Yellowish Newborns: A Common Concern For New Parents?

It is very common for newborn babies to have a yellow hue to their skin and eyes, known as jaundice. This occurs when there is a build-up of bilirubin, a yellow substance, in their blood. Jaundice is usually harmless and goes away within a couple of weeks as the baby's liver matures, but in rare cases, it can lead to severe jaundice and brain damage if left untreated. It is important for parents to monitor their baby's jaundice and seek medical advice if they are concerned.

Jaundice is caused by a chemical called bilirubin

Jaundice is a common condition in newborns, characterised by a yellowing of the skin and eyes. This occurs when there is a buildup of a chemical called bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells break down. While a pregnant person's liver removes bilirubin for the baby, after birth, the baby's liver must start removing bilirubin by itself.

Bilirubin is made up of two components: unconjugated (indirect) and conjugated (direct). Unconjugated bilirubin is toxic, whereas conjugated bilirubin is usually not, as it can be excreted from the body. Once bilirubin reaches the liver, it becomes conjugated, making it water-soluble and easily removable from the body.

In newborns, jaundice occurs when the liver is not developed enough to remove bilirubin effectively. This is because it takes a few days for a newborn's liver to develop and get better at removing bilirubin. Jaundice usually peaks in the first two to five days of life and lasts about one to two weeks. In newborns, jaundice is usually not serious and goes away within a couple of weeks. However, it is important for a healthcare provider to check for jaundice, as severe jaundice can lead to brain damage if left untreated.

Jaundice may actually protect babies, as bilirubin is an antioxidant that may help fight infection in newborns. This is another reason why parents shouldn't be too worried by a bit of yellowing. In rare cases, however, jaundice can signal a more serious problem. When bilirubin levels get very high, it can affect the brain, causing a rare condition called kernicterus.

Treatment for jaundice depends on its cause, the bilirubin levels, and the baby's age. Mild jaundice usually goes away on its own as the liver continues to develop. Feeding a newborn frequently can also help encourage bowel movements, which aid the body in getting rid of excess bilirubin. If bilirubin levels are high or continue to rise, a healthcare provider may recommend phototherapy treatment. During phototherapy, the baby is placed under special blue lights, which help the liver get rid of excess bilirubin. In rare cases, if phototherapy doesn't work, an exchange transfusion may be necessary, where some of the baby's blood is replaced with fresh, donated blood.

Bilirubin is a yellow substance produced during the breakdown of red blood cells

It is normal for newborns to be a little yellow. This condition is called jaundice and it affects up to 60% of full-term babies and 80% of premature babies. Jaundice is caused by a buildup of bilirubin, a yellow substance produced during the breakdown of red blood cells.

Bilirubin is a byproduct of broken-down old red blood cells. When red blood cells finish their life cycles, they break down and pass through the bloodstream to the liver for processing. The liver sorts bilirubin with other waste products into a fluid called bile. Bile exits the body through the intestines. Bilirubin is the pigment that gives bile its distinctive yellow colour. It also colours your stool.

The process of removing iron from each cell's hemoglobin helps the cells break down into bilirubin and other substances. Bilirubin is transported to the liver by albumin, a simple protein. Liver cells absorb bilirubin, which then undergoes several chemical processes.

Once in the liver, bilirubin becomes "conjugated". This means it is water-soluble, and the body can excrete it. The body ultimately expels bilirubin through stool. Bilirubin is brown and yellow, and it is this pigment that makes feces brown.

Unconjugated bilirubin is toxic. Conjugated bilirubin is usually not toxic because it can come out of the body as long as nothing interferes with its removal.

In newborns, jaundice occurs because their livers are not yet developed enough to get rid of bilirubin. Newborns also have more red blood cells than older children and adults, and those brand-new red cells do not last as long as red cells made as babies grow older.

Jaundice is very common and usually goes away on its own

It is very common for newborn babies to develop jaundice, a yellowing of the skin and eyes caused by a buildup of bilirubin in the blood. Jaundice occurs because a newborn's liver is not yet mature enough to process and remove bilirubin, a yellow substance created when red blood cells break down. While jaundice can sometimes signal a more serious health problem, it usually goes away on its own within a couple of weeks as the liver matures and starts to function.

Types of Jaundice

There are two main types of jaundice: physiological and pathological. Physiological jaundice is the most common type, accounting for around 75% of cases. This type typically develops within a few days of birth and clears up on its own within a few weeks as the breakdown of red blood cells slows and liver function improves. Pathological jaundice, on the other hand, is caused by an underlying condition that affects the body's ability to filter out bilirubin. This type may appear within the first 24 hours after birth and often requires treatment.

Treatment for Jaundice

In most cases, mild jaundice will resolve without treatment as the baby's liver continues to develop. Frequent feedings (8-12 times a day) can help stimulate bowel movements, which aid in the elimination of bilirubin from the body. For more severe cases of jaundice, treatment options such as phototherapy or exchange transfusion may be recommended. Phototherapy involves placing the baby under special blue lights to help break down bilirubin, while exchange transfusion involves replacing some of the baby's blood with fresh, donated blood.

When to Seek Medical Attention

While jaundice is typically not serious, it is important to monitor your baby's condition and seek medical attention if the jaundice worsens or lasts longer than two weeks. Signs of severe jaundice may include increased yellowing of the skin, listlessness, fussiness, poor feeding, and a decrease in the number of wet and dirty diapers. If left untreated, severe jaundice can lead to serious health complications, including acute bilirubin encephalopathy and kernicterus, a type of permanent brain damage.

In rare cases, jaundice can lead to brain damage

Jaundice is a common condition in newborns, with up to 80% of newborns experiencing it. It is characterised by a yellowing of the skin and eyes due to high levels of bilirubin in the blood. While jaundice usually clears up on its own within 1-2 weeks, in rare cases, it can lead to brain damage if left untreated.

Brain damage caused by severe, untreated jaundice is known as kernicterus. Kernicterus occurs when bilirubin levels in the blood become so high that they cross the blood-brain barrier and damage the brain tissue. This can result in permanent neurological complications, including:

• Cerebral palsy
• Hearing loss
• Learning disabilities
• Involuntary twitching
• Poor development of teeth
• Movement disorders
• Intellectual and developmental disabilities
• Autism spectrum disorders
• Inattention and hyperexcitability disorders

The risk of kernicterus is higher in babies with certain risk factors, including:

• Premature birth
• Blood type differences between mother and baby
• Difficulty feeding
• Family history of jaundice
• Dark skin colour
• Mediterranean or East Asian descent
• Bruising during birth

Prompt treatment of high bilirubin levels can almost always prevent kernicterus. Treatment for kernicterus involves lowering bilirubin levels as quickly as possible, using methods such as light therapy, blood transfusions, or exchange transfusions.

Treatment for jaundice includes phototherapy and exchange transfusion

Treatment for Jaundice in Newborns

Overview

Newborn jaundice is a common condition affecting around 50% of term and 80% of preterm babies. It is caused by a buildup of bilirubin in the blood, which occurs when the liver is not developed enough to remove it. While jaundice usually resolves on its own within 1 to 2 weeks, in some cases, treatment is required to lower bilirubin levels. The two main treatment options are phototherapy and exchange transfusion.

Phototherapy

Phototherapy is the primary treatment for jaundice in newborns and is often used to reduce levels of unconjugated bilirubin that may lead to acute or chronic encephalopathy. During phototherapy, the baby is placed under special blue lights that help the liver break down and remove bilirubin from the blood. The treatment is generally safe and effective, with few side effects.

Exchange Transfusion

Exchange transfusion is a less common but more invasive treatment option for jaundice. It is typically reserved for cases where bilirubin levels are extremely high and there is a risk of brain damage. During an exchange transfusion, the baby's blood is replaced with blood from a donor to quickly lower bilirubin levels. This procedure carries some risks for the infant and is only performed when necessary.

While jaundice in newborns is usually a mild and self-resolving condition, in some cases, treatment with phototherapy or exchange transfusion may be necessary to prevent serious complications.

Frequently asked questions