Jaundice in Newborn Babies - How to Identify it Early

Jaundice a common condition among newborns caused by excess of bilirubin in the blood leads to yellow color of the skin and whites of the eye. Affecting around 9/10 newborns on the 2nd or 3rd day after birth it will reach its peak around the 4th day and would normally disappear in 2 weeks of age. Bilirubin  that is produced by the normal breakdown of red blood cells normally passes through the liver to the intestines as bile that aids digestion; however newborns build up bilirubin faster than a their liver is able to break it down and pass it from the body.

There are 3 main reasons for jaundice in newborns. First newborns have a higher turnover of red blood cells than adults and make more bilirubin. Secondly the developing liver of a newborn is not able to remove enough bilirubin from the blood. Thirdly a newborn’s intestine absorbs bilirubin that would normally leave the body as stools or poop.

It is very important that liver disease is identified and treated promptly; severe jaundice not treated promptly would lead to deafness, cerebral palsy, or other forms of brain damage, with jaundice in rare cases being a sign of infection or thyroid problem.

Here are some signs to identify newborn jaundice early:

 
• Prolonged jaundice persists beyond 2 weeks of age in term babies and 3 weeks in pre-term babies. Newborn jaundice appears   around the 2nd or 3rd day, with the baby’s skin on the face appearing yellow at first, followed by the chest, stomach and finally the legs. Sometimes the eyes of the baby also look yellow. Jaundice in babies with dark skin can be ascertained by gently pressing the skin on your baby's nose or forehead; jaundice is indicated by the skin appearing appear yellow when you lift your finger.

• Look out for persistent pale colored stools; stools of healthy bottle fed babies are English mustard yellow and daffodil yellow in breast fed babies. The color of urine other than colorless indicates jaundice or liver disease.

• Newborns with prolonged or persistent pale stools or urine indicate liver disease or jaundice; they should be urgently referred for special blood test called a split bilirubin blood test.  Sometimes a light meter may be used to get an approximate measurement before taking a blood sample.

A doctor’s prompt attention is required if:

• A newborn has jaundice during the first 24 hours.

• The baby has a temperature over 100°F (37.8°C) rectally.

• The jaundice is spreading or getting darker and more intense.

• The baby starts to look or act sick.

• The newborn is sleepier than usual.

• The baby is not feeding well.

Usually mild and moderate jaundice would go away on its own in 1 or 2 weeks as the baby’s body is able to get rid of the excess bilirubin.  Mothers may be recommended to give more frequent feedings of breast milk or formula to help eliminate bilirubin in their stools. However in some cases, the doctor may ask a mother to temporarily stop breastfeeding and then start nursing again once the jaundice has cleared. In severe cases phototherapy and blood transfusion may be recommended.

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