Jaundice in babies, also known as neonatal jaundice, occurs in almost half of the newborn babies. Premature babies are more severely affected with neonatal jaundice as compared to babies delivered after completing full-term. The condition is characterized by the yellowing of skin and eyes. Jaundice in babies is due to the presence of high level of bilirubin in the blood. The babies suffering from neonatal jaundice have an ill appearance, improper feeding, and mild fever. The condition is generally diagnosed with physical appearance and by testing blood for bilirubin levels.

Types

Depending upon the cause, neonatal jaundice may be classified into following types:

  1. Physiological jaundice: Physiological Jaundice is the type of jaundice which is caused due to the abnormality in physiological parameters. It is established by high levels of unconjugated bilirubin in the blood. The patient with physiological jaundice has low activity of enzyme glucuronosyltransferase.
  2. Pathological Jaundice: Pathological jaundice is a serious condition and is caused due to liver disease. The rate of increase in bilirubin levels is relatively fast. Immediate medical intervention is required to manage pathological jaundice.
  3. Breast milk Jaundice: This type of jaundice is relatively uncommon and is characterized by the high level of bilirubin in the blood due to inhibition of bilirubin breakdown. A substance present in the mother’s milk prevents the breakdown of bilirubin.
  4. Hemolytic Jaundice: This jaundice is caused due to high red blood cell destruction. The baby’s liver is not able to manage such a large amount of bilirubin, thereby increasing its levels in the blood.

Causes

Neonatal jaundice may be caused due to:

  1. Physiological cause: This is the most common cause of infant jaundice. The liver of infant is not mature enough to eliminate the bilirubin from the blood. This is a harmless condition and is reversed once the liver starts functioning properly.
  2. Blood incompatibility: When there is an incompatibility between the blood of mother and fetus, the rate of hemolysis is high. Hemolysis results in increased bilirubin levels.
  3. Cephalohematoma: Due to various reasons such as bruises, the blood is collected under the scalp. This results in the sudden destruction of red blood cells leading to a high level of bilirubin.
  4. Enzyme defect: Hemolysis is increased in the case of pyruvate kinase and glucose-6-phosphate dehydrogenase deficiency.
  5. Miscellaneous causes: Other reasons for increased bilirubin levels includes infection, polycythemia, hypothyroidism, Crigler-Najjar syndrome, liver diseases, Gilbert syndrome, and thalassemia.  

Symptoms

Following are the symptoms experienced by the patient suffering from neonatal jaundice:

  1. Yellow color on skin, white of the eye and mucous membranes.
  2. Weakness, lethargy, and sleepiness
  3. Inadequate feeding
  4. Dark-colored urine
  5. Pale-colored stool
  6. High-tone Crying
  7. Seizures in severe conditions

How to diagnose

The pediatricians identify the presence of jaundice on the basis of yellow appearance on the skin and in white of the eyes. Blood testing is advised to determine the level of bilirubin in the blood. On the basis of bilirubin levels, the severity of the disease is evaluated.

Blood testing is generally performed 3-5 days after birth. Within this period, the bilirubin levels are highest.

The baby is kept under observation for around two weeks. If the bilirubin levels are stagnant or increased during this period, further testing is advised to diagnose the underlying disease.

Risk neglecting neonatal Jaundice

If the neonatal jaundice is not managed at an early stage, it may lead to the following complications:

  1. Encephalopathy: Most of the symptoms in advanced stages of jaundice is due to encephalopathy. As the high level of bilirubin is toxic to nerve cells, severe jaundice may cause abnormal muscle tone, poor sucking and feeding, and lethargy.
  2. Kernicterus: This is an advanced stage of encephalopathy. If the levels of bilirubin are high in the brain for long period, it may result in permanent brain damage. The risk is high in patients whose bilirubin levels rise at a rapid rate.

Prolonged hyperbilirubinemia may also lead to cerebral palsy and problem in hearing.

Stages

The stages of the jaundice are divided on the basis of severity of the disease, level of bilirubin and period during which the patient suffers from hyperbilirubinemia:

  1. Mild to moderate neonatal jaundice: Mild to moderate jaundice is present in almost 60% of the newborn babies. The level of bilirubin in these patients are highest 3-5 days after birth and the level becomes normal within 12-15 days. This type of jaundice is harmless and temporary.
  2. Severe neonatal jaundice: This stage of neonatal jaundice continues for almost one month and the pre-term babies are most commonly affected. If the severe jaundice is not managed, it may lead to brain damage.

Foods

Following are the food ingredients that can be helpful in managing jaundice:

  1. Ziziphus jujuba fruit extract can be given to the baby.
  2. Infant supplement formula can be given along with mother’s milk.
  3. Few drops of carrot and spinach juice can help manage jaundice.
  4. A small amount of juice such as sugarcane juice, tomato juice, and wheatgrass juice may improve the condition.

Prevention tips

  1. Blood tests during pregnancy: One of the causes of jaundice is blood incompatibility. Thus, mothers with Rh-negative blood and O+ blood group should take extra care.
  2. Pre-term delivery: Premature infants are at higher risk of developing jaundice. The risk of preterm delivery should be reduced. Tobacco, alcohol and certain medication increases the risk of pre-term delivery and should be avoided.
  3. Breastfeed: Although it is recommended to continue to breastfeed while the baby suffers from jaundice, in certain severe cases, doctors recommend additional milk formula until the baby becomes normal.
  4. Light Exposure: Baby, when exposed to ultraviolet light, leads to a reduction in the level of bilirubin.

When to see a doctor

Immediately call the doctor if:

  • Your baby becomes significantly yellow.
  • Your baby shows severe signs of irritation such as high pitch cries
  • Your baby becomes lethargic and has prolonged sleep.
  • Your baby refuses to suck and feed.
  • Any other symptoms which make you more concerned.