Infant Jaundice Causes, Prevention And Treatment Options

Jaundice in infants is a yellow coloring of the skin and eyes of a newborn. Due to an excess of bilirubin, a yellow pigment of red blood cells, which is present in the baby's blood, infant jaundice develops.

Infant jaundice is a frequent illness, especially in preterm infants and in breastfed infants who were born before 38 weeks of gestation. Jaundice in infants typically develops because a baby's liver is not developed enough to eliminate bilirubin from circulation. Infant jaundice may be brought on in some neonates by an underlying illness.

Jaundice is often not a problem for newborns delivered between 35 weeks of pregnancy and full term. Rarely, particularly in the presence of certain risk factors for severe jaundice, a baby may be in danger of brain injury from an exceptionally high blood level of bilirubin.

Causes

Jaundice is mostly caused by an overabundance of bilirubin (hyperbilirubinemia). A typical component of this pigment is bilirubin, which is the pigment produced by the breakdown of "used" red blood cells and gives jaundice its distinctive yellow color.

As red blood cells are produced in higher quantities and are broken down more quickly in the first few days of life, newborns generate more bilirubin than adults do. Bilirubin is typically removed by the liver from circulation and released into the intestines. Babies commonly have an excess of bilirubin because their developing livers can not get rid of it quickly enough. Physiologic jaundice, which commonly manifests on the second or third day is brought on by a number of common newborn illnesses.

Other factors

An underlying disease may cause infant jaundice. When this occurs, When compared to the more prevalent form of baby jaundice, jaundice frequently manifests significantly earlier or later. The following illnesses or disorders can result in jaundice:

• Bleeding inside (hemorrhage)
• A blood infection in your infant (sepsis)
• Additional bacterial or viral illnesses
• A liver condition 
• A blood type incompatibility between the mother and the child
• Babies with biliary atresia, a condition in which the bile ducts are clogged or harmed
• An absence of an enzyme
• A condition that causes your baby's red blood cells to degrade quickly

How to check if you have Infant Jaundice?

The majority of hospitals have a policy of checking infants for jaundice before releasing them. During routine medical exams and at least once every eight to twelve hours while in the hospital, infants should have their jaundice monitored.

Between the third and seventh day after birth, when bilirubin levels often reach their peak, you should have your newborn checked for jaundice. Make a follow-up visit within two days after discharge if your infant is released from the hospital before 72 hours have passed since delivery in order to check for jaundice.

The following indications or symptoms might point to the consequences of excessive bilirubin or severe jaundice. Call your doctor if:

• Your baby's skin becomes lighter in colour.
• The skin on your baby's arms, legs, and abdomen look yellowish.
• Whites of your infant's eyes
• Your infant appears lethargic, ill or challenged to wake up.
• If your infant is not eating well or is not gaining weight,
• Your infant cries in a loud voice.
• If your infant exhibits any further worrisome behaviors or symptoms

Risk Factors

Significant risk factors for jaundice, particularly for severe jaundice that might cause consequences, include the following:

Birth before term. It is possible that a baby born before 38 weeks of pregnancy will not be able to metabolize bilirubin as rapidly as a kid delivered at term. Additionally, premature infants may consume less and have fewer bowel movements, which results in less bilirubin being excreted in the stool.

Significant bruising after delivery. Greater levels of bilirubin in neonates that bruise during birth may be caused by the breakdown of more red blood cells during delivery.

Blood group. If the mother's blood type differs from that of her child, the newborn may have acquired antibodies through the placenta, which would cause an unusually rapid breakdown of red blood cells.

Breast-feeding. Infants who are breastfed, especially those who have trouble breastfeeding or obtaining enough infants who are breastfed are more likely to get jaundice. Dehydration or a low-calorie intake may promote the development of jaundice. Experts still advise breastfeeding, nevertheless, because of its advantages. 

Symptoms

The primary indicator of baby jaundice, yellowing of the skin and eye whites, often emerges between the second and fourth day following birth.

Gently touch your newborn's forehead or nose to check for infant jaundice. Your baby likely has mild jaundice if the region where you pressed the skin appears yellow. The skin tone might momentarily look a bit paler than usual if your baby does not have jaundice.

Examine your infant in well-lit areas, ideally during the daytime.

Prevention

The best defense against newborn jaundice is proper nutrition. For the first few days of life, breastfed newborns require eight to twelve feedings daily. For the first week, newborns who are formula-fed should typically have 1 to 2 ounces (or 30 to 60 milliliters) of formula every two to three hours.

Treatments

Mild jaundice in infants often resolves on its own in two to three weeks. Your newborn may need to spend more time in the newborn nursery or may be readmitted to the hospital if they have moderate or severe jaundice.

The following treatments might help your baby's blood contain less bilirubin:

Improved nutrition. Your doctor can advise more frequent feedings or supplements to make sure your kid gets enough nourishment in order to prevent weight loss.

Luminous therapy (phototherapy). A specific lamp that generates light in the blue-green spectrum may be used to place your infant beneath. In order for bilirubin molecules to be eliminated in both urine and feces, the light modifies their shape and structure. Only a diaper and safety goggles will be worn by your infant throughout therapy.

Eye coverings. A light-emitting cushion or mattress can be used as an addition to light therapy.

Injectable immunoglobulin (IVIg). Jaundice may be caused by blood type differences between the mother and the kid. Because of this problem, the newborn has antibodies from the mother that cause the baby's red blood cells to degrade rapidly. Though intravenous transfusion of an immunoglobulin, a blood protein that can lower antibody levels, may lessen the requirement for an exchange transfusion and lessen jaundice, the results are unclear.

A transfusion of exchange. Rarely, a newborn can require a blood exchange transfusion if their acute jaundice does not improve with other therapies. The bilirubin and maternal antibodies are diluted in the critical care unit by repeatedly withdrawing little volumes of blood and replacing it with donor blood.

Complications of Infant Jaundice

If untreated, high bilirubin levels that produce severe jaundice might have dangerous side effects.

Bilirubin encephalopathy acute

Brain cells are poisoned by bilirubin. Acute bilirubin encephalopathy is a condition where bilirubin enters the brain, and it can happen in newborns with severe jaundice. Early action might prevent significant, long-lasting damage.

In a newborn with jaundice, symptoms of acute bilirubin encephalopathy include:

• Trouble waking up
• Weeping with a loud voice
• Mediocre feeding or sucking
• Neck and body arching backwards
• Fever

Kernicterus

Kernicterus is a kind of acute bilirubin encephalopathy that causes permanent brain damage. Kernicterus might lead to:

• Uncontrollable and unfree motions (athetoid cerebral palsy)
• Persistent rising posture
• Loss of hearing
• Improper tooth enamel growth

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