blood test to check the total serum bilirubin level. Your health care professional should closely follow your newborn for the development of jaundice, and many hospitals routinely check total bilirubin levels on newborns prior to hospital discharge. Though the blood test is the most accurate, in certain instances, a transcutaneous bilirubin reading can be obtained by placing a handheld sensor against the newborns skin. If this reading is high, a blood test may be ordered to confirm the total bilirubin level. Bilirubin levels are usually highest at 3 of 5 days of life. Additional blood tests may be ordered for those newborns who require treatment and monitoring, or for those who may have other underlying conditions thought to be causing neonatal jaundice.
What is the treatment for jaundice in newborns?
The need to treat jaundice in newborns is determined by interpreting the total bilirubin level in relation to the newborns age in hours. If the level is deemed to be too high, or if it is rising too quickly, treatment is necessary. Sometimes, all that is needed for treatment is close monitoring of the bilirubin levels, and no further interventions may be necessary. In certain instances, treatment for neonatal jaundice can occur at home, while in other cases, admission to a hospital is necessary.
Based on the total bilirubin level, the underlying cause leading to jaundice, and the newborns clinical condition, various treatment modalities are available to treat jaundice in newborns. These include the following:
- Feeding/hydration: By encouraging frequent feeding with breast milk or formula, newborns will produce more stool and urine, and thus eliminate bilirubin more rapidly from the body. Newborns may need to be fed up to 12 times per day, thus ensuring proper hydration and elimination. In certain instances, newborns may require observation in a hospital to receive intravenous fluids and closer monitoring of bilirubin levels.
- Phototherapy: This treatment is the most common for newborns requiring medical treatment for neonatal jaundice. Phototherapy (light treatment) involves placing the newborn under artificial blue lights with the baby undressed (wearing only a diaper) and using a special mask to protect the eyes. This treatment may occur in an open bassinet or warmer, or sometimes with a phototherapy blanket. These special lights work by converting bilirubin to lumirubin through a chemical reaction that occurs when the newborns skin is exposed to these special lights. This allows the newborn to more easily eliminate bilirubin from the body. Care needs to be taken to avoid excessive heat and dehydration. Phototherapy is used in hospitals, and in certain cases, newborns may be treated at home with phototherapy. Generally speaking, phototherapy is very safe and effective, and this treatment is successful for almost all newborns who require it. Phototherapy treatment is stopped once the newborns closely monitored bilirubin levels have decreased to appropriate values.
- Exchange transfusion: This urgent treatment is used in newborns with severe jaundice who may have failed phototherapy treatment or in those who are at higher risk of developing or have signs of kernicterus. During an exchange transfusion, the newborns blood is replaced with donated blood to rapidly decrease bilirubin levels. It is a more specialized procedure that is used on a case-by-case basis.
- Intravenous immunoglobulin: Administering this treatment may be used in select cases of significant neonatal jaundice due to maternal-fetal blood group incompatibility, and it may in some cases reduce the need for an exchange transfusion.