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They said my newborn baby has jaundice; What is this? Is it important?

Neonatal jaundice occurs among 60% of the full-term and 80% of the premature newborns. Most of the neonatal jaundice cases are physiological; that is, it is usually harmless and goes away within a week or two.

How did my baby develop neonatal jaundice?

Neonatal jaundice occurs as a result of the bilirubin increment in blood and its accumulation in the skin which is the substance gives the skin a yellow color.

Why did my baby develop neonatal jaundice?

1-Baby has lower amount of oxygen in the womb. Bone marrow works more to maintain balance. As much oxygen after birth is distributed throughout the body with more red sphere cells (red blood cells/erythrocytes). Therefore, your newborn baby has more red sphere cells (red blood cells). For this reason, newborn babies appear more red.As a result of reaching to an environment contains more oxygen with birth, red blood cells (erythrocytes) are not needed any more, and their degradation results in bilirubin.

2- Before delivery, your baby’s bilirubin cleanses your/mother’s liver; but after the delivery, it takes a few days for baby’s liver to reach the capacity to be able to clear the bilirubin. In the meantime, bilirubin which cannot be sufficiently excreted by the liver, increases and causes jaundice.


How long will my baby's physiological jaundice last?

Newborn physiological jaundice, which occurs in almost every infant for above stated reasons, usually starts on the second day of their life, reaches its highest level in third and fourth days, and gradually decreases until the 15th day.





How does my baby's neonatal jaundice progress?

The yellowing of the skin of a newborn with jaundice starts with the face, then spreads to the neck, abdomen and finally to the legs. Usually, baby’s sclera is also yellow. You should carefully observe your baby for neonatal jaundice, and it is especially hard to notice the signs of jaundice in children with dark skin tones.

Genlty press your baby’s nose or forehead with your finger to be sure since it is easier to see the signs of jaundice when you pull your finger. The yellow discoloration of the skin can be best observed in daylight or under a fluorescent lamp. The yellow color can be more clearly detected when the finger is slightly pressed and lifted onto the abdominal skin.


How do I understand values of neonatal jaundice at home?

»If the bilirubin ratio is between 5 and 8 mg / dl, the head and neck area turns yellow,

»If the amount of bilirubin is between 8 and 10 mg /, the upper part of the body turns yellow,

»If the amount of bilirubin is between 10 and 13 mg / dl, the lower part of the body turns yellow,

»If the amount of bilirubin is between 13 and 16 mg / dl, the arms and legs will turn yellow,

»If the amount of bilirubin is around 20 mg / dl, hands and feet turn yellow.

To be able to determine bilirubin level, it is important to seek medical advise as soon as you notice that your baby has jaundice.

After examination, your physician, will measure jaundice value with forehead measurement without blood test (Transcutaneous measurement, bilichek) if finds necessity. If the value is significantly high, he/she will offer treatment for jaundice or guide you through follow-up by deciding whether to look at the level of bilirubin in the blood.

What kind of symptoms will occur if my baby’s bilirubin level is too high?

At first, yellow color in baby's skin gradually darkens and becomes more pronounced. Baby sleeps more, and sucks less milk (which increases jaundice further). If the bilirubin got too high and affected the brain (kernicterus), then baby starts to cry with a high-pitched voice, throws its head back, can go to the eclampsia. As a result, a baby in this situation usually has delays in mental and motor development, and has hearing and vision problems.

Is my baby at risk for jaundice?

»Premature babies (under 37 weeks),

»Bleeding under the scalp during birth,

»Those whose jaundice were detected in the first 24 hours,

»Infants who have problems with sucking and cannot feed well,

»Mothers with pregnancy-related diabetes or thyroid disease,

»Incompatibility between mother and baby in terms of Rh (Mother Rh negative; Baby Rh positive) or ABO (Mother 0; Baby A, B or AB),

»Colorless stool (white) and dark urine,

»Having older siblings/brothers who had neonatal jaundice that requires light therapy.

How to decide treatment?

Based on the age, weight and risk group of the baby, BHUTANI curves are formed. According to this table, treatment is started when bilirubin reaches a certain level.



How is neonatal jaundice treated?

In 1958, the observing the jaundiced babies skin were lightened after taken for a walk in the garden by coincident, created the foundations of phototherapy. Since then, phototherapy has been the most widely used treatment for jaundice.

1 - Phototherapy (Light therapy): Baby is placed under a special light source. Light source is used in the blue-green spectrum. This light makes bilirubin to dissolve in water and be excreted from the body through urine and feces. Phototherapy does not harm the baby in any way. Baby's eyes are closed to prevent damage from light. Sometimes, it can cause red rashes, tanning or frequent and watery stools as side effects. After light therapy, bilirubin levels usually rise again in one or two days. During this period, doctor control is also recommended.


  2 - Intravenous immunoglobulins: If jaundice is due to blodd type differences between mother and baby,in this case, antibodies that pass through the mother may cause the destruction of red blood cells. Intravenous immunoglobulin administration can reduce antibody levels and reduce the risk of blood exchange.


3-Blood Exchange Transfusion: In cases of severe jaundice, if there is no response to other treatments, baby’s blood may need to be transfused.


What should I do to prevent my baby’s jaundice becoming serious?

1 - Baby should be encouraged to suck, and breastfed 8-12 times a day.

2 - When the mother and the baby are discharged, they should be informed about neonatal jaundice and nutrition. They should be checked by the pediatrician after 2 days of discharge.

Does neonatal jaundice pose a risk if left untreated?

If your baby scores high on the neonatal jaundice curve, you should have a treatment as soon as possible before being affected from high levels. Because high bilirubin settles in the brain and causes irreversible damage to the baby's brain. In particular, it is known that hearing of the babies with high level of jaundice are affected.


As a parent, do we affect the emergence of jaundice in our baby by having a disease or a medication that we use?

It is known that mother and father’s race affects the level of jaundice. Approximate bilirubin level is higher in yellow race and lower in dark people. Additionally, the risk is higher in consanguineous marriages since risk for congenital metabolic and genetic diseases are also high. Jaundice is more common and reaches risky levels in babies of diabetic mothers.


Uzm. Dr. Süleyman Mevlitoğlu

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