Neonatal Jaundice

What Is Neonatal Jaundice?

The most common condition that requires medical attention and hospital readmissions in newborns is Neonatal jaundice – sometimes referred to as infant jaundice. It is the yellow discoloration of a newborn baby’s skin and eyes. Neonatal jaundice is a condition, especially in babies born before 38 weeks gestation.

Physiologic And Non-Physiologic Jaundice

Physiological Jaundice is sometimes referred to as ‘normal’ jaundice. This is the most common type of jaundice, affecting up to 60 percent of full-term babies in the first week of life. This type of jaundice occurs more than 24 hours after a baby is born.

Non-physiological Jaundice occurs much sooner, with infants developing jaundice less than 24 hours after birth. In these cases, an infant’s levels of bilirubin tend to be much higher than physiological jaundice.

Signs and Symptoms of Neonatal Jaundice

The main symptoms of neonatal jaundice are yellowing of the skin and the whites of the eyes. This typically occurs between the second and fourth day after birth.

You can check for neonatal jaundice by gently pressing on your baby’s nose or forehead. If the skin looks yellow where you pressed, it’s possible that your baby has a mild form of jaundice.

Causes of Neonatal Jaundice

Neonatal jaundice is caused by excess bilirubin, which is a yellow pigment of red blood cells. Often times, a newborn baby’s liver is not mature enough to rid the body of the bilirubin in the bloodstream, leading to neonatal jaundice. This is most common in preterm babies, especially babies who are born before 35 weeks.

In some babies, an underlying condition or disease may cause neonatal jaundice, including:

• Liver malfunction
• Enzyme deficiency
• Abnormality in the red blood cells
• Incompatibility between the baby’s blood and the mother’s blood
• Internal bleeding
• Blood infection
• Bacterial or viral infection

How Is Neonatal Jaundice Diagnosed?

Your doctor will likely diagnose neonatal jaundice on the basis of your baby’s appearance. It is still necessary to measure the level of bilirubin in your baby’s blood to determine the severity of jaundice and the appropriate treatment.

How Long Does Jaundice Last in a Newborn?

Jaundice typically occurs between two and four days after birth. Physiological jaundice typically goes away within one to two weeks but can last longer in some cases. You may notice your baby’s jaundice symptoms peak at five to seven days and then lessen over the following month.

Neonatal Jaundice Risk Factors

Certain factors can put your baby at a greater risk for jaundice, which can include complications. These factors include:

The Mother’s Blood Type: Sometimes, if a mother’s blood type is different than her baby’s, the baby can receive antibodies via the placenta. These antibodies can cause an abnormal, rapid breakdown of the red blood cells.

Breastfeeding: Babies who are breastfed – in particular, those who have trouble getting enough nutrients via breastfeeding – are at a higher risk for jaundice. This is typical because nursing difficulty can lead to dehydration and low caloric intake, which can contribute to the onset of jaundice. Still, doctors recommend breastfeeding due to its vast benefits.

Bruising During Birth: Sometimes newborns can bruise during delivery, which can cause a higher level of bilirubin due to the breakdown of more red blood cells.

Premature Birth: Babies born before 38 weeks of gestation have a greater risk of jaundice. This is often influenced by lower caloric intake and fewer bowel movements, which result in less bilirubin being eliminated.

Neonatal Jaundice Complications

Sometimes, high levels of bilirubin can cause severe jaundice. Severe jaundice can lead to serious complications, including:

Acute Bilirubin Encephalopathy

Bilirubin is toxic to the brain cells. Severe jaundice poses a greater risk of bilirubin affecting the brain, but quick treatment can prevent lasting damage. Signs of acute bilirubin encephalopathy include:

• Fever
• Trouble waking
• High-pitched crying
• Poor feeding or sucking
• Backward arching of the body

Kernicterus

If acute bilirubin encephalopathy causes damage to the brain, a syndrome known as kernicterus can occur. Kernicterus can result in the following:

• Hearing damage
• Permanent upward gaze
• Improper development of tooth enamel
• Athetoid cerebral palsy causing involuntary movements

Preventing Neonatal Jaundice

Jaundice is best prevented by adequate feeding. Infants who are breastfed should have eight to 12 feedings every day during the first days after birth. If you are using a formula for feeding, infants should have one to two ounces of formula every two to three hours during the first week after birth.

Neonatal Jaundice Treatment

If your baby is diagnosed with neonatal jaundice, your doctor will decide the best treatment based on how severe the levels of bilirubin are. Treatment typically includes:

Light Therapy

Special lamps that emit light on the blue-green spectrum help change the shape and structure of bilirubin molecules. In doing so, your baby’s body can excrete excess bilirubin via urine and stool. During this treatment, your baby will simply wear a protective eye covering and a diaper.

Intravenous Immunoglobulin

Sometimes jaundice occurs due to a difference in blood types between mom and baby. When this is the case, intravenous immunoglobin may be the best option. This treatment transfuses a blood protein called immunoglobin into your baby. The transfusion helps reduce the levels of antibodies, decreasing jaundice.

Exchange Transfusions

This treatment is rare but used if your baby doesn’t respond to other types of treatment. This treatment involves withdrawing small amounts of blood from your baby and replacing it with donor blood. This dilutes the bilirubin and maternal antibodies. This procedure is performed in the neonatal intensive care unit.

Contact Sonas for Pediatric Home Health Care Services in Florida

If you need assistance in caring for your newborn with a medical condition, we are here to help. At Sonas Home Health Care, we have an entire team of experienced caregivers to ensure the wellbeing of our pediatric patients. Contact us or call us today to learn more.

If you are considering pediatric home health care services in Florida, contact the caring staff at Sonas Home Health Care. Call today (888) 592-5855.

Jillian Miller BSN, RN

Director of Nursing at Sonas Home Health Care

This blog was reviewed by Jillian Miller BSN, RN — Director of Nursing for Sonas Home Health Care’s Tampa Bay market — for clinical accuracy. Jillian Miller has been a nurse for 16 years — working primarily in pediatrics. She believes the best part of working with the pediatric population is when you see smiles from clients when you first enter the room. She loves seeing the difference you can make in families’ lives while providing the best care possible for them.