5 Important Things You Should Know About Jaundice

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What is jaundice?

Simply put, jaundice is a common and usually harmless condition that most newborn babies have. Common symptoms are the yellowing of the skin and eyes about a few hours after birth.

Jaundice is also known as hyperbilirubinemia. The main cause of jaundice is the buildup of bilirubin levels in infants due to their hepatic immaturity, or immature liver functions. Bilirubin is a yellow-orange pigment that’s a byproduct of regular red blood cell breakdown.

In most cases, jaundice tends to go away on its own after a few weeks. The yellow colour of the infant’s skin may darken for a few days before lightening up.

What are the effects of jaundice?

Newborn babies with jaundice may experience weight loss, excessive fussiness, lethargy, and poor feeding.

For infants with abnormal levels of bilirubin, it could lead to bloodstream infections, viral infections, enzyme and membrane abnormality, and liver issues. In extremely rare cases, it might even cause brain damage, known as kernicterus.

Why do most newborns have jaundice?

As soon as the baby is born, excess red blood cells from while it was in the uterus start breaking down, producing bilirubin. However, their still-developing liver isn’t mature enough to remove the bilirubin produced, so the yellow starts showing in their skin and the whites of their eyes.

Photo by Nowshad Arefin on Unsplash

There are 3 types of newborns most susceptible to jaundice:

1. Premature babies
Premature babies are infants born before the 37th week of gestation or 3 weeks before the estimated due date. Their organs might still be underdeveloped and therefore they aren’t able to quickly get rid of bilirubin levels in their blood.

Infants born prematurely are usually treated with phototherapy. Their skin absorbs the light that can change the makeup of bilirubin into substances that are easier to remove.

2. Babies who aren’t getting fed enough
The mother’s first milk, called colostrum, contains a natural laxative that encourages her baby to excrete bilirubin through the passing of stools. Infant formula lacks this specific type of laxative.

After feeding, a newborn baby’s first stool is usually a black, sticky substance that contains high levels of excreted bilirubin. Therefore the more the baby feeds, the more stool is produced, the faster the excretion of bilirubin, and the quicker their skin colour will return to normal.

3. Babies whose mothers have Rh disease
If a mother has Rh disease, it means that her blood type isn’t compatible with that of her baby’s, and her baby is most probably going to be jaundiced.

This is because the buildup of antibodies in the baby’s bloodstream can destroy red blood cells, causing a sudden rise in bilirubin levels.

How many types of jaundice are there?

Physiologic jaundice
The most common type of jaundice in newborn babies is physiologic jaundice. It happens due to the inability of the liver to filter out bilirubin yet. Constant breastfeeding will help to reduce this type of jaundice, as it usually goes away by itself after some time.

Breast milk jaundice
Quite rare, but it is believed to be caused by certain substances in the mother’s milk that prohibits her baby’s liver from filtering out bilirubin. In this case, paediatricians may tell mothers to supplement their baby with infant formula instead.

Breastfeeding jaundice (Suboptimal intake jaundice)
Also known as the ‘starvation jaundice’. It happens to babies who are not feeding as frequently as they should due to improper latching, rigid feeding schedules, or mother’s insufficient milk.

Pathologic jaundice
The most serious kind of jaundice in newborns. It is due to incompatible blood types with the mother and can be a sign of underlying liver disease. Newborns with this kind of jaundice may require blood transfusions.

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How can jaundice be prevented?

Breastfeeding early and often
As discussed earlier, a mother’s first milk is essential to quickly getting rid of her baby’s bilirubin buildup. Breastfeed the baby as early as possible, ideally within the first hour of birth — and do it as often as possible.

Skin-to-skin care
There’s a reason why newborns are often placed on their mother’s chest after being born. Besides deepening the bond between mother and child, skin-to-skin contact also helps to stimulate the mother’s milk production, ensuring that she always has milk available for her baby.

A warm, herbal bath
It’s a common practice in Malaysia for babies to bathe in herb-infused water during the mother’s confinement period.

Bitter gourd and gardenia seeds are some of the best herbs for reducing jaundice in newborn babies.

Exposure to sunlight
Sun exposure may help, but only do so with extreme caution. Sunlight helps to convert bilirubin into other products easily excreted by infants. However, keep in mind that it also contains harsh UV rays that can penetrate through the newborn baby’s delicate skin.

All information provided above is for informational purposes only, not intended to substitute for professional medical advice, diagnosis or treatment.