Neonatal Jaundice Symptoms and Treatment

Neonatal JaundiceMany newborns show a slight yellowing of the skin (jaundice) shortly after birth. You should not worry because it usually disappears in a few days.

Jaundice is usually caused by excessive amounts of yellowish brown substance, bilirubin, in the bloodstream; bilirubin is a natural substance, a result of continuous degradation of red blood cells. A liver, which uses bilirubin to create a bile, removes it from the bloodstream. A part of the bile is stored in the gallbladder from where it passes through the main bile duct to the digestive tract where it helps to digest fat. The rest of the bile passes directly from the liver to the small bile ducts and into the main bile duct, then into the digestive tract. If the function of any of these organs fails, bilirubin accumulates in the blood and ”paints” the skin in yellow. In newborns, this is mostly a consequence of liver immaturity, which does not function normally and does not convert bilirubin quite fast. The resulting jaundice is known as a physiological or normal jaundice. In some newborns, the jaundice is caused by the excessive disintegrations of red blood cells (hemolytic disease of the newborn), which releases too much bilirubin into the blood.

Hemolytic disease of the newborn usually occurs when the blood of the fetus is Rh-positive, and antibodies of Rh-negative blood of mother enter in it (see Rh incompatibility).
Obstructive jaundice occurs due to the deformation or complete absence of bile ducts in newborns. The bile and, with, a bilirubin, cannot get out of the liver, so bilirubin accumulates in the bloodstream.

Symptoms

In all types of jaundice, the skin and sclera of newborns turn yellow. In hemolytic diseases the jaundice is occurring on the day of birth, in physiological jaundice approximately two days later, and in obstructive after one week. In physiological jaundice and mild hemolytic disease, yellowing is weak and usually disappears within a few days. However, in severe haemolytic diseases and obstructive jaundice, color changes are more pronounced and will remain if the condition is not treated. A newborn with physiological jaundice has no appetite. In obstructive jaundice, a newborn can get diarrhea and will not gain weight.

Frequency

Physiological jaundice is very common; it occurs in more than 50% of newborns. Hemolytic disease is not common and obstructive jaundice is very rare.

Dangers

In hemolytic disease, there is a slight risk of brain damage due to high bilirubin concentrations in the blood. But this almost never happens because the disease is immediately treated as soon as it is diagnosed, and the concentration of bilirubin in blood is constantly monitored. A stagnation in obstructive jaundice will cause fatal liver damage if not treated immediately.

Treatment

In most cases of physiological jaundice, a newborn will get a plenty of water to drink. If the concentration of bilirubin is high, a newborn is exposed to ultraviolet rays (phototherapy) that help liver in the production of chemical substances needed for bilirubin processing. Mild cases of hemolytic disease disappear without treatment, and heavy cases are treated by blood transfusion. Obstructive jaundice is treated surgically. If the main bile duct is deformed  the operative treatment is quite successful, but the odds are weak if many tiny bile ducts are deformed.