Summary about Disease
Neonatal jaundice is a common condition in newborns, characterized by a yellowing of the skin and whites of the eyes. It occurs because the baby's blood contains an excess of bilirubin, a yellow pigment of red blood cells. It is a common condition, especially in premature babies, because a newborn baby's liver isn't mature enough to get rid of bilirubin quickly enough.
Symptoms
Yellowing of the skin and the whites of the eyes (icterus), usually starting on the face and then spreading to the chest, abdomen, and legs.
Poor feeding or sucking.
Lethargy or sleepiness.
High-pitched crying.
Dark urine or pale stools (less common, may indicate a more serious problem).
Causes
Physiological Jaundice: The most common type, due to the normal breakdown of red blood cells and the immaturity of the baby's liver.
Breastfeeding Jaundice: Can occur if the baby is not getting enough breast milk.
Breast Milk Jaundice: A substance in breast milk can interfere with bilirubin breakdown.
Blood Group Incompatibility (Rh or ABO): Occurs when the mother's and baby's blood types are incompatible, causing the baby's red blood cells to break down rapidly.
Other causes: Infections, liver problems, enzyme deficiencies, and certain medications.
Medicine Used
4. Medicine used
Phototherapy: Exposure to special blue light helps break down bilirubin in the skin. This is the most common treatment.
Exchange Transfusion: In severe cases, the baby's blood is replaced with donor blood to rapidly lower bilirubin levels.
Intravenous Immunoglobulin (IVIG): May be used in cases of Rh or ABO incompatibility.
Ursodeoxycholic acid: May be used to promote bile flow and bilirubin excretion
Hydration: Ensuring adequate hydration helps to excrete bilirubin.
Is Communicable
Neonatal jaundice itself is not communicable. It is not an infection that can be spread from one baby to another. The underlying cause in rare cases might be infectious (e.g., a viral infection causing liver damage), but the jaundice itself is a symptom, not the disease being spread.
Precautions
Ensure adequate feeding: Frequent breastfeeding or formula feeding helps promote bowel movements and bilirubin excretion.
Monitor for jaundice: Observe the baby's skin and eyes for yellowing.
Follow up with a healthcare provider: If jaundice is suspected, a bilirubin level should be checked.
Avoid unnecessary medications: Some medications can increase bilirubin levels.
Good prenatal care: Can help prevent Rh or ABO incompatibility problems.
How long does an outbreak last?
Neonatal jaundice is not an outbreak in the traditional sense of a communicable disease. Physiological jaundice typically peaks around 3-5 days of age and usually resolves within 1-2 weeks. Breast milk jaundice can last for several weeks to a few months. Jaundice due to other causes (e.g., blood group incompatibility) can have a variable duration depending on the underlying condition and treatment.
How is it diagnosed?
Visual Examination: A doctor will visually assess the baby's skin and eyes for yellowing.
Bilirubin Blood Test: A blood sample is taken to measure the level of bilirubin in the baby's blood. This is the most accurate way to diagnose and monitor jaundice.
Transcutaneous Bilirubinometer: A non-invasive device is placed on the baby's skin to estimate bilirubin levels. If the level is high, a blood test is usually performed to confirm the result.
Additional Tests: If the jaundice is severe or prolonged, further tests may be done to determine the underlying cause, such as a complete blood count, liver function tests, and Coombs test.
Timeline of Symptoms
Day 1-2: Jaundice may start to appear.
Day 3-5: Jaundice usually peaks.
Day 5-7: Bilirubin levels typically start to decrease with or without treatment.
Week 1-2: Physiological jaundice usually resolves.
Beyond 2 weeks: Jaundice that persists beyond 2 weeks needs further evaluation.
Important Considerations
Kernicterus: High bilirubin levels can damage the brain, leading to a rare but serious condition called kernicterus. Early detection and treatment are crucial to prevent this complication.
Prematurity: Premature babies are at higher risk for jaundice.
Ethnicity: Certain ethnic groups, such as East Asians, have a higher risk of jaundice.
Parental Concerns: It is important to address parental concerns and provide education about jaundice.
Discharge Planning: Before discharge from the hospital, ensure that parents understand how to monitor for jaundice and when to seek medical attention.