Jaundice in Newborns
Jaundice, or an overabundance of bilirubin in the blood, is a common ailment for otherwise healthy newborns. It is so common in fact that most doctors will check for it as a cautious preventative test as opposed to waiting for symptoms to develop. Despite how regularly doctors may see this, we understand that this is likely your first newborn, and you may be a bit alarmed at the diagnosis. Here’s a look at why jaundice happens and how it’s treated in newborns.
Bilirubin is produced as a byproduct of the healthy breakdown of red blood cells. In most cases, the bilirubin will pass through the liver, ultimately going into the small intestines as bile. In the case of newborns, it is quite common that the body begins accruing bilirubin in the blood more quickly than your child’s tiny liver can break it down. The result is a yellowing of the skin and, in some cases, the whites of the eyes.
Newborns do tend to create more bilirubin than adults, as their red blood cell turnover is greater than that of an adult. Their still-developing livers may be unable to remove enough of the bilirubin to prevent jaundice or, in some cases, bilirubin that does make it to the intestines is absorbed and not passed through the stool.
Typically doctors report seeing five types of jaundice. These include:
- Normal (Standard)- Appearing within the first days of life and up to two weeks of age, this form of jaundice is generally the result of a still developing liver.
- Prematurity Jaundice- When a baby is born prematurely, the liver is even less developed and jaundice is often observed. Many doctors will treat for jaundice even when bilirubin numbers remain in acceptable ranges with premature births.
- Breastmilk Jaundice- If you offer your newborn breast milk, doctors can occasionally see a jaundice issue arise as the result of insufficient breastmilk. This does not denote a problem with the milk itself, just the supply. Generally parents will be advised to seek out a lactation specialist for help.
- Blood Group Incompatibility- If an Rh negative woman carries a child who is Rh positive the woman’s blood may begin producing antibodies that destroy red blood cells in the newborn. This type of jaundice was once the most severe of forms, but is now rarely an issue due to Rh immune-globulin (Rhogam) injections given early in the pregnancy.
Despite newborn jaundice being a very popular diagnosis, it still carries risks. High levels of jaundice, generally any diagnosis above 25 mg, can lead to deafness, cerebral palsy, or brain damage if left untreated. If the bilirubin levels do not level out, or if a more severe case is diagnosed, the child may be treated with phototherapy. Phototherapy places the child under a special light in order to rid the body of bilirubin. In rare, severe cases a blood transfusion may be needed.
It is more common, however, for a child to have a mild case of jaundice. Most normal cases of mild to moderate newborn jaundice will not require treatment beyond observation and monitoring, often self-correcting within one or two weeks of life.