Quite often after delivery, newborn babies have yellow-looking skin. This yellow discoloration, known as neonatal jaundice, is one of the most common conditions in newborns, and requires evaluation and treatment by medical professionals, according to the author Robin L. Watson in her article "Hyperbilirubinemia." There are several known factors that contribute to newborns developing neonatal jaundice.
Red Blood Cell Breakdown
This common neonatal condition occurs due to the normal destruction of old red blood cells. Once red blood cells breakdown, bilirubin is made, and newborns have a high red blood cell volume, increasing the bilirubin load. The baby's liver has the job of clearing bilirubin out of his body. His immature liver in many cases cannot process the circulating bilirubin. The result is bilirubin depositing itself into his skin, thereby causing the yellow discoloration.
Birth Trauma
Sometimes babies have a tough time coming out of the birth canal. If a baby sustains a large bruise on his scalp, this can lead to an increase in circulating bilirubin as his body tries to reabsorb the old blood from the bruise.
Breast Milk Jaundice
A small percentage of breastfed babies, approximately 1 to 2 percent, have higher bilirubin levels because of an inhibitor substance found in the mother's breast milk, according to authors Gerald Merenstein and Sandra Gardner in "Handbook of Neonatal Intensive Care." The breastfeeding mother should receive additional support during this time so breastfeeding can be optimized. Limiting feedings at the breast will decrease her milk supply.
Breastfeeding Jaundice
Breastfeeding jaundice differs from breast milk jaundice. It is thought that breastfed babies have higher bilirubin levels because of decreased calorie and fluid intake from the initial milk made, known as colostrum. The bilirubin continues to circulate within his body as a result from low stool output. Again, the best thing a mother can do for her baby is to continue breastfeeding frequently so fluid intake is high and stooling occurs often.
Phototherapy
According to Merenstein and Gardner, phototherapy is the most common treatment used for neonatal jaundice. Phototherapy consists of a special light being placed over the baby, or a fiberoptic blanket placed under him. During phototherapy, the baby's eyes need to be protected from the strong lights so damage does not occur.
Kernicterus
A baby can develop permanent brain damage if he develops kernicterus, or bilirubin toxicity. In kernicterus, the bilirubin levels raise so high that the bilirubin leaves the blood stream and deposits in the brain. The newborn becomes quite sleepy and is difficult to arouse for feeds; other signs include a high-pitched cry, decreased muscle tone and the inability to stay awake once aroused. As the condition worsens, he can develop a fever and begin arching his head, known as retrocollis, according to the Virginia Commonwealth University. Very few babies have untreated high bilirubin levels leading to kernicterous; most will recover from jaundice without difficulty.
References
- "Critical Care Nursing Clinics of North America"; Hyperbilirubenemia; Robin L. Watson; March 2009
- "Handbook of Neonatal Intensive Care"; Gerald Merenstein, Sandra Gardner; 2006
- Virginia Commonwealth University; Kernicterous and Newborn Jaundice Online
