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Understanding Newborn Jaundice

Jul 12, 2024

Understanding Newborn Jaundice

Introduction

  • Presenter: Dr. Mona, board-certified pediatrician and mom.
  • Topic: Jaundice in newborns, including causes, myths, symptoms, management, and when to seek medical attention.
  • Audience: Parents expecting a baby or with a baby under one year of age.
  • Resource Mentioned: New Mom Survival Guide.

Basics of Jaundice

  • Definition: Yellow discoloration of the skin and whites of the eyes due to bilirubin buildup in the blood.
  • Bilirubin Process: New red blood cells are constantly produced and old ones broken down. Bilirubin, a yellowish pigment, is processed by the liver and excreted in bile through stool and urine.
  • Newborn Jaundice: Due to an immature liver and higher red blood cell breakdown in infants.
  • Physiologic Jaundice: Normal jaundice in newborns caused by immature liver; peaks and resolves within 2-3 weeks.
  • Clinical Monitoring: All infants are screened for jaundice in hospitals.

Causes and Risk Factors

  • Common Causes: Prematurity, delivery bruises (cephalohematomas), family history, blood type incompatibilities, and race.
    • Prematurity: More immature liver; harder time feeding.
    • Bruising: Trauma from delivery; blood collection under the scalp.
    • Family History: Increased risk if parent/sibling needed phototherapy.
    • Blood Type: Maternal antibodies can increase red blood cell breakdown.
    • Race: Higher risk in East Asian ancestry.

Myths and Facts

  • Vaccines: Jaundice is falsely attributed to vaccines; no evidence supports this.
  • Two Types of Jaundice: Physiologic and Pathologic: Physiologic jaundice is common and expected; Pathologic jaundice is out of the ordinary and requires closer monitoring.
    • Pathologic Jaundice: Appears within 24 hours; rapid rise; may have clay-colored stools.

Screening and Treatment

  • Routine Checks: Bilirubin levels checked 24-48 hours after birth; higher levels may require intervention.
  • Treatment Options: Phototherapy with UV light is common; babies may receive light therapy in hospitals or use biliblankets at home.
  • Severe Cases: Can lead to kernicterus (bilirubin accumulation in the brain); exchange transfusion may be needed in extreme cases.
  • Feeding: Critical for bilirubin elimination; breastfeeding or formula feeding is encouraged.

Special Conditions

  • Breastfeeding Jaundice: Due to poor milk transfer; intervention to increase feeding frequency may be required.
  • Breast Milk Jaundice: Due to substances in breast milk; usually resolves on its own but may need monitoring.

Conclusion

  • Common Issue: Jaundice is very common; important to monitor but generally not a cause for alarm.
  • Support: Parents should work with their clinician for proper management.
  • Additional Resources: Subscribe for more information and consult with clinicians for any concerns.