|
FAQ's on
JAUNDICE IN NEWBORNS
(NEONATAL JAUNDICE)
BACKGROUND:
Yellowness of the eyes or skin ( known as Jaundice ) is a
fairly common problem in newborns and in most of the cases causes
unnecessary worry in the parents.
At an estimate – some 60 % of newborns develop Jaundice and it is only
some 10 % of these that need investigations ( blood tests etc ) –
meaning thereby that this problem is very common and usually ( almost
always ) does not have a basis for worry.
WHAT IS THE MEDICAL BASIS OF THIS
JAUNDICE ?
One of the reasons why most
parents worry is that they think this jaundice is the same as the
Jaundice they have seen in older people and adults in
the family or their circle of relatives / friends.
There is a very basic difference in the two types of Jaundice –
the one involving newborns and the other one involving older people /
adults.
In adults – it is the LIVER that gets affected and causes Jaundice.
There is infection and inflammation of the liver cells and the whole
disease process may take some 1 month or so.
Whereas in newborns – the LIVER is JUST not involved. The basic reason
why many newborns get “ Jaundice” is that the newborn has more
Hemoglobin ( the molecule that causes the blood to be red )
than the body needs. Nature reduces this hemoglobin on its own – and
in this process one of the by products is BILIRUBIN ( the blood
test that is usually done to estimate the degree of jaundice). Since
this is a natural process – it shall naturally occur in most children
and would naturally get okay on its own too. This is exactly what
happens in newborns ( except a few rare problem cases).
WHAT SHOULD I EXPECT OVER THE NEXT FEW DAYS
?
The usual outcome would be that
the yellowness would increase to a peak on sometime like the 4-6th
day of age and then gradually get less yellow and the newborn would
usually get fully okay by some 12-14 days.
WHEN DO I NEED TO WORRY ?
|
|
-
Jaundice getting “ very dark yellow ”
-
Mother having negative Blood Group ( e g O
negative or B negative ) and child having positive blood group –
jaundice may get very deep in these situations
-
Jaundice not getting okay by about 14 days of
age
-
The child having fever and dullness and
feeding poorly
-
The child passing pale colored ( clay colored
) stools
-
In weak , premature and underweight newborns
– there is need to show your Pediatrician periodically and to
be very careful
|
WHAT WILL MY PEDIATRICIAN USUALLY ADVISE ?
After you have gone through the
list of “ reasons when you should worry “ you may yourself find that
your child fits in none of these problem cases and your worry should
get reduced anyway.
The medical advice that you will usually get is that you may
wait and watch and show your Pediatrician
regularly. One does not need to do anything else except when the
Jaundice is deep and then your Pediatrician may ask you for a few
blood tests to confirm the Bilirubin ( level of Jaundice ). If the
blood levels are within expected limits – no specific treatment will
be offered.
If it is a very high level then he may suggest the child to be
admitted to the Hospital for Phototherapy ( providing specially
designed tubelight rays and keeping the baby in the Nursery) . Very
infrequently, drastic measures like changing the blood of the child
( Exchange Transfusion ) may be needed.
SOME COMMON MYTHS ABOUT JAUNDICE IN NEWBORNS :
-
The mother should not eat / drink / wear yellow
items : no scientific basis
-
The mother should avoid fatty foods : no
scientific basis
-
Keeping the child under a tubelight at home is
helpful : This technique of providing
-
Phototherapy ( specially designed set of
tubelights of a specific radiation wavelength kept at a specified
distance from the newborn ) is a specialised technique and a short
cut of putting the child under a tubelight at home is simply
deluding oneself. If the need for Phototherapy is indicated by your
Pediatrician – it HAS TO BE done at an Institutional level in a
Hospital.
-
Breast milk should be stopped as “ mother’s milk
is defective ”: Breast milk
leading to Jaundice (known medically as Breast Milk Jaundice) is a
well defined medical entity and can be diagnosed only by your
Pediatrician. A general impression that mother’s milk is not
“suiting” the child will do more harm than good since it shall
disturb the vital breast milk supply to the newborn.
-
Keeping the child is sunlight helps : Yes ,
sunlight does help as a source of warmth , for vitamin D production
but has no role in reducing Jaundice. It may instead be hazardous if
one is not careful about the heat it generates and the child may get
needlessly warmed / develop fever – this shall add further to your
anxiety !
|
