Jaundice of the newborn
One of the more common problems we encounter in the newborn period is jaundice. This is simply when the baby presents with yellowing of the skin and or eyes as a result of increased bilirubin levels in the bloodstream.
We categorize these into 2 groups either:
In the majority of the cases this jaundice is in the first category, normal jaundice of the newborn. This occurs because baby’s new liver is learning to cope with its new duties, one of them being the processing of bilirubin. This results in mildly elevated levels of bilirubin, and in turn yellowing of the skin. We now understand that this state of mildly elevated bilirubin levels actually is protective for the baby (an anti-oxidant) and is Mother Nature’s way of protecting baby from infection. No mom should ever stop breast feeding or start giving baby water in between feeds. Exposure to sunlight is not necessary since this jaundice benefits the baby.
The above, however, is what we call a diagnosis of exclusion, i.e. we can only diagnose the above by excluding pathological jaundice.
This is done by:
So in summary we need to look at several factors based on baby’s age, weight, bilirubin level and other clinical parameters to determine if this is truly normal jaundice of the newborn, or diseased jaundice. The goal of which is to avoid any complications or long term effects in baby.
Article prepared by Dr NB Singh (Specialist Paediatrician)