Neonatal Jaundice: Why Do Newborns Turn Yellow?

When Priya and Rahul welcomed their first child, they were overjoyed. But shortly after birth, their excitement turned to worry when doctors noticed a yellow tint in their baby’s skin and eyes. Diagnosed with neonatal jaundice, their newborn was quickly moved to the Neonatal Intensive Care Unit (NICU) for monitoring and treatment. Seeing their tiny baby under special lights in the NICU was overwhelming and heartbreaking. Priya and Rahul felt helpless and anxious, wondering if everything would be okay. However, as they learned more, they discovered that neonatal jaundice is common and usually temporary, affecting many newborns within the first few days of life.

In this blog, we’ll explore what causes neonatal jaundice, how it’s treated, and what signs parents should look for to help them feel prepared and reassured during those early days.

What is Neonatal Jaundice?

Neonatal jaundice is a condition where a newborn’s skin and eyes take on a yellow tint due to elevated levels of bilirubin, a yellow pigment produced during the breakdown of red blood cells. Normally, the liver processes bilirubin and then eliminates it from the body. However, newborns’ livers are still developing, which can lead to a temporary buildup of bilirubin in the bloodstream.

In most cases, neonatal jaundice is mild and resolves naturally. Nevertheless, understanding the condition and recognizing when to seek medical advice can provide parents with reassurance (American Academy of Pediatrics, 2021).

Why Does Jaundice Occur in Newborns?

In the womb, babies have a higher concentration of red blood cells, which helps them obtain adequate oxygen. After birth, these extra red blood cells are broken down, releasing bilirubin. Newborns’ immature livers may require additional time to process bilirubin, causing it to temporarily accumulate in the bloodstream and lead to jaundice.

Several factors increase the risk of neonatal jaundice, including:

• Premature birth (before 37 weeks), which slows bilirubin processing (American Academy of Pediatrics, 2021).
• Bruising during birth, which can increase red blood cell breakdown (Bhutani et al., 2016).
• Blood type incompatibilities between mother and baby, leading to increased red blood cell destruction (Kumar et al., 2020).

Types of Neonatal Jaundice

• Physiological Jaundice: The most common type, usually appearing 2-4 days after birth, which typically clears up on its own within a week or two.
• Breastfeeding Jaundice: Some breastfed babies may develop jaundice if they aren’t getting enough milk initially. Ensuring adequate feeding helps manage this type of jaundice (Academy of Breastfeeding Medicine Protocol Committee, 2017).
• Breast Milk Jaundice: A rare type that may persist longer due to substances in breast milk affecting bilirubin processing. This type usually resolves without impacting the baby’s health.
• Pathologic Jaundice: Unlike other types, this form appears within the first 24 hours and may indicate a more serious condition. Immediate medical attention is necessary (Kaplan et al., 2022).

How is Neonatal Jaundice Diagnosed?

Before leaving the hospital, doctors examine newborns for jaundice symptoms. If jaundice is suspected, a skin or blood test may be performed to measure bilirubin levels. Parents should monitor signs of jaundice at home, focusing on yellowing on the chest, legs, or the whites of the eyes. (American Academy of Pediatrics, 2021).

Treatment Options

Most cases of neonatal jaundice resolve naturally as the baby’s liver matures. If bilirubin levels are high, doctors may suggest the following treatments:

• Phototherapy: The baby is placed under special blue lights that help break down bilirubin for easier elimination (Bhutani et al., 2016).
• Exchange Transfusion: In rare, severe cases, the baby’s blood may be partially replaced to reduce bilirubin levels quickly (Kaplan et al., 2022).

When to Call the Doctor

Although neonatal jaundice is usually harmless, parents should consult a healthcare provider if they notice:

• Extreme yellowing of the skin or eyes
• Lethargy or difficulty waking
• Poor feeding
• High-pitched crying (American Academy of Pediatrics, 2021)

For assistance with neonatal care, feel free to reach out here:

Wrapping Up

Neonatal jaundice, though initially concerning, is often a short-lived phase in a newborn’s development. By understanding the condition and keeping an eye out for specific symptoms, parents can feel more confident in managing this common issue. And remember, healthcare providers are always available to help. A little knowledge and guidance can go a long way toward easing parents’ minds in those early days.

References:

1. American Academy of Pediatrics. (2021). Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation.
2. Bhutani, V. K., Stark, A. R., & Kumar, P. (2016). Neonatal Hyperbilirubinemia and Risk for Brain Damage. Journal of Perinatology, 36(3), 165-177.
3. Kaplan, M., Muraca, M., & Hammerman, C. (2022). Severe Neonatal Hyperbilirubinemia and the Risk of Kernicterus. The New England Journal of Medicine, 387(4), 251-259.
4. Academy of Breastfeeding Medicine Protocol Committee. (2017). Breastfeeding and Jaundice: The Academy of Breastfeeding Medicine Protocol.