Brief overview
- Description: Yellowing of skin and eyes in newborns a few days after birth.
- Causes: After birth, babies’ bodies break down more excess red blood cells. As a by-product, a lot of bilirubin is produced. If the yellow-brownish pigment cannot be completely broken down by the liver, which has not yet matured, its blood level rises and it is deposited in the tissue.
- Treatment: when blood bilirubin concentrations exceed a certain level, treatment is needed to prevent neurological damage. Treatment options: Phototherapy, exchange transfusion. Breastfeeding may also be helpful.
Neonatal jaundice: Description
In jaundice (icterus), the blood level of something called bilirubin is significantly elevated. Bilirubin is a yellowish-brown pigment that is formed when red blood cells are broken down. Above a certain blood concentration, it is deposited in the tissues: Skin, mucous membrane and the white of the eye can then turn yellowish. Common accompanying symptoms are light-colored stools and dark-colored urine.
Neonatal jaundice: Duration and forms
Neonatal jaundice usually first appears on the 2nd or 3rd day after birth. It usually peaks around the 5th day of life and then regresses by the 10th day of life. It is then a harmless neonatal jaundice (icterus neonatorum).
However, various concomitant diseases can influence neonatal jaundice, for example sickle cell anemia or blood group incompatibility between maternal and fetal blood. In these cases, severe jaundice already occurs on the 1st day of life (jaundice praecox).
When neonatal jaundice levels rise above 18 mg/dl (milligrams per deciliter), physicians refer to it as icterus gravis. It can lead to dangerous kernicterus with permanent neurological damage and must therefore be treated without fail.
Neonatal jaundice: Causes
In newborns, however, the liver is usually not yet fully mature. Therefore, the organ may initially be overwhelmed with the metabolism of bilirubin. The dye can then be deposited in the tissue, resulting in a yellowish discoloration of the skin and eyes – characteristic signs of neonatal jaundice. How long the symptoms last can vary from case to case. In most cases, neonatal jaundice resolves within the first ten days of life (see above).
Neonatal jaundice: Treatment
Therefore, neonatal jaundice with significantly elevated bilirubin levels is treated as a precautionary measure. The following therapeutic options are available:
- Phototherapy: In light therapy, the baby is irradiated with blue light of wavelength 460 nm (nanometers). This breaks down the indirect bilirubin, which still has to be converted by the liver, into the direct form. It is excreted in the urine, which relieves the liver. Among other things, phototherapy can damage the retina, which is why the newborn’s eyes must be protected with special glasses.
- Breastfeeding: Increased feeding and drinking is thought to stimulate intestinal activity, increasing the removal of bilirubin in the bile.
Doctors in the hospital take care of the treatment of neonatal jaundice. How long a baby has to stay in the hospital depends on how quickly the bilirubin levels return to normal.
