Newborn Jaundice

Neonatal jaundice is a very common finding in newborn babies. More than 60% of the babies who are born at term and 80% who are preterm babies have jaundice within the first week of life. Of this, 10-12% have clinically significant jaundice that requires treatment. Those babies born prematurely are more prone to the ill-effects of jaundice due to various reasons. Severe jaundice if left unnoticed can take a toll on the brain causing irreversible damage to the baby’s growth and development. It is therefore vital to get the bilirubin levels of all newborn babies checked appropriately after birth. It is one of the preventable causes of mental retardation if identified and treated at the right time.

Red flag signs:

• Poor feeding
• Drowsiness
• Excessive crying, irritability without any apparent reason
• Seizures
• Clay-coloured stools
• Abdominal distension

Physiological Jaundice:

It represents the physiological immaturity of the neonates to handle the excess bilirubin. Visible jaundice usually appears at 24-72 hrs of birth. It usually peaks by the third day and falls within a week.

Pathological Jaundice:

1. Jaundice within 24 hrs of birth
2. Bilirubin levels above the expected range
3. Persistence beyond three weeks of age
4. Associated with clay-coloured stools and abdominal distension

Management:

The severity of jaundice can be assessed clinically along with serum bilirubin levels. Treatment depends on the serum levels of bilirubin. Most of the babies respond well to phototherapy. A proportion of babies with severe jaundice might require other forms of treatment like exchange transfusion and other medications.