Neonatal jaundice refers to the yellow discoloration of a newborn's skin and eyes. It is a very common reason for parents to seek medical attention during the first week of a baby's life. In fact, about half of all full-term babies and 80 percent of pre-term infants will develop jaundice during the first week of life. Despite its prevalence, infant jaundice usually requires no specific medical treatment and resolves on its own within one to two weeks. But, because complications can arise, parents are encouraged to seek medical attention for any yellowing of a baby's skin or eyes.
Physiologic Jaundice
Jaundice occurring in a health infant without any specific underlying cause is termed physiologic jaundice. This is a result of an accumulation of bilirubin in the baby. Bilirubin is a normal product of the breakdown of old red blood cells in the body.
The liver usually clears away bilirubin without difficulty, but a newborn's liver is still immature, resulting in a buildup of bilirubin and, therefore, yellow skin. Also, there are a lot of red blood cells broken down shortly after birth, resulting in more bilirubin. Physiologic jaundice typically occurs on the second to fourth day of life. A pre-term baby, born before 36 weeks, may be more likely to get jaundice.
Breast Milk Jaundice
Occasionally, breast-fed babies become jaundiced. Although the exact cause is not clear, it may be due to an unidentified factor in the breast milk. Infants who have difficulty breastfeeding initially may be more susceptible to jaundice due to dehydration or poor feeding. Breast milk jaundice typically begins three days to a week after birth.
Birth Trauma
Newborns who have been bruised during childbirth may have higher levels of bilirubin and develop jaundice. Again, this is due to the breakdown of red blood cells.
Blood type incompatibility
If a baby has a different blood type than the mother, there may be antibodies present in the baby that will cause red blood cells to break down quickly in a newborn. This process, called hemolysis, will result in extra bilirubin.
Other Causes
Infection, particularly when widespread throughout an infant, can contribute to high levels of bilirubin and subsequent jaundice. More rare causes include abnormal formation of a baby's red blood cells, liver problems and digestive abnormalities.
Despite being very common, neonatal jaundice can cause severe problems in newborns. It is extremely important that a medical professional evaluate any yellowing of the skin after birth.
References
- "Neonatal Jaundice, An Update for Family Physicians"; Kumar RK; AUST FAM Physician 1999; 28, 679-82
