J is for Jaundice

J is for Jaundice

Jaundice occurs when bilirubin, a metabolic product of the breakdown of red blood cells (RBCs) builds up in the blood. It manifests as a yellow tine to the skin and whites of the eyes. About 60% of newborns have some degree of jaundice as their body adjusts from having the placenta eliminate bilirubin to having their liver take on that task.

The body eliminates bilirubin through the stool. The best non-medical thing you can do to help your baby eliminate excess bilirubin is to nurse your baby. Colostrum, your “early milk,” is a natural laxative, helping to clear meconium (which contains a large amount of bilirubin). The more colostrum your baby drinks, the more quickly he is likely to eliminate the excess bilirubin.

According to the Academy of Breastfeeding Medicine, “jaundice, which occurs in the first week in association with ongoing weight loss, has been termed breastfeeding jaundice, breastfeeding-associated jaundice, breast-nonfeeding jaundice, or starvation jaundice. However, this jaundice is almost always associated with low enteral intake rather than breastfeeding per se.” If this is suspected, your baby’s pediatrician may recommend supplementation with formula. This is done simply to increase the volume of fluid baby is taking in (and some pediatricians may approve you supplementing with expressed breast milk, as this also allows you to monitor the volume your baby is taking in). If your goal is to continue to breastfeed after the jaundice has been resolved, it is strongly recommended that you continue to pump every 2-3 hours, while supplementing, to keep your supply up.

What causes jaundice? When will it get better?

Jaundice can occur because a baby’s liver is adjusting to having to function on it’s own. It can also be the result of prematurity, infection, blood-type mismatch, and blood or liver problems.

As your baby continues to feed on his own and his liver develops, bilirubin passes through the body much more easily. Physiologic jaundice typically resolves within 2-3 weeks after birth. A persistence in symptoms beyond this period may indicate an underlying condition. Pathologic jaundice is caused by an issue with the hepatic (liver) system, which must be identified, before the condition can be fully remedied. Only your child’s doctor can determine an appropriate course of treatment and provide a time frame for the resolution of your baby’s symptoms.

Complications of Jaundice

Most cases of jaundice resolve within a few weeks’ time and have no lasting effect on baby. In extreme cases, if levels become too high, your baby can be at risk of brain damage, cerebral palsy, and deafness. You can rest assured knowing that if your baby appears jaundiced in the first few days after birth, your pediatrician will be on top of monitoring his bilirubin levels. The pediatrician will likely request that you follow up (either in the office or at a lab) to have repeat blood work done in the days and weeks after discharge, until the levels start to subside or treatment is prescribed.

How is Jaundice Treated?

As previously mentioned, your baby’s pediatrician will monitor his bilirubin levels to see if they are trending down. Treatment is typically not required if this is the case. If your baby’s levels are increasing, the following are the most common treatment options.

Light Therapy (Phototherapy) – your baby will be put under a special light wearing only his diaper and an eye mask (to protect his eyes). This will maximize the amount of his skin that is exposed to the light. A phototherapy mattress or blanket may also be used. This light changes the shape and structure of bilirubin molecules so they are more easily excreted.

IVIg (Intravenous Immunoglobulin) – this is a common treatment if your baby’s jaundice is caused by blood type differences. In this case, your baby has some maternal antibodies in their blood that are against their blood type. This leads to an excess in the breakdown of RBCs. IVIg transfusion can reduce the maternal antibody levels, thus helping to decrease bilirubin levels and ameliorate the jaundice.

Exchange Transfusion – this occurs rarely as it is used only to treat severe jaundice. Small amounts of blood are removed from your baby’s blood stream, the levels of bilirubin and maternal antibodies are diluted, and the blood is transfused back to the baby.

 

Please note that the information provided her is for educational purposes only and is not meant to diagnose, treat, cure, or prevent any disease. This is not meant to take the place of consultation or treatment by a physician.

 

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