Newborn babies are often affected by jaundice within the first week of their births. The baby’s skin appears to be yellow during this time. The white part of the eye also tends to get yellowish. Almost 50% of infants suffer from infant jaundice or neonatal jaundice.

Infant jaundice is, however, not a reason for alarm. It usually goes away on its own. In case there is a requirement of any treatment, non-invasive therapy is given to the newborn for faster recovery.

In few rare cases, infant jaundice may cause brain damage and even death, if left untreated. However, there are various medications and therapies to treat the baby affected with this syndrome. Fluctuations in the level of bilirubin at the time of baby’s birth are normal and are generally noticed in babies.

Causes of Infant Jaundice

Bilirubin secretion is a common phenomenon in newborn babies. If we discuss it in details, we will come to know that the old red blood corpuses of the baby breaks down soon after the birth. It breaks down to form new blood in the baby. During this time bilirubin is produced as a waste product. The excess bilirubin that comes out as a waste product of the red blood cells breaking down is what causes jaundice in infants.

The baby’s liver sometimes fails to filter all the waste bilirubin when the amount is high and cannot pass it through the intestine properly. In such cases, the baby suffers from jaundice as the bilirubin fails to go out of the body through the stool.

The baby has a different form of haemoglobin when it is inside the womb. Once they are born, the old haemoglobin breaks down rapidly. Thus, an excessive amount of bilirubin is formed that is filtered from the bloodstream. In case of hyperbilirubinemia (an excess of bilirubin), the liver fails to filter the blood and cannot send the bilirubin to the intestine for excretion.

Infant jaundice while breastfeeding is a usual syndrome located in newborn babies. Breastfeeding babies suffer from such jaundice in two separate forms:

Breastfeeding Jaundice – This syndrome is noticed in the newborn babies in the very first week of life. This occurs when the baby is not able to suck well, or the pressure of the mother’s milk is slow to move as the baby sucks.

Breast milk jaundice – This syndrome occurs when some substances present in the breast milk causes interference in the bilirubin breakdown process. This occurs usually after a week of the baby’s birth, peaking at 2-3 weeks.

The following disorders can occur in infants in case of severe jaundice:

1. Various liver disease

2. Red blood cell disorders like sickle cell anaemia

3. Cephalohematoma or traumatic subperiosteal haematoma occurring in infants underneath the skull bone

4. Blood infections like sepsis

5. Enzyme deficiency

6. Low levels of oxygen or hypoxia

7. Infections like syphilis and rubella

8. Abnormality in the growth of the baby’s red blood cells

9. Bacterial or viral infections

10. Severe inflammation of the liver or hepatitis

11. Underactive thyroid gland or hypothyroidism

12. Blockage of bowel or bile duct

Symptoms of Infant Jaundice

The major symptoms of infant jaundice are the yellowishness of the sclerae and skin. The excess bilirubin hits the head first and then spreads to the rest of the body. The chest, arms, legs, and stomach eventually gets the yellowish colour that suggests the occurrence of infant jaundice or neonatal jaundice.

Symptoms of infant jaundice also include the following:

1. Drowsiness in the baby

2. Pale stools of the baby instead of greenish-yellow stools or greenish-mustard stool

3. Problem in sucking or feeding

4. Dark coloured stool in newborn

Symptoms of severe infant jaundice are:

1. Extreme drowsiness

2. Yellowish limbs or abdomen

3. Irritability in sucking

4. No growth or weight gain

Diagnosis of Infant Jaundice

It is expected to have misbalanced levels of bilirubin in newborn babies. Hence, we test the bilirubin level of newborn continuously for 3 to 5 days after the baby’s birth. We closely monitor the ups and down of bilirubin level to ascertain the liver function as well as the blood formation of the baby. The baby is not discharged until and unless the bilirubin level is under control.

In infants, the treatment is mostly based on physical diagnosis. However, the level of severity is determined by bilirubin test. Bilirubin levels are determined by the serum bilirubin (SBR) blood test. It is done by a transcutaneous bilirubinometer device.

In case jaundice persists for more than a week, further blood tests are prescribed to determine the underlying disorders. This is the same for breastfed babies as well.

Treatment

Usually, mild jaundice disappears within a week or two. The baby needs to be exposed to sunlight for some time to treat mild jaundice. There is no other medication required.

In case the jaundice is severe, the baby needs to be admitted to the hospital for further treatment until the levels of bilirubin in the bloodstream are lowered. In less severe cases, home treatment is enough for the baby to recover soon.

A few other treatment options for severe jaundice are:

– Phototherapy or Light Therapy

In this therapy, the baby is put under a ray that manipulates the bilirubin molecule structures to let them get excreted. The baby is covered by a plastic protection to shield from the ultraviolet light.

– Exchange Blood Transfusion

Under this procedure, the baby’s blood is withdrawn and replaced with external blood. This procedure is repeatedly done when the phototherapy procedure fails to clear out the excess bilirubin. Newborns are kept in intensive care unit (ICU) for this medical procedure.

– Intravenous Immunoglobulin or Ivig

In rare cases of ABO incompatibility or rhesus, the newborn is considered for transfusion of immunoglobulin. Immunoglobulin is the protein substance of the blood that decreases antibody levels from the mother and restricts it from attacking the newborn’s red blood cells.

Complications

Untreated jaundice leads to varied complications in newborn. These are:

– Acute Bilirubin Encephalopathy

This condition usually develops when the bilirubin build-up reaches the brain and intoxicates the brain cells. Effects of acute bilirubin encephalopathy cause sluggishness, high fever, irritation and crying, body ache and poor feeding in newborns. Immediate treatment and attention are required in such cases.

– Kernicterus or Nuclear Jaundice

This syndrome is potentially fatal and occurs when the acute bilirubin encephalopathy induces permanent brain damage.

At dire occasions, high level of bilirubin in newborns causes complications like deafness and cerebral palsy.

Prevention

The best way to prevent the increase of bilirubin level in infants is to feed them well right from birth. The mother should eat properly during her gestation period. Her nutrition bypasses the child and develops immunity in them. Babies get immunity from their mothers, so it is very important to take utmost care of the surrogates at the time of pregnancy. We at New Life consider this to be an important phase that has serious consequences after the childbirth. Hence, our surrogates are all closely monitored and well maintained.

In case our babies born out of surrogacy have issues with bilirubin levels, our expert team of medical professional deal with it immediately.