Have you ever noticed that your newborn baby's skin is a little yellow? Maybe the whites of their eyes are also a little yellow. This is called jaundice. Many newborn babies get this condition. So don't worry at first. Most of the time, it's not serious and will get better on its own in a few days. However, sometimes this condition can be serious and can damage the baby's brain. That dangerous condition is called 'Kernicterus'. Today, we'll talk about the facts that every parent should be aware of.
Why do babies get jaundice?
Simply put, when red blood cells in our body naturally break down, a yellow chemical called bilirubin is produced. Normally, our liver removes this bilirubin from the body. But a newborn baby's liver is not yet mature enough to do this job properly. Therefore, this bilirubin accumulates in the baby's blood. That's when the baby's skin and eyes turn yellow. This is what we call jaundice.
Imagine, this condition occurs in about 60% - 80% of babies born in Sri Lanka to some extent. So this is very common. However, if this bilirubin level becomes uncontrollable, that is, if it is not treated, that bilirubin goes to the brain and damages the brain cells. This is an irreversible and preventable brain damage called Kernicterus. Doctors also call this condition Bilirubin-Induced Neurologic Dysfunction, or BIND.
Be very careful about these symptoms!
It is very important to know if your baby has jaundice. And it is even more important to recognize if it is getting serious. The table below can help you understand these symptoms clearly.
| Type of symptom | What you should see |
|---|---|
| Symptoms of common jaundice | |
| Skin discoloration | A yellow or orange rash that starts on the baby's face and runs down the chest, stomach, arms, and legs. This can be a little harder to spot in babies with darker skin. At that point, look at the whites of the eyes. |
| Difficulty waking up | Constant drowsiness, difficulty waking up, or complete lack of sleep. |
| Problems with drinking milk | Difficulty or lack of interest in drinking breast milk or formula. |
| Excessive anxiety | A personality that is more restless than usual, cries often, and is difficult to comfort. |
| Number of wet nappies | The number of wet nappies per day is lower than normal. |
| Symptoms when the condition becomes severe and turns into Kernicterus | |
| Excessive sleepiness | A state of being without strength, very lifeless. |
| Unusual crying | Uncontrollable, piercing, high-pitched crying. |
| Fever | The baby's body feels feverish. |
| Body changes | The whole body becomes lifeless (sluggish) or, conversely, the body becomes stiff, muscles twitch. |
| Eye movement | Abnormal eye movement. |
The most important thing is, if you notice any of these symptoms, see your doctor without delay.
As the child gets older, untreated kernicterus can cause other symptoms, including seizures, movement and growth problems, hearing problems, inability to look up, and tooth staining.
How do you find this, Doctor?
Bilirubin levels usually peak between 3-5 days after birth. That's why doctors and nurses check your baby for jaundice every 8-12 hours while they're in the hospital. They also check it before you go home from the hospital.
Now, you can get a rough idea of your bilirubin level using a small light meter placed on your skin. If you suspect your level is high, a blood test is the only way to know for sure. That's the most accurate way.
If your baby's bilirubin level is high, your doctor will decide on treatment based on how many hours after birth your baby is and whether your baby has other risk factors. Even after treatment begins, more blood tests may be ordered to see if the bilirubin level returns to normal.
What are the treatments for this?
Most of the time, mild jaundice does not require treatment. However, if the bilirubin level is high, or if there are risk factors, such as the baby being born prematurely, treatment is necessary.
1. Feed well.
If the baby is not getting enough breast milk or formula, the bilirubin that builds up in the body is not excreted through urine and stool. A newborn baby should have at least 6 wet diapers a day. Also, his stool should turn from dark green to yellow. These are signs that the baby is getting enough nutrition.
2. Phototherapy - that means exposure to light
This involves shining a special blue light on the baby's skin. This can be done in the hospital or even at home. This light breaks down the bilirubin particles and allows them to be easily excreted from the body. Although it was previously thought that sun exposure was good, it is no longer recommended because it can burn the baby's skin. Phototherapy is a very safe method. Sometimes, the baby may experience minor side effects, such as passing stool.
3. Giving fluids
It is very important that your baby gets plenty of fluids while you are on the light. You should continue to breastfeed or bottle-feed. If your baby is very dehydrated, you may need to give him IV fluids.
4. Blood transfusion
This is rarely done. It is only used to suddenly lower bilirubin levels if the baby is not responding to other treatments and is showing signs of brain damage.
Take-Home Message
- Jaundice is common in newborns, but don't take it lightly. If you notice a yellow color in your baby's skin or eyes , see a doctor immediately.
- If bilirubin levels become too high, it can lead to a dangerous condition called 'kernicterus', which damages the brain.
- Always be on the lookout for signs like difficulty breastfeeding, excessive sleepiness, and loud crying.
- The treatment given by the doctor, especially phototherapy, is essential for the baby's well-being. Never stop treatment without medical advice.
- If you have any doubts or fears, talk to your doctor about them openly. There are no stupid questions, especially when it comes to your baby.
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