JAUNDICE IN NEWBORN

• Over half of all newborns are jaundiced at some point in the newborn period. The commonest cause is a 'Physiological' jaundice which is harmless and due to a normal liver maturation(in simple terms) process.
• The important point to remember is that Physiological jaundice happens from day 2 or later. Any jaundice seen in the first 24 hours of life needs assessment and investigation by a medical professional. The reasons for early jaundice(within 24 hours of birth) could be anything from blood group incompatibility (between mother and baby) to any type of infection in the baby. A doctor or a midwives' assessment of the baby will specifically look for these type of problems. A clinical examination and some blood tests will help with the diagnosis and guide further management.

• The cut-off points for treating jaundice varies from place to place although there is ample evidence in medical literature about the the small possibility of brain damage related to high levels of the jaundice pigment bilirubin( the unconjugated bilirubin) in the newborn baby.
• Treatment is generally simple- phototherapy(special lights) works well for the vast majority. The doctors will also ensure to exclude other problems like infection and dehydration which can complicate the problem. Occasionally when the bilirubin levels are dangerously high(particularly with blood group incomptibility issues) the doctors might opt to do an exchange transfusion which will aim to replace the baby's blood with new blood in order to reduce the incidence of bilirubin toxicity.

  Practice Points

  Practice tip- If your baby develops jaundice in the first 24hours of age, please get the baby medically assessed immediately.

  Practice tip- If your baby continues to have jaundice beyond 2 weeks of age arrange for an early appointment with your doctor, midwife orhealth visitor.

  Practice tip- The following are some important things thatshould alert you to the baby being unwell-lethargy, poor feeding, very irritable, passing little urine, passingpale stools.

  Practice tip- The yellow discouration is easily seen on the face and eyes. In dark skinned babies, pinching the nose gently will reveal the jaundice easily. In general, if you see yellow below the the level of the baby’s hip, the jaundice levels are likely to be significantly high( jaundice appears first on face and proceeds downwards)