How to know that the newborn baby has jaundice and how to treat jaundice in newborn

           
            Jaundice is a condition in a newborn in which the bilirubin level will be high when compared with the normal range. It is the most common problem in the first week of life of a newborn.

           In newborn, the jaundice is clinically classified into physiological jaundice and pathological jaundice. Physiological jaundice may happen due to the physiological immaturity of the newborn to handle the increased bilirubin production. Normally, visible jaundice will appear during 24-72 hour of age. In physiological jaundice, the total serum bilirubin level peaks on the third day of life and they usually fall in term neonates (28 days of life). Adequate breastfeeding will help decrease this kind of physiological jaundice.


            The presence of clinical jaundice for more than 3 weeks and if the urine is dark which stains the nappy will be suggested as pathological jaundice in newborn. If jaundice exceeds beyond the third to fourth weeks of life, then the physician should suspect other causes of jaundice. BREASTFEEDING should not be stopped for diagnosis or treatment of jaundice.

CLINICAL FINDINGS OF JAUNDICE:

• YELLOWISH DISCOLOURATION OF THE SKIN AND THE SUBCUTANEOUS TISSUE (skin of forehead, chest, abdomen, legs, palms and soles are blanched with digital pressure and the colour of skin and subcutaneous tissue is noted)

• yellow colour staining of palms and soles are the DANGER SIGNS OF JAUNDICE which should be immediately intervened by the physician.

CLINICAL ASSESSMENT OF NEWBORN JAUNDICE:

•  TOTAL SERUM BILIRUBIN - if there is yellow staining of nappies.

• Blood grouping of mother and baby - if a baby Rh positive born to Rh-negative mother and there is high risk for hyperbilirubinemia.

OTHER CAUSES FOR NEWBORN JAUNDICE:

•  CHOLESTASIS - obstruction of bile from the liver to the duodenum.
•  Hemolysis - G6PD deficiency, thalassemias and so on.
•  Hypothyroidism
•  Urinary tract infection

TREATMENT AND MANAGEMENT:

                 PHOTOTHERAPY is the main treatment for hyperbilirubinemia in neonates.

                 EXCHANGE TRANSFUSION is done in the severe condition of jaundice.

PREVENTION:

                 An Early antenatal intervention like maternal blood grouping and administration of ANTI-D injection for preventing the risk of Rh incompatibility.

                If danger sign is seen then immediate hospital intervention will reduce other complication of neonatal jaundice.