New guidelines for neonatal jaundice: Information for parents

Occasionally, a common birth symptom warns of a significant health issue.

The majority of newborn infants tan at least slightly. This condition, often known as jaundice, is a very typical and mostly benign aspect of the newborn period. However, in certain extremely rare circumstances, it may indicate or even cause a more serious issue. Because of this, parents need to be informed.

Why does jaundice occur?

High blood levels of a chemical called bilirubin are what give infant jaundice its yellow appearance. Most bilirubin is produced when red blood cells are broken down. To make it simpler for the body to eliminate through the urine and faeces, it is digested in the liver.

When it comes to eliminating bilirubin, newborn livers take some time to start going. Additionally, newborns have more red blood cells than older kids or adults do, and those fresh red blood cells don't persist as long as those produced as babies age. These two elements working together is what makes jaundice so widespread.

Jaundice Typically lasts one to two weeks and peaks in the first two to five days of life. We don't precisely understand why it can linger longer in breastfed newborns, but there is nothing to be concerned about.

Because bilirubin is an antioxidant that may assist newborn infants fight infection, jaundice may actually protect the baby. Another reason why parents shouldn't be overly concerned by a little yellowness is that it is both temporary and might even be beneficial for their child as they emerge from the safety of the womb.

Rarely, jaundice may be an issue.

Jaundice can occasionally be a symptom of another condition, and when bilirubin levels soar, the brain may be permanently affected. This condition, known as kernicterus, is extremely uncommon and affects less than 1% of newborns.

The likelihood of having high bilirubin levels is increased by a number of factors, including:

1.either lack calories or dehydration. This most frequently occurs when infants are breastfed exclusively and a breastfeeding issue goes undiagnosed.

2.Rh or ABO compatibility issues. There may be a greater than usual breakdown of red blood cells when the mother and the baby have different blood types. Obstetricians are very aware of this problem, and blood tests for all mothers should be done to determine the risk.

3.Babies who are born early might not yet have developed bilirubin removal systems.

4.either an intestinal obstruction or an infection. Typically, this would not only cause jaundice.

5. A Cephalohematoma or bruising (a lump or a bruise on the head). Both are possible during a challenging birth. This causes more red blood cells to degrade.

6.liver ailments. It may be more difficult for the baby's body to get rid of bilirubin if there are any number of different liver issues.

7.illnesses that impact a vital enzyme. Glucose-6-phosphate dehydrogenase (G6PD) insufficiency is a frequent condition that can lead to the deterioration of red blood cells. Other illnesses, such Gilbert syndrome or Crigler-Najjar syndrome, can cause an enzyme that is crucial for eliminating bilirubin to malfunction.

8.genetic influences. Not all of these elements are fully comprehended. Future babies may be at a higher risk if their family member has jaundice. For instance, babies with East Asian ancestry are more likely to have greater bilirubin levels.

What are the new recommendations?

The necessity of preventing and evaluating jaundice is emphasised in the revised recommendations. Parents and doctors can collaborate to

*Check the mother's blood type and antibodies to make sure they are appropriate. If there is a problem, the infant should also be examined.

*Examine all potential jaundice hazards, including the mother's blood type as well as the gestational age, any bruising, the severity of the jaundice, and other variables.

*At 24 to 48 hours of life, use a device to assess the bilirubin level, or earlier if the baby appears jaundiced or is leaving the hospital earlier.

*Make sure mothers receive adequate assistance with feeding. Babies who do not feed enough during their first three to five days of life are more likely to develop jaundice.

*Make another appointment with the baby's physician. The bilirubin level and risk variables determine the ideal timing for this. Parents, it's crucial that you heed this advice!

How is jaundice in newborns treated?

The most popular form of therapy is phototherapy. The infant is placed in front of a particular light that aids in the body's removal of bilirubin, or it may be wrapped in a special blanket with the light within. This is secure and reliable. Therapies like exchange transfusion, in which blood is drawn out and new blood is infused back in, are required when bilirubin levels are exceedingly high and there is worry about the potential for brain damage. This is quite uncommon, though.

Feeding is a crucial component of therapy because it facilitates the body's ability to eliminate bilirubin through the blood and urine. Frequent feedings to a newborn also aid in preventing jaundice-related issues. In a 24-hour period, a baby should wet at least six diapers, and faeces should be frequent. Stools should transform from the typical newborn black, tarry stools to lighter-colored, looser, and "seedy" stools.

What further information concerning neonatal jaundice should parents know?

Before leaving the hospital, you should be given written information about jaundice, details regarding various lab tests and your baby's bilirubin level, as well as specific instructions regarding when the child should visit the paediatrician.

After you leave the hospital and return home, it's critical to monitor your infant for jaundice. Babies with dark skin may have more difficultly detecting jaundice. You can find it by briefly pressing down on the baby's skin in an area where the bone is close (the forehead, nose, chest, or shin are good places to do this). The skin should temporarily turn paler as a result of the temporary release of blood.