Jaundice is a common condition in newborns that causes a yellowish tint to the skin and eyes. It occurs due to the buildup of bilirubin, a yellow pigment that is a byproduct of the breakdown of red blood cells. In most cases, jaundice is harmless and resolves on its own within a few weeks. However, in some instances, jaundice levels can increase, leading to potential complications. This article will explore the reasons behind the increase in jaundice levels and the factors that contribute to this condition.
Understanding Jaundice in Newborns
What Is Bilirubin?
Bilirubin is produced when red blood cells break down. Normally, the liver processes bilirubin and excretes it in bile, which is then removed from the body through stool. In newborns, the liver is still maturing and may not be efficient enough to handle the bilirubin load. This leads to an accumulation of bilirubin in the blood, causing jaundice.
Physiological Jaundice: A Common Cause
Most newborns experience physiological jaundice, which usually appears within the first few days after birth. This type of jaundice is due to the normal breakdown of fetal hemoglobin as the baby’s body switches to producing adult hemoglobin. The immature liver of the newborn cannot process the increased bilirubin quickly enough, leading to a temporary rise in bilirubin levels.
Breastfeeding Jaundice: A Contributing Factor
Breastfeeding jaundice is another reason why jaundice levels may increase. This type of jaundice occurs when a newborn does not get enough breast milk, leading to dehydration and a slower elimination of bilirubin. This is often due to challenges with breastfeeding, such as improper latch or low milk supply. As a result, bilirubin levels can rise, and jaundice may persist.
Breast Milk Jaundice: A Less Common Cause
Breast milk jaundice differs from breastfeeding jaundice and typically appears later, around the second or third week of life. It is thought to be caused by substances in breast milk that inhibit the liver’s ability to process bilirubin. While breast milk jaundice is generally not harmful, it can lead to prolonged jaundice if bilirubin levels continue to rise.
Pathological Jaundice: When It’s a Sign of a Problem
In some cases, increased jaundice levels are a sign of a more serious underlying condition. This is known as pathological jaundice, which can occur due to several factors, including:
Hemolytic disease of the newborn:
This condition occurs when there is an incompatibility between the mother’s and baby’s blood types, leading to the rapid destruction of the baby’s red blood cells. This causes a significant increase in bilirubin levels.
Infections:
Infections in newborns, such as sepsis, can lead to increased breakdown of red blood cells and impaired liver function, both of which contribute to elevated bilirubin levels.
Liver disorders:
Conditions such as biliary atresia, where the bile ducts are blocked or malformed, prevent bilirubin from being excreted properly, leading to its accumulation in the body.
Genetic disorders:
Certain genetic conditions, such as Gilbert’s syndrome or Crigler-Najjar syndrome, can affect the liver’s ability to process bilirubin, resulting in higher jaundice levels.
Risk Factors for Increased Jaundice Levels
Several factors increase the risk of elevated jaundice levels in newborns. These include:
Prematurity:
Premature babies have underdeveloped livers, making it harder for them to process bilirubin efficiently.
Blood type incompatibility:
As mentioned earlier, if there is a mismatch between the mother’s and baby’s blood types, the baby’s red blood cells may break down more quickly, leading to increased bilirubin levels.
Bruising during delivery:
Babies who experience bruising during birth have more red blood cells to break down, which can contribute to higher bilirubin levels.
Family history:
A family history of jaundice or liver conditions can increase the likelihood of elevated bilirubin levels in newborns.
Signs That Jaundice Levels Are Increasing
It’s important to monitor newborns for signs that jaundice levels may be increasing. These signs include:
Deepening yellow color:
The yellowish tint of the skin and eyes becomes more pronounced.
Lethargy:
The baby may appear unusually sleepy or have difficulty waking up for feedings.
Poor feeding:
The baby may have trouble breastfeeding or bottle-feeding.
High-pitched crying:
Some babies with increased jaundice levels may have a high-pitched cry, which can be a sign of discomfort.
Complications of Elevated Jaundice Levels
If jaundice levels continue to rise without intervention, complications can occur. One of the most serious complications is kernicterus, a rare but severe form of brain damage caused by extremely high levels of bilirubin. Kernicterus can lead to long-term neurological problems, including hearing loss, vision problems, and developmental delays. Therefore, it is crucial to address rising jaundice levels promptly to prevent such outcomes.
Diagnosing and Monitoring Jaundice Levels
Healthcare providers use several methods to diagnose and monitor jaundice levels in newborns. These include:
Visual assessment:
A physical examination to check the yellowing of the skin and eyes.
Bilirubin tests:
Blood tests to measure the levels of bilirubin in the baby’s blood. A transcutaneous bilirubinometer, a device that measures bilirubin levels through the skin, may also be used.
Monitoring risk factors:
Healthcare providers consider the baby’s gestational age, weight, and any underlying conditions that may contribute to jaundice.
SEE ALSO: What to Eat to Prevent Jaundice in Newborns?
Treatment Options for Elevated Jaundice Levels
The treatment of jaundice depends on the severity and underlying cause. Common treatment options include:
Phototherapy:
This is the most common treatment for jaundice. The baby is placed under a special light that helps break down bilirubin in the skin, making it easier for the body to eliminate it.
Exchange transfusion:
In severe cases, an exchange transfusion may be necessary. This procedure involves replacing the baby’s blood with fresh blood to quickly reduce bilirubin levels.
Intravenous immunoglobulin (IVIG):
For babies with hemolytic disease, IVIG can help reduce the need for an exchange transfusion by blocking the antibodies that are attacking the baby’s red blood cells.
Feeding support:
Ensuring that the baby is feeding well, whether through breastfeeding or formula feeding, is crucial for helping the body eliminate bilirubin.
Preventing Elevated Jaundice Levels
While some cases of jaundice are unavoidable, there are steps that parents and healthcare providers can take to reduce the risk of elevated jaundice levels. These include:
Early feeding:
Encouraging frequent breastfeeding or formula feeding in the first few days of life can help the baby’s body eliminate bilirubin more effectively.
Monitoring:
Babies at risk for jaundice, such as those born prematurely or with a family history of jaundice, should be closely monitored for signs of rising bilirubin levels.
Proactive treatment:
In cases where jaundice is identified early, initiating phototherapy or other treatments promptly can prevent bilirubin levels from reaching dangerous levels.
Conclusion
Jaundice is a common condition that can become a cause for concern if bilirubin levels continue to rise. Understanding the factors that contribute to increased jaundice levels, recognizing the signs, and seeking appropriate treatment are crucial for ensuring the health and well-being of newborns. With proper monitoring and intervention, most cases of jaundice can be managed effectively, allowing babies to thrive and develop without complications.
