$Unique_ID{PAR00113}
$Pretitle{}
$Title{Medical Advice:  Jaundice in Newborns}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Jaundice Newborns Yellow tinge skin eye eyes bilirubin blood cells
liver blood poisoning erythroblastosis fetalis Rh factor Rh-negative
Rh-positive ABO factors A B O blood type breast-fed newborn anemia hepatitis
German measles Blood tests cultures}
$Log{}

Your Child:  A Medical Guide


Jaundice in Newborns


     Quick Reference

     SYMPTOM
     - Yellow tinge to the skin and the whites of the eyes

     HOME CARE
     - Watch your newborn baby closely for signs of jaundice in the first week
       after the baby goes home from the hospital.  Inform the doctor if you
       suspect jaundice.

     PRECAUTIONS
     - Although it is normal for jaundice to develop in the first week of a
       newborn's life, it is not normal for jaundice to develop in the first
       24 hours after birth.
     - If jaundice develops or worsens after the baby comes home from the
       hospital, consult your doctor.
     - Consult the doctor immediately if your jaundiced baby is nursing
       poorly, seems excessively drowsy, has a fever, or is irritable.
     - Follow your doctor's instructions exactly if your baby has jaundice.


     A substance known as bilirubin is released when old blood cells are
replaced by new cells.  The liver transforms bilirubin into bile, which is
then passed into the intestine.  When the liver is not functioning properly,
either because of immaturity or because of injury or abnormality, this
transformation process is slowed or halted; bilirubin accumulates in the body,
and jaundice results.
     Approximately 60 percent of full-term infants and 80 percent of premature
babies have so-called normal jaundice during the first week of life.  This
occurs because of the rapid destruction of the excess red blood cells with
which all healthy babies are born.  The jaundice usually begins in the second
or third day of life and disappears between the fifth and tenth days.  With
rare exceptions, this jaundice is harmless.
     The two most frequent causes of abnormal jaundice in the newborn are
blood poisoning and erythroblastosis fetalis.  Blood poisoning, a generalized
infection caused by bacteria or viruses, causes jaundice in the newborn by
destroying red blood cells and injuring the liver.  Erythroblastosis fetalis
is due to incompatibility between the child's blood and that of the mother.
The mismatch may be in the Rh factor (for example, when the mother is
Rh-negative and the infant is Rh-positive), in the ABO factors (for example,
when the mother's blood is type O and the baby's is type A or B), or in rarer
blood factors.  Because of the incompatibility, the mother's blood forms
antibodies (protective substances that form to fight off disease or anything
the body interprets as an attacking organism) that rapidly destroy the
infant's red blood cells.
     Jaundice may also develop in breast-fed newborns because a substance in
the mother's milk interferes with the functioning of the baby's liver.  This
form of jaundice usually is harmless.  There are many other causes of jaundice
in the newborn, including certain forms of anemia, hepatitis, and German
measles, but jaundice due to these causes is rare.
     Because either erythroblastosis fetalis or blood poisoning can be fatal
to newborn babies if not treated immediately, a doctor's diagnosis must be
made promptly.  Other forms of jaundice can also be serious if the bilirubin
in the blood exceeds a safe level.  If jaundice is suspected, a doctor must
monitor the bilirubin level closely.

SIGNS AND SYMPTOMS

     The condition is recognized by the presence of a yellow tinge to the skin
and the whites of the eyes.  To judge the yellowness of the skin and eyes
accurately, observe the baby in natural light.  (Artificial light obscures the
true color.)  If you suspect jaundice, inform your doctor at once.

HOME CARE

     The parents of a newborn should watch carefully for the development of
jaundice in the first week of the child's life at home.  If jaundice develops,
a doctor should see the child promptly.

PRECAUTIONS

  -  Jaundice in the first 24 hours of life is abnormal.  Because a newborn
     infant's nervous system is especially susceptible to permanent damage,
     jaundice during the first days of life has special significance.
  -  Jaundice that develops or worsens after a baby leaves the hospital should
     be reported to your doctor.
  -  Poor nursing, excessive drowsiness, irritability, and fever in a
     jaundiced baby should be reported to the doctor immediately.
  -  If jaundice develops in your infant, follow your physician's directions
     exactly.

MEDICAL TREATMENT

     Blood tests and cultures are used to identify the cause of the jaundice
and to chart the progress of the condition.  To lower the bilirubin level,
your doctor may expose the baby to special lights or replace the infant's
blood with that of a donor.

RELATED TOPICS:  Blood poisoning; G6PD deficiency; Jaundice in children