Red blood cells continually recycle in the body and when old cells die, the byproduct results in a yellow pigment called bilirubin. Normally, your liver processes it and removes it from the body via bowel movements. Without adequate excretion, bilirubin builds up in the body causing the skin, mucous membranes and whites of the eyes to appear yellowish. Some types of jaundice in newborns include physiological jaundice, breastfeeding jaundice, and pathological jaundice.
Physiological Jaundice: Immature Liver
Prior to the birth of the baby, the mother's liver processes and removes bilirubin from the baby by the placental connection. After birth, the umbilical cord is cut and the baby's liver has to work on its own. It takes approximately two weeks for the liver to reach its functional maturity. Therefore, physiological jaundice is common in newborns and is usually quite mild.
Breastfeeding Jaundice
Medline Plus, a service from National Institutes of Health and the National Library of Medicine, states that another harmless form of jaundice in newborns is caused by breast milk. Certain factors in breast milk block proteins in the liver needed for bilirubin processing, thus bilirubin builds up in the baby's system, causing jaundice. This form of jaundice is also normal and mild.
Pathological Jaundice: Breakdown of Red Blood Cells
Jaundice that appears within the first 24 hours of life is considered abnormal, or pathological. Any number of conditions that destroy a large number of red blood cells, and thus increase bilirubin levels, can cause pathological jaundice.
Dr. Preud'Homme, from the American College of Gastroenterology, says this type of jaundice can be caused by a blood-type incompatibility between the mother and baby, or large bruises on the baby's head due to birth trauma. Medline Plus also includes infection, abnormal red blood cell shapes and polycythemia as causes.
Pathological Jaundice: Other Causes
Jaundice can also be a consequence of conditions that prevent the body from processing and clearing bilirubin. Some medications, infectious agents and congenitally transmitted diseases, such as herpes or syphillis, can cause this. Some newborns suffer from a rare disorder causing problems with bilirubin metabolism. In any situation causing pathological jaundice, immediate treatment is necessary to prevent kernicterus: permanent brain damage resulting from excessive bilirubin deposits in the brain cells.
References
- Medline Plus: Newborn jaundice
- University of Maryland Medical Center: Breast milk jaundice
- The American College of Gastroenterology: Neonatal Jaundice
- "Saunders Comprehensive Review for the NCLEX-RN Examination"; Linda Anne Silvestri M.S.N., R.N.; 2008
