Neonatal jaundice, a common condition in newborns occurs when a baby accumulates too much bilirubin in his body. Parent's and caregivers will see a yellow discoloration in the baby's skin and the white part of his eyes. In physiologic jaundice, the bilirubin is produced during the normal process of old red blood cells breaking down. According to Robin L. Watson, sixty percent of healthy newborns become jaundiced and almost all premature babies will develop it.
Increased Breakdown of Red Blood Cells
A healthy baby makes a lot of bilirubin because of the large number of red blood cells circulating in his body. He breaks down cells at a faster rate in comparison to adults due to the shortened lifespan of his cells and the increased number of them, according to the article "Hyperbilirubinemia", by author Robin Watson.
Birth Trauma
Sometimes babies have a rough time coming out of the birth canal and the difficult delivery causes bruising. If a baby receives a large bruise on his scalp or head, his body must reabsorb the old blood. During this breakdown process, more bilirubin is made and his liver needs to work hard to clear the bilirubin from his body.
Infection
If a baby has an infection, he might become unable to process the bilirubin and high levels of bilirubin would develop. This can occur with infections in any part of his body to include his urine and blood, according to the article "Neonatal Jaundice", by author Daniel Preud' Homme, M.D.
Breastfeeding
Breastfeeding jaundice usually develops on the second or third day of life, according to Marion Alex and Donna Pierrynowski Gallant. Inadequate breast milk consumption causes the jaundice to worsen. Poor feeding leads to dehydration and a decrease in the amount of meconium stool being excreted. Receiving breastfeeding help and increasing the amount of breastfeeding a baby does ensure he has the best possible outcome.
Breast Milk
Breast milk jaundice differs from breastfeeding jaundice. Robin Watson notes breast milk jaundice in a baby usually starts 4 to 7 days of life and peaks around 5 to 15 days of life. Not one theory has identified the cause of breast milk jaundice but it is thought that the components of breast milk cause it. Specifically, it is thought that a steroid metabolite of progesterone and free fatty acids found in mother's milk inhibit and interfere with the bilirubin conjugating, according to Robin Watson. A doctor or lactation specialist can give concerned mothers advice about breastfeeding while her baby stabilizes from the jaundice.
Decreased Excretion
A baby's liver has a decreased ability to excrete conjugated bilirubin leading to elevated bilirubin levels. Also, a baby has decreased motility and no intestinal flora in his intestines which also is a factor in developing jaundice. Being without intestinal flora leaves conjugated bilirubin in the bowel and allows it to become reabsorbed in his body.
References
- "Critical Care Nursing Clinics of North America"; Hyperbilirubinemia; Robin L. Watson; March 2009
- The American College of Gastroenterology: Neonatal Jaundice
- "Journal of Pediatric Nursing"; Toward Understanding the Connection Between Infant Jaundice and Infant Feeding; Marion Alex and Donna Pierrynowski Gallant; December 2008
