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Jaundice In The Newborn
Jaundice In The Newborn

What is Jaundice?

Jaundice is the term used to refer to a yellow or orange discoloration of the skin and the white part of the eyes. It results from having too much bilirubin in the blood. Bilirubin is formed when the body breaks down old blood cells. The yellowish discoloration starts at the face and spreads to the rest of the body as the level of bilirubin increases.

What causes jaundice?

Your baby’s body recycles some red blood cells each day. Bilirubin is a yellow substance that forms as red blood cells break down. During pregnancy, your liver removes bilirubin for your baby. After birth, your baby’s liver may not be developed enough to properly remove bilirubin on its own. It can take a few days for your baby’s liver to be able to do this.

When a baby’s liver causes jaundice in the first days of life, it’s called physiologic jaundice. This is the most common kind of jaundice in newborns. But sometimes a health condition in your baby can cause jaundice. These conditions include:

  • Blood type mismatches, like Rh disease. A small number of babies have different blood types than their mothers. These mismatches can lead to a faster breakdown of red blood cells.
  • Internal bleeding. This is bleeding inside the body.
  • A problem with your baby’s liver. Your baby’s liver may not work well if he has an infection, like hepatitis, or a disease, like cystic fibrosis, that affects the liver.
  • A problem with your baby’s red blood cells. Some babies have too many red blood cells. This is more common in some twins and babies who are small for gestational age (37 week).
  • A genetic condition, like G6PD deficiency. This condition is when your body doesn’t have enough G6PD, an enzyme that helps your red blood cells work the right way.
  • An infection, like sepsis. This is an infection in your baby’s blood.
  • Bruising at birth. A bruise happens when blood leaks out of a blood vessel. Sometimes babies get bruises during labor and birth. When large bruises heal, bilirubin levels may rise.
  • Breastfed babies, especially babies who aren’t breastfeeding well. If you’re breastfeeding, feed your baby when he’s hungry. For most newborns, this is once every 2 to 3 hours (about eight to 12 times each day). Feeding this often helps keep your baby’s bilirubin level down. If you’re having trouble breastfeeding, ask your baby’s provider, a nurse or a lactation consultant for help.

How do you know if your baby has jaundice?

When a baby has jaundice, a yellowish color usually first appears on his face. It then may spread to his chest, belly, arms, legs and white parts of his eyes. The best way to see jaundice is in good light, like in daylight or under fluorescent lights. Jaundice can be harder to see in babies with darker skin.

A.    Call your baby’s health care provider right away if your baby:

  • Looks very yellow, orange or greenish-yellow
  • Is hard to wake up or won’t sleep at all
  • Has trouble breastfeeding or sucking from a bottle
  • Is very fussy
  • Has too few wet or dirty diapers

B.    Take your baby to the hospital if he:

  • Won’t stop crying or has a high-pitched cry
  • Arches backward
  • Has a stiff, limp or floppy body
  • Has strange eye movements

These may be warning signs of dangerously high levels of bilirubin that need quick treatment to prevent kernicterus (brain damage caused by high bilirubin levels).

Why is jaundice a concern?

Most infants have jaundice that is harmless, but in unusual situations the bilirubin levels can get very high and cause brain damage. This is called kernicterus.

How is jaundice diagnosed?

Diagnostic procedures for jaundice may include:

  • Physical exam. Your baby’s provider checks your baby’s body for signs of jaundice.
  • A blood sample is taken from the baby to measure: o Bilirubin levels o red blood cell counts o blood type and testing for Rh incompatibility (Coomb's test)

What are the treatments for jaundice?

A.    Phototherapy:

Phototherapy involves exposing the baby to a special fluorescent light. The special light transforms the bilirubin into a form that the body can quickly eliminate. The baby is either placed under special lamps or on a blue light emitting blanket (biliblanket). As much as possible of the baby’s skin is exposed to the light. The eyes and the genitalia (in males) of the baby are covered to protect them from the light.
B.    Exchange transfusion:
If phototherapy doesn’t work and your baby’s bilirubin levels are still very high, she may need a special type of blood transfusion called an exchange transfusion. An exchange transfusion gets rid of bilirubin by replacing your baby’s blood with fresh blood in small amounts.
C.    Intravenous immunoglobulin (also called IVIg):
If you and your baby have different blood types, your baby may get immunoglobulin (a blood protein) through a needle into a vein. This can help her treat her jaundice so that she’s less likely to need an exchange transfusion.

Home redeem

A.

Sunlight helps to break down indirect bilirubin so that a baby's liver can process it more easily: Place the child in a well-lit window for 10 minutes twice a day is often all that is needed to help cure mild jaundice. Never place an infant in direct sunlight.

B.

The best thing you can do to reduce jaundice is to make sure that your baby gets enough to eat. That will help your baby's body get rid of the extra bilirubin.

  • If you are breast-feeding, feed your baby about 8 to 12 times every 24 hours.
  • If you are feeding your baby from a bottle, stay on your schedule (usually about 6 to 10 feedings every 24 hours).
  • If you aren't sure that your baby is getting enough milk, ask your doctor, a nurse, or a lactation consultant for help.

Does my Insurance Policy cover jaundice?

Yes. According to CCHI unified Policy terms and conditions, health insurance policies in Saudi Arabia cover jaundice.

Please Click Here to access the Unified CCHI Policy Wordings.

References:

"Newborn Jaundice". Newborn Jaundice. N.p., 18 Feb. 2016. Web. 11 Oct. 2016.
"New Born Jaundice." Infant Jaundice: Causes, Symptoms and Treatments. N.p., 28 Aug. 2015. Web. 16 Oct. 2016.
"Newborn Jaundice." Newborn Jaundice. N.p., Apr. 2013. Web. 16 Oct. 2016.
"Newborn jaundice." Rules. N.p., n.d. Web. Oct. 2016.
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