Neonatal Jaundice:
It is a common condition resulting from the accumulation of bilirubin in the blood (a substance resulting from the breakdown of old red blood cells to be replaced by new red blood cells, so that the bile is filtered in the liver and excreted through the stool), which leads to yellowing of the skin and eyes in newborns. During pregnancy, the mother's liver removes bilirubin for the fetus, but after birth, the infant's liver removes this substance.
Reasons for Neonatal Jaundice:
- Natural Jaundice: While the fetus is in the womb, the placenta gets rid of the yellow matter from its body, and after birth, the role of the liver begins to carry out this task. Yellowing is normal for most newborns between the ages of two to four days and usually goes away within two weeks.
- Pathological Jaundice:
- Jaundice that appears within the first 24 hours after birth, or yellowing of the palms of the hands and soles of the feet is a medical emergency.
- Hypothyroidism where it does not produce enough hormones.
- Incompatibility of the blood type of the mother and the infant.
- Urinary tract infection.
- Crigler-Najjar syndrome (a genetic condition that affects an enzyme responsible for processing bilirubin).
- Obstruction or problem in the bile duct and gallbladder.
Symptoms:
Symptoms in newborns usually appear as yellowing of the skin, first appearing on the face, and then moving to the chest, abdomen, arms, and legs with elevated levels of bilirubin, in addition to yellowing of the whites of the eyes as well.
When to see a doctor:
- Difficulty waking the infant or not sleeping at all.
- The appearance of jaundice in the first 24 hours after birth.
- The infant's temperature rises.
- The infant's refusal to breastfeed.
- No soiled diapers at least 4-6 completely wet diapers in 24 hours and 3-4 stools per day by day 4.
- High-pitched cry and crying of the infant.
- The head or neck and heels are bent back, and the body is bent forward.
- Body stiffness.
Risk factors:
- People with any of the following risk factors need close monitoring and early management of jaundice:
- Dark-skinned newborns.
- Family history of blood diseases.
- An infant who has a sister or brother with jaundice is more likely to develop jaundice.
- Malnutrition of the infant in the first days of his life.
- Preterm birth (premature birth) before 37 weeks.
- The infant had bruises during childbirth.
- The difference in blood type between mother and infant.
Complications:
Infants whose blood levels of bilirubin reach harmful levels, bilirubin may enter the brain and cause temporary, correctable damage (acute bilirubin encephalopathy) or permanent damage (jaundice or chronic bilirubin encephalopathy). Frequent monitoring and early and prompt treatment of infants at risk for jaundice helps prevent severe hyperbilirubinemia. When severe jaundice is not treated for a long time, it can cause:
- Brain damage caused by high levels of bilirubin in the blood.
- Cerebral Palsy.
- hearing loss.
- Vision and dental problems.
- Mental disabilities.
Treatment:
The goal of treating jaundice is to reduce the level of bilirubin efficiently and safely. Infants with high levels of bilirubin will need treatment. It usually improves without treatment by the time the infant is about two weeks old, but some may need:
- Phototherapy (special therapeutic light) that helps break down bilirubin in the skin.
- In severe cases, treatment is by changing the blood.
- Exposure to sunlight is not recommended as a safe way to treat jaundice.
Protection:
- Ensuring breastfeeding (8 to 12 times a day) in the first days of the infant's life.
- Ensure appointments for postpartum medical tests.
- Monitor the infant carefully for the first five days after birth.