Sunday, July 25, 2021

Jaundice

This is an INFORMATION page, verified by physician

Many new-born babies (up to 60%) become jaundice. This is usually identified in a yellow colour of the eyes or skin. It can have many causes, but generally it is not a significant cause for concern.

Jaundice is caused by a chemical in the body called bilirubin. Bilirubin comes from red blood cells as they break down in the body. At birth babies have much higher numbers of red blood cells. These break down at a faster rate than even a few weeks after birth.

Before birth bilirubin is cleared from the baby’s body through the mother’s placenta. After birth a baby’s liver has to begin working to ensure the bilirubin clears from his or her body. The liver takes a few days to do this properly and so many babies will become jaundiced in the first few days of life.

Most jaundice occurs between 2 and 5 days of age and is more common in breast fed babies. Jaundice starting before a baby is 1 day old or lasting more than 2 weeks can signify other underlying problems. In Cayman it is rare for a baby to go home before 24 hours of age. If your paediatrician or midwife is worried your baby looks jaundice, they will do a test for the bilirubin level whilst your baby is in hospital.

How Do I Know if My Baby is Jaundiced?

Often the first signs of jaundice is a yellowing of the white of the eyes. Another way to look for jaundice is to press on your baby’s nose in the day light. Worried about jaundice when your baby has been brought home? Your doctor needs to see your baby as soon as possible.

What Should I Do if My Baby Looks Yellow?

If you think your baby looks jaundiced, you must contact your doctor and have your baby seen as soon as possible. This is not something that can wait.

Your baby needs to be seen within 6 hours of you noticing them looking yellow. All babies who look yellow need a test of their jaundice level.

Sometimes this is done by a special machine called a bilirubinometer. But usually in Cayman it is done by a blood test. It has been shown that even doctors cannot predict just looking at the colour of a baby the level of jaundice.

Why are Doctors Worried About Jaundice?

High levels of bilirubin if left untreated can cause irreversible brain injury and even death. Doctors have developed specific protocols to ensure all jaundiced babies are treated early. These protocols mean that these dreadful outcomes are rarely seen today.

What Happens if My Baby’s Jaundice Level is High?

The level of jaundice that is worrying depends on how many weeks a baby was when they were born and how old they are now. Your baby’s jaundice level will be plotted on a chart. That will guide your paediatrician about whether your baby needs treatment. And if they don’t whether they will need further blood tests.

For most babies this is a treatment with a special blue light called phototherapy. Phototherapy is always given in hospital. Very rarely, baby’s need an infusion of something called immunoglobulin. Or a very special type of blood transfusion. If your baby needs any of these treatments your paediatrician will explain to you why they are needed.

What Happens if My Baby is Still Jaundiced at 2 Weeks of Age?

Many breastfed babies particularly will still be yellow at 2 weeks of age. Yet, jaundice at this age can signify serious underlying problem. Your baby needs further investigation by your paediatrician.

This usually starts with a simple blood test. In most babies this blood test will be reassuring. If at any time your jaundiced baby develops pale stools or their urine never looks clear (or always looks very dark) you need to see your Paediatrician as soon as possible.

What About Sunlight for Jaundice?

It is nice to take an early morning walk or late afternoon walk to get some natural sunlight. But this won’t really make much of a difference to the Jaundice.

Never place your baby in direct sunlight. Including through a window as they can get burnt and dehydrated.

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about the author

Dr Sara Watkin

MB ChB, MRCP (paeds), FRCPCH, MD

SPECIALIST PAEDIATRICIAN & NEONATOLOGIST

Dr Sara Watkin is a highly experienced, tertiary trained paediatric and neonatal (newborn) specialist, based out of Grand Pavilion on West Bay Road, with paediatric & neonatal admitting rights at George Town. She has 25+ years experience as a consultant in the United Kingdom, including as Chief of Service at the world-renowned University College London Hospitals.



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