What is Neonatal Jaundice?
is also known as Neonatal Hyperbilirubinemia. It is a condition which is associated with elevated levels of the serum bilirubin in just born babies. This is a condition which is extremely common in newborns and affects about more than half of all babies born during the first week of their life.
The word “jaundice” refers to the color yellow. In this context, it is the yellowing of skin. It is caused by the presence of excess bilirubin in the blood stream. A bilirubin level above 5 mg/dL would indicate the discussed condition.
How is the condition diagnosed?
It is mostly detected by the yellowing of skin. The face is first affected and it gradually proceeds towards the trunk. Infants with a yellowish pigmentation on the soles of feet and palms of hand are thought to have relatively high levels of serum bilirubin in blood.
A blood test generally helps in the measurement of the serum bilirubin levels in blood.
Causes of Neonatal Jaundice
Even though it is very common in new borns, there could be some serious implications of the condition. The different causes of neo natal jaundice are as follows:
Fetal Hemoglobin Breakdown
: Bilirubin is derived from the break down of heme proteins which are present in the hemoglobin in blood. About 75% of hemoglobin comes from this source. The breakdown of the fetal hemoglobin produces bilirubin. However, the nascent hepatic metabolic pathways do not have the necessary catalysts and enzymes to help in its conjugation. As a result, the levels of serum bilirubin in the blood increase leading to the jaundice.
Pediatric Liver Disease
: Other causes could be any malformation or congenital defect in the liver, pancreas, bile ducts or associated organs. Pediatric liver diseases like biliary artesia, bile duct paucity, Alagille’s syndrome etc should be considered.
Breast Feeding jaundice
: It is caused by insufficient breast feeding. Inadequate feeding results in lesser bowel movements in newborns whereby the excess bilirubin is not discharged from the body.
Breast Milk jaundice
: The infant gut is bereft of the normal intestinal bacteria which helps in digestion. In the absence of that, the infant gut finds it hard to process the conjugated bilirubin and excrete it through stool. Certain enzymes in breast milk like lipo protein lipase react with the bilirubin and adversely affect the excretion of excess bilirubin with stools.
Treatment of Neonatal Jaundice
: The infant is exposed to lights which could be full spectrum or of a specified wave length for a particular duration. Exposing infants to different colored lights has been found to help change excess bilirubin into more water soluble forms which is excreted in the bile. Medically, this process is known as isomerization.
: Increased breast feeding may help the infant pass out the excess bilirubin with stools.
: In infants whose serum bilirubin level is above 25mg/dL, a blood transfusion, where red blood cells and platelets of the person are replaced with transfused blood products is recommended.