What Is Neonatal Jaundice?

What Is Jaundice?

Neonatal jaundice is a condition seen in two thirds of babies that resolves on its own but may nevertheless lead to serious problems. As jaundice becomes more severe, the colour change appears first on the face, then the trunk, the arms and legs, and finally the palms and soles. Recovery proceeds from the feet towards the head, and the white of the eye is the last to clear.

Deciding which babies are affected to a degree that requires treatment is an important criterion here. To make the diagnosis, follow-up must always be carried out by a healthcare professional.

This condition is evaluated in two separate groups: physiological and pathological jaundice. The bilirubin level is assessed by taking into account the baby's gestational age, age in days and risk factors. In this way, it is decided whether the jaundice is pathological or not.

Types of Jaundice

Physiological jaundice begins on the 2nd-4th day after birth and usually resolves on its own within 7-10 days without any treatment. Bilirubin in the blood of a baby in the womb does not harm the fetus, because it passes through the placenta into the mother's blood and is processed in her liver and eliminated from the body.

While the bilirubin in the baby's blood begins to rise gradually after birth, this temporary condition is called physiological jaundice. For many babies, physiological jaundice can pass without treatment; nevertheless, regular medical supervision during this period is essential.

Pathological jaundice is a condition that often appears right after birth and must be taken seriously. This type of jaundice can result from blood group incompatibility between mother and baby, certain infections the mother had during pregnancy, medications taken by the mother, or the baby's congenital lack of certain substances.

In addition, the condition defined as "prolonged jaundice" refers to jaundice lasting longer than two weeks in full-term babies and longer than three weeks in premature babies. This condition needs to be evaluated in detail and its causes identified. In prolonged jaundice, direct bilirubin should also be measured; if the stool is pale-colored or the urine is dark, see a doctor immediately.

 

What Causes Jaundice?

Many factors, such as genetic causes, inadequate feeding, and premature or late birth, play a major role in the development of neonatal jaundice. At this point, families need to be attentive and consult a doctor immediately when they notice the symptoms.

Neonatal jaundice is a type of jaundice that occurs when the substance called 'bilirubin' rises in the blood and accumulates in areas such as the skin, the inside of the cheeks and the white of the eye. This shows itself as yellowing of the baby's skin and eyes.

What Are the Risk Factors for Jaundice?

The babies in the risk group for neonatal jaundice are as follows:

1. Premature birth,
2. Babies with sucking problems who consequently cannot feed well,
3. Those with blood group incompatibility with the mother,
4. Those who had bleeding under the scalp during birth,
5. Those in whom jaundice is detected in the first 24 hours,
6. Babies of diabetic mothers,
7. Those whose jaundice lasts longer than two weeks,
8. Babies whose older siblings had jaundice severe enough to require phototherapy in infancy.
9. Babies with G6PD deficiency or a family history of favism are at risk of severe jaundice; they should be monitored closely.

 

What Are the Symptoms of Neonatal Jaundice?

Neonatal jaundice starts on the face, after which the whites of the eyes turn yellow too. As the bilirubin level in the blood rises, it spreads in sequence to the chest, abdomen, arms and legs.

1. The yellow colour of the skin is best seen in daylight or under a fluorescent lamp.
2. When the skin of the nose or abdomen is lightly pressed with a finger and released, the yellow colour can be detected more clearly. The jaundice on the baby's skin gradually deepens and becomes more pronounced.
3. A baby with jaundice tends to sleep more and suckles less.
4. If jaundice is present on the baby's abdomen, arms and legs, and it is noticed that the baby sleeps a lot and sucks weakly, parents should consult a doctor immediately, no matter how many days old the baby is. This is because these symptoms may indicate that the bilirubin level has risen.

 

 

How Is Neonatal Jaundice Diagnosed?

In newborns, it is of great importance that parents notice the jaundice and consult a physician, that the diagnosis is clarified and that treatment is started if necessary; when jaundice treatment is delayed, a disease called kernicterus, which can cause serious damage to the nervous system, may develop in the baby.

Among the tests performed in newborns, ABO and Rh blood group incompatibility between mother and baby is determined, and the baby is monitored because of the risk of early jaundice. Before discharge, the babies' blood counts and jaundice levels are checked. When jaundice is suspected the bilirubin level in the blood can be measured quickly with a few drops of blood taken from the heel.

 

How Is Neonatal Jaundice Treated?

The need for treatment is determined according to 3 parameters: the baby's weight, age in days and the bilirubin level in the blood. The paediatrician decides whether treatment is needed by taking these parameters into account.

Neonatal jaundice usually resolves on its own within two weeks. However, appropriate follow-up by a doctor during this period is important.

If the bilirubin level is high, the baby is given light treatment under lamps that emit light of a special wavelength, called "phototherapy". This light makes the bilirubin that causes the jaundice dissolve in the urine and be eliminated from the body.

Phototherapy does not harm the baby in any way. The baby's eyes are covered to protect them from the light. Occasionally, red skin rashes, tanning, or frequent watery stools may be observed as side effects.

In babies whose bilirubin level has risen very high due to blood group incompatibility, an exchange transfusion may be necessary. Breastfeeding is important in preventing jaundice. For this reason, breastfeeding should be started as early as possible, preferably within the first hour after birth.