Dr Vijay Kumar

Jaundice In Infants – Why and When Should Parents Worry?

Catagory: NICU Author: Dr T.V Vijay Kumar

Jaundice In Infants

Did you know that neonatal jaundice can affect up to 60–70% of newborns? When it comes to infant jaundice, parents frequently question when to be concerned.

Here are some queries for the neonatologist regarding infant jaundice.


What makes newborns develop jaundice?


Babies get jaundice when bilirubin, a yellow pigment, builds up in their bodies. The placenta of the mother assists in removing the pigment from the baby’s body while the child is still in the womb.

Haemoglobin is necessary for babies in the womb to absorb oxygen from the mother’s blood. However, after delivery, the liver converts the excess haemoglobin in their blood to bilirubin, which is then excreted from the body.


However, the newborn’s liver is still developing and frequently unable to manage and get rid of the bilirubin on its own. This is the cause of the postpartum jaundice that many babies experience.

The concentration of the yellow pigment often reaches its peak around the third or fourth day after birth and then begins to decline.


After delivery, most newborns with jaundice follow a similar pattern.


However, several conditions or behaviours may raise a newborn’s risk of jaundice.


  1. Inadequate Nutrition

The infant may get dehydrated if underfed or improperly nourished. The body will begin to accumulate bilirubin, a yellow pigment.


  1. Blood Group Discrepancies

If the mother’s blood type and the baby’s blood type are incompatible, the jaundice is more likely to be severe (babies born to mothers with O blood group or Rh negative blood group are at higher risk).


  1. Additional Rare Disorders

Baby jaundice may also be exacerbated by a few other uncommon diseases, such as a G6DP (glucose 6 phosphate dehydrogenase) deficit.


What impact does infant jaundice have?


Among the signs of jaundice in infants are:


  • Yellowish skin, particularly on the scalp and face
  • The baby’s eyes’ white portions have a yellow tint to them.
  • Yellower, darker urine
  • Light-colored or white stools
  • feeding problems

Can jaundice affect young children?


Although severe jaundice in infants might result in future issues including cerebral palsy, hearing loss, etc., it is not lethal. Additionally, the jaundice could seep into the brain and harm it permanently (by staining the basal ganglia, also called kernicterus).

When levels of jaundice in infants reach dangerous levels without medical oversight or appropriate care, it can be deadly. This often happens when serum bilirubin levels exceed 20–25 mg/dl.

However, parents should remember that jaundice is often not a reason for concern if prompt intervention is done. You should get counsel from a specialist as soon as possible.


What degree of jaundice in neonates is dangerous?

Bilirubin, the pigment that causes jaundice, does not have a single number that is always harmful. The baby’s susceptibility to bilirubin depends on things like:


  • Baby’s gestational age, including whether or not the child is premature
  • Baby’s size
  • concomitant characteristics like blood group incompatibility
  • Day of Life, since the tolerance varies from the first to the fifth day of life

Neonatal doctors are able to evaluate each baby’s needs and tolerance levels by using the American Academy of Pediatrics (AAP) recommendations to give suitable treatment alternatives.


Treatment for Infant Jaundice


Phototherapy is advised if the bilirubin level exceeds the baby’s upper tolerance limit.


What is the treatment for jaundice in a baby other than phototherapy?


Babies with severe jaundice may benefit from phototherapy, or light therapy, which decreases bilirubin levels in the body through a process known as photo-oxidation and photo-isomerization.

The infant will have his or her eyes and genitalia covered while being held beneath a halogen or fluorescent light. Thus, the yellow pigment in their bodies is broken down or lysed, which is subsequently eliminated through their faeces or urine.


How safe is phototherapy?


When performed correctly, phototherapy is relatively safe and has no noticeable negative effects. The baby’s eyes are not damaged by the strong light because of the safeguards used during the operation.

Infants that are admitted to the NICU for phototherapy are often released 24 to 48 hours after being hospitalised.


How may jaundice be treated at home?


Although we do not advise treating infant jaundice at home, there are several steps parents may take to avoid the development of severe jaundice. For example:


  • Breastfeeding in a supervised manner

It is important to follow good breastfeeding procedures since improper nursing might make newborns’ jaundice worse.


  • Proper sunshine exposure

Jaundice can be lessened by sunlight. However, keep in mind that exposure to sunshine is not a cure, and if the infant’s condition worsens, phototherapy will be necessary.


What occurs if a baby’s jaundice persists?

Jaundice in infants often goes away within 14 days of birth, so parents need not worry in most cases.


Jaundice in newborns is referred to as chronic or protracted if it persists more than 14 days after delivery. Your kid will go through a series of exams to rule out any illnesses that might be the cause of their recurrent jaundice, and they will then receive the appropriate treatment.