Neonatal jaundice
Jaundice is yellow discoloration of the skin and eye whites. So, jaundice is a symptom, rather than a disease and we can say that someone has jaundice, not that they suffer from jaundice. The yellow color comes from bilirubin, which is a product of the normal breakdown of old red blood cells, and after being "processed" in the liver, it is excreted in the bile and removed from the body through the stool. This normal process may be disrupted for a number of reasons; elevated bilirubin levels lead to neonatal jaundice. In addition to jaundice, the baby sometimes experiences drowsiness or difficulty feeding, and the urine is darker.
Causes of jaundice
Physiological neonatal jaundice occurs because the immature liver is not able to process and excrete bilirubin. It is usually noticed on the second or third day that the baby's face and eye whites are yellowish. Jaundice starts from the newborn's head/face, and if the levels increase, it can be seen on the trunk and extremities. If only the baby's face is yellow, bilirubin levels are certainly significantly lower than if the trunk and legs are yellow.
Breastmilk jaundice occurs due to the presence of inhibitory substances in milk that temporarily disrupt the metabolism and excretion of bilirubin. It usually occurs a few days after birth, does not harm the baby and passes spontaneously, although it can last for several weeks. It is not necessary or recommended to stop breastfeeding during this time!
Jaundice due to blood type mismatch between the mother and child (hemolytic disease of the newborn) is accompanied by other laboratory indicators and requires treatment.
Rare causes of jaundice are infection in the newborn, congenital metabolic disorders or abnormalities of the biliary tract. These are serious, but fortunately extremely rare conditions. Neonatal jaundice is sometimes mistaken for infectious hepatitis, most often caused by viruses, which is extremely rare in newborns.
Is jaundice common in newborns?
About 20% of term babies and 50%, even up to 80% of preterm babies turn yellow two or three days after birth. Most of them are completely healthy and do not require any treatment, and jaundice recedes spontaneously.
What are the risk factors for jaundice?
Preterm birth, birth injuries (cephalohematoma, pronounced suffusions - hemorrhages on the face or other body parts), neonatal jaundice in an older sibling. There is also an increased risk in children who suffered from oxygen deprivation at birth or have an infection.
Measurement of bilirubin concentration
The measurement is performed from the newborn's serum/blood or through the skin. Transcutaneous measurement, although there are some limitations, is a far more practical measurement method, painless for babies, and gives reliable results in children who have not received phototherapy. When the values are significantly elevated or the child has other symptoms, additional laboratory tests are performed.
Why is jaundice treated if it is physiological?
Although neonatal jaundice is most often physiologically caused, values are sometimes so elevated that they pose a potential risk to the newborn and require treatment. Phototherapy effectively lowers bilirubin levels and is safe for the newborn. If the bilirubin levels are very high and accompanied by other disorders, the necessary treatment is applied.
Prevention
Breastfeeding is the most important preventive measure! Breastmilk not only provides the newborn with enough fluids and energy, but also accelerates the "processing" of bilirubin in the liver, owing to its composition. Colostrum stimulates bowel movement and the colonization of the large intestine with desirable probiotic bacteria, which also prevents the occurrence of jaundice.
Giving water or glucose to a newborn who is not dehydrated will not prevent or alleviate jaundice. Never "sunbathe" your baby! Sunlight is not effective in treating jaundice and can be harmful and dangerous for the newborn's delicate skin.
Does the baby need supervision due to jaundice after discharge from the maternity hospital?
If a newborn has any of the risk factors or bilirubin is at the limit values on discharge from the maternity hospital, further monitoring is required. Find out if you can come for a check-up at the maternity hospital, or where the baby will be followed up if the need arises.
You should take the child for a check-up if you notice that he/she is more yellow, especially if he/she suckles less, is sleepy and passive, the urine becomes darker or the stool is pale and colorless.
