Jaundice in newborns

Jaundice in newborns, also known as neonatal jaundice, is a common condition caused by elevated levels of bilirubin in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells. In newborns, jaundice typically occurs due to the following causes:

1. Physiological Jaundice

Immature Liver: A newborn’s liver is not fully developed and may not efficiently process bilirubin, leading to its accumulation.
Increased Red Blood Cell Breakdown: Newborns have a higher turnover of red blood cells, which increases bilirubin production.
This type of jaundice usually appears 2-4 days after birth and resolves within 1-2 weeks.

2. Breastfeeding Jaundice

Occurs in some breastfed babies due to inadequate milk intake, leading to dehydration or insufficient calorie intake, which slows bilirubin excretion.
It typically appears in the first week of life and improves with increased feeding.

3. Breast Milk Jaundice

Caused by substances in breast milk that may interfere with bilirubin metabolism.
It appears after the first week of life and can persist for several weeks but is usually harmless.

4. Blood Group Incompatibility (Hemolytic Disease)

If the mother and baby have incompatible blood types (e.g., Rh or ABO incompatibility), the mother’s antibodies may attack the baby’s red blood cells, causing excessive bilirubin production.
This can lead to severe jaundice and requires prompt treatment.

5. Infections

Neonatal infections (e.g., sepsis, urinary tract infections) can increase red blood cell breakdown or impair liver function, leading to jaundice.

6. Bruising or Birth Trauma

Bruising or bleeding during delivery can increase red blood cell breakdown, raising bilirubin levels.

7. Liver or Biliary Tract Issues

Conditions like biliary atresia (blockage of bile ducts) or neonatal hepatitis can impair bilirubin excretion, causing prolonged jaundice.

8. Genetic or Metabolic Disorders

Conditions like Gilbert syndrome, Crigler-Najjar syndrome, or G6PD deficiency can affect bilirubin metabolism and lead to jaundice.

9. Prematurity

Premature babies are more prone to jaundice because their livers are even less developed than those of full-term infants.

10. Polycythemia

A higher-than-normal number of red blood cells increases bilirubin production as these cells break down.

Symptoms of Neonatal Jaundice

Yellowing of the skin and whites of the eyes (starting from the face and spreading downward).
Poor feeding, lethargy, or excessive sleepiness.
Dark urine or pale stools (in severe cases).

When to Seek Medical Attention

Jaundice appearing within the first 24 hours of life.
Rapid worsening of jaundice.
Poor feeding, lethargy, or high-pitched crying.
Jaundice persisting beyond 2 weeks in full-term babies or 3 weeks in preterm babies.

Treatment

Phototherapy: Exposure to special blue light helps break down bilirubin.
Increased Feeding: Ensures proper hydration and bilirubin excretion.
Exchange Transfusion: In severe cases, to replace the baby’s blood with donor blood.
Treating Underlying Causes: Addressing infections, blood group incompatibility, or other conditions.

Most cases of neonatal jaundice are mild and resolve on their own, but severe or untreated jaundice can lead to complications like kernicterus (brain damage due to high bilirubin levels). Regular monitoring and early intervention are key to preventing complications.