New Born Juandice

New born jaundice is when a baby has a high level of bilirubin in the blood.
High levels of bilirubin make your baby’s skin and whites of the eyes look yellow.
Jaundice is a common and usually harmless condition in new born babies, however it is important to determine whether your baby requires treatment or not.

Causes
When the baby is growing in the mother’s womb, the placenta removes bilirubin from the baby’s body. After birth it is normal for a baby’s bilirubin level to be a bit high.

Bilirubin is a yellow substance that the baby creates when it replaces old red blood cells.
The liver helps break down the substance so it can be removed from the body in the baby’s bowel movements. The liver in the new born is not fully developed so it is less effective at removing the bilirubin from the blood.

Physiological Jaundice
Most new born babies have some yellowing of the skin or jaundice, this is called physiological jaundice. It appears around day 2-4. By the time the baby is 2 weeks old the liver is working more effective and the jaundice corrects itself without causing any harm.

Breastfeeding
For reasons that are unclear breastfed babies are at an increased risk of developing jaundice, however in most cases the benefits of breastfeeding far outweigh any risks associated with jaundice.

Two types of jaundice may occur in breast fed babies. Both types are most often harmless.
• Breastfeeding jaundice is seen in breastfed babies during the first week of life. It is more likely to occur if babies are not feeding well or if mum’s milk is slow to come in.
• Breast milk jaundice can occur in healthy breastfed babies after 7 days old. It can often peak during week 2 to week 3 and can last for a month or more at very low levels. The problem is due to how the breast milk may affect the breakdown of bilirubin in the liver.
Breast milk jaundice is different to breastfeeding jaundice.

In a small number of cases jaundice can be a sign of an underlying health problem.
This is sometimes the case if the jaundice develops shortly after birth within the first 24hours.

Examinations and Tests

Your midwife and doctor will watch for signs of jaundice both in the hospital and after you go home with your baby.
Any baby who appears jaundiced should have their bilirubin level measured.
This can be done with a blood test.
Further tests may be needed for babies who need treatment or whose bilirubin levels are rising.

Treatment

Most cases of jaundice in babies do not need any treatment as the symptoms normally pass within 10 – 14 days.

When treatment is required the type depends on;
• The baby’s bilirubin level
• How fast the level is rising
• If the baby was born early
• How old the baby is

A baby will need treatment if the bilirubin level is too high or is rising quickly.
A baby with jaundice needs to be kept well hydrated with frequent feeding.
By feeding the baby every 2 hours it will encourage more frequent bowel movements and it is through the bowel movements that helps remove the bilirubin.

The 2 main treatments that can be carried out in hospital to quickly reduce the baby’s bilirubin levels are:

• Phototherapy- a special type of light shines on the baby’s skin, and this alters the bilirubin into a form that can be more easily broken down by the liver
• For more severe jaundice- An exchange transfusion – a type of blood transfusion where small amounts of your baby’s blood are removed and replaced with blood from a matching donor.

Most babies respond well to treatment and can leave hospital after a few days.

If you are ever concerned about your baby’s jaundice have your baby examined by a midwife or doctor to check if treatment is required.