I saw baby Charlotte at work, she was three weeks old, and the parents were proud to tell me she had a great skin colour. I told them that she had newborn jaundice which can take six to eight weeks to dissipate. The head is the last part of the body that will change to its right colour given that the yellow pigment reacts to light (the rest of their body is usually covered). Poor parents, I just burst their bubble, but we had a good laugh nonetheless…😊

In the hospital when they tell you your baby has jaundice, it doesn’t mean they have pathological jaundice (abnormal). Their bilirubin blood rate (yellow pigment) is not at a dangerous level. All babies have jaundice, but at different degrees and often not really turning yellow. As a preventative measure, babies are often clinically checked and will have a blood test from their heel after they are born (bilirubin rate in their blood based on age in hours). They may also use a transcutaneous measurement device (which is considered a reliable screening device) before treating because a visual exam for jaundice alone is not enough to know if the situation is under control for the baby.

This is called physiological jaundice because, at birth, the baby has too many red blood cells for its size. There is massive destruction of its hemoglobin, which is called hemolysis. That is why there’s an accumulation of a yellow pigment in their blood circulation, and this will make their skin yellowish in colour called jaundice. This accumulation will dissipate as the liver, skin exposure to light and bowel movements do their jobs. Blood RH incompatibility is another factor that can sometimes increase a baby’s jaundice, as well as breastfeeding and other health problems. If the jaundice is deep or persists beyond two weeks after birth, the baby must be re-examined to find possible subjacent causes.

The baby may sleep more and be less toned, and their suction capacity will be inadequate. Your baby will be monitored to ensure that the symptoms disappear after a few days through milk consumption and bowel movements that will be, surprise, yellow in colour. Monitoring by public health professionals will continue after returning home.

Nature is well designed. Today, following in-depth research on the topic, we know that bilirubin is a potent physiological antioxidant that can protect many cells in mammals, including humans (and newborns). So we can say that newborn jaundice, as long as there are no health problems, is beneficial as the bilirubin protects the baby’s cells.

In the hospital, if the baby has an overly high level of bilirubin in its blood, which is called hyperbilirubinemia (which affects up to 60% of babies including premature babies), and the situation is not necessarily dangerous, the doctor will request increased monitoring. They may prescribe phototherapy for the baby. This is a small bed where the baby will be placed under a light wearing their diaper. This helps speed up the elimination of the yellow pigment through the skin and prevent a harmful accumulation that can pass through the brain barrier and cause damage (neurotoxicity and encephalopathy risks). There are different degrees to designate an overly high concentration of bilirubin in the blood (serious, severe and dangerous hyperbilirubinemia).

Light pointed directly at the baby can dehydrate them, and they need to consume high amounts of milk to compensate. This is why health professionals will ensure that the jaundice is not just a benign form and not dangerous for the baby before treating with phototherapy.

Early jaundice often occurs in Asian, Indian and Hispanic children, and also in the presence of specific illnesses or conditions such as hypothyroidism, intestinal function problems, liver or blood disease or an infection.

A premature baby will often need phototherapy because their liver is still immature and it’s much more difficult for them to eliminate the accumulating bilirubin. This will be for a short period, and it prevents potential complications that could follow.

Other things you can do to eliminate jaundice:

  • Cohabitate with your baby
  • Start breastfeeding as quickly as possible, and frequently breastfeed to promote hydration and                  engorgement. The best thing to do for jaundice and to help the mother breastfeed her baby is to promote good milk flow and ingestion
  • Ensure proper latching and nutritious breastfeeding
  • Avoid water supplements or formulas
  • Monitor the baby’s first stools, can compare their stool and urine elimination from day to day
  • Monitor the baby’s weight

I hope this short article has helped you better understand newborn jaundice.

Talk soon,

Marie
The Baby Expert

This post is also available in: Français

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