Baby Jaundice

The First Week -
Baby Jaundice

During the first week Yana had baby jaundice. It continued much longer than 2 weeks and yet it turned out normal and without lasting effect on the baby.

Jaundice is a normal event and is not serious in most cases. It disappears in 1-2 weeks and there is no need of special treatment. Also it does not have any lasting effect on the baby.

Bilirubin is created when red blood cells break down. When the red blood cells become old, they are destroyed and release haemoglobin. Hemoglobin is the iron-containing chemical that carries oxygen. After the iron is removed, another chemical remain in the blood - it is bilirubin. Normally newborns have a high level of red blood cells. This makes bilirubin more. Normally this bilirubin goes through the liver and is expelled as bile through the intestines. Jaundice occurs when bilirubin builds up faster than the liver of the baby can break it down and excrete it from the body.

The cause of physiological jaundice is that during life in the uterus, the red blood cells of the fetus contain a type of hemoglobin that is different than the hemoglobin after birth. The body of the baby begins rapidly to destroy the red blood cells containing the fetal-type of haemoglobin and produces red blood cells with adult-type hemoglobin. In a newborn the liver is still developing and cannot remove all the bilirubin from the blood. The level of bilirubin is too high to be properly processed by the liver. A large amount of bilirubin is reabsorbed from the intestines, before it passes from the body. Within two or three weeks, the destruction of red blood cells ends, the liver matures and the levels of bilirubin return to normal.

When there is jaundice the stool becomes light in color, not brown as when bilirubin is excreted. My daughter Yana when she had jaundice has yellow stool. The urine got dark or brownish when the bilirubin started passing from the body.

Not a common syndrome is breat-milk or breast feeding jaundice. It appears that jaundice might be accentuated by breast feeding. The cause of this kind of jaundice is unknown, but it is supposed that there is something in breast milk which reduces the ability of the liver to process and eliminate bilirubin. With breast-milk jaundice the timing of elevation of bilirubin is different than normal jaundice. Bilirubin rises and achieves pick levels in approximately 2 weeks and declines to normal over the next weeks or months. Breast-milk jaundice alone does not cause any problems to infants.

High levels of bilirubin and prolonged jaundice might cause neurological damage to an infant. This is the reason why jaundice is often treated to prevent this to happen. Phototherapy with artificial or natural sunlight is the most common treatment. If it is not successful, exchange transfusion (replacement of the infant’s blood with normal blood from donors) is applied.

Physiologic and breast-milk jaundice are different from hemolytic disease. This is a serious, sometimes life-threatening cause of jaundice in the newborn. It is caused by blood group incompatibilities between mother and fetus, usually Rh incompatibility. It leads to an attack of the mother's antibodies on the babies’ red blood cells. Because of modern management of pregnancy this cause of jaundice is rare.

Jaundice occurs frequently in premature babies. The reason is that they take longer to adjust to excreting bilirubin effectively.

In rare cases the jaundice might be caused by liver disease. In this case there are symptoms like fatigue, swelling of the ankles, muscle wasting, and fluid accumulation in the abdominal cavity, mental confusion, and coma or bleeding into the intestines.

If the cause of jaundice is blockage of the bile ducts, no bile is released into the intestines. Without bile fats cannot be digested and vitamins are not processed and absorbed into the body. So there might be vitamin deficiency. When vitamin K is missing, the liver does not produce proteins needed for normal clothing of blood. The result is uncontrolled bleeding.

When should you call the doctor?

If the jaundice is noted during the first 24 hours of life; The jaundice goes down to arms and legs The baby has fever - body temperature over 100 degrees Fahrenheit or 37.8 degrees Celsius If the child looks or acts sick. In children under 5, temperature is taken aurally or rectally If the jaundice is not gone after day 15; The baby is not gaining sufficient weight.

Be patient, and know that once the bilirubin level drops, it is unlikely to increase again.

I know it hurts to see your baby with jaundice, you can read some general treatments here, but if you are concerned contact your doctor.

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