Jaundice in babies

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WHAT IS JAUNDICE AND WHAT CAUSES IT?

Jaundice is usually recognised due to the yellow discolouration of the skin
Jaundice is usually recognised due to the yellow discolouration of the skin

Jaundice is a symptom, not a disease and there are many reasons for it happening. It is recognized primarily by the yellow discoloration of the skin.

In the womb, baby does not breathe but rely on a high level of red blood cells to receive enough oxygen from the mother. After birth, the extra red cells are broken down. One of the waste products is a substance called bilirubin which is fat soluble (unconjugated bilirubin) that is, it dissolves in fat. This bilirubin must be taken to the liver to be changed into water soluble bilirubin (conjugated bilirubin) which is then passed out through the urine, stools and sweat.

Process of conversion of bilirubin
Process of conversion of bilirubin

If for some reason the fat soluble bilirubin is not converted, it will attach itself to fatty tissues that it comes into contact with, mainly in the skin and brain. If too much bilirubin attaches itself to fatty tissues in the brain it may cause brain damage.

Physiological jaundice is due to the above process and is the most common. It usually appears on the 3rd day and disappears by 7th day. It is not dangerous as long as the bilirubin level does not go up too high.

Early feeding after birth may reduce the occurrence of jaundice therefore try putting baby to the breast in the delivery room. This also stimulates the breast to start producing milk.

Other main causes of jaundice

Excessive bruising from a traumatic birth causes more than the usual amount of red blood cells to be broken down, leading to higher levels of bilirubin to be conjugated.

The preterm baby is more likely to become jaundiced because of an immature liver which cannot cope with the high load of bilirubin.

G6PD deficiency is a condition where an enzyme necessary for the conjugation of bilirubin is missing or insufficient.

Breast milk may interfere with the liver’s ability to conjugate bilirubin therefore the jaundice may be prolonged. Often, it is not necessary to stop breast feeding but if the levels become too high, the paediatrician may recommend stopping for a couple of days for the levels to come down.

Blood group and Rhesus incompatibility causes jaundice to appear during the first 24 hours of life. It is important that all pregnant women go for prenatal check-ups in order to identify the possibility of this problem occurring, so that preventive treatment for jaundice can be started fairly quickly after birth.

Prenatal infection of the mother such as rubella, syphilis, toxoplasmosis or cytomegalovirus may cause jaundice in the newborn. After birth, any bacterial or viral infection in the baby may cause jaundice.

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