Dealing with jaundice in babies
AMONG the common baby myths shared in Jamaica is that mothers who indulge in too many sweets while pregnant increase their babies’ exposure to jaundice – a usually mild condition which causes yellow discolouration in the eyes and skin of newborns.
But paediatrician Dr Anona Griffith said this is not so.
“The yellow colour is that of bilirubin, a by-product from the breakdown of red blood cells. The process of removal of old red blood cells was done by the placenta prior to delivery. After delivery, the baby’s liver takes over that role. The process is a sluggish one initially, hence the build-up of bilirubin which stains the skin, eyes and other mucous membranes yellow,” Dr Griffith explained.
She said the condition, which is usually noticed in the first three to five days of life, and which is most intense at about day five to seven, usually fades as the infant matures.
“This is referred to as physiological jaundice and is considered for the most part normal, and does not require intervention. In fact, most babies who have jaundice require no intervention. However, the level of bilirubin can be measured in the blood to assess the need for intervention,” Dr Griffith advised.
Dr Griffith noted that there are certain conditions under which jaundice can become a matter of concern (pathological), when levels approach those requiring intervention. These are:
1) If it occurs in the first 24 hours of life.
2) If mummy has a different blood group from baby or is Rh negative and baby positive, setting the stage for possible incompatibility between the cells and exaggerated breakdown of baby’s red cells.
3) Prematurity, where the organs of these babies are not as developed as in full-term infants.
4) The infant is unwell and showing signs of infection. Infection in babies can worsen jaundice.
5) Bruising of any part of baby during delivery may predispose baby to increased jaundice levels.
6) If there is a history of siblings with jaundice especially requiring intervention. There may be a genetic blood disorder such as G6PD deficiency.
7) If jaundice persists beyond two weeks of life.
8) If the infant’s stools are pale and the urine very dark. This could indicate a very serious liver condition which is best handled with early detection and intervention, as delay can be fatal.
9) Certain genetic conditions which may be identified by abnormal facial and body features.
Jaundice usually takes care of itself over a short period because with frequent feeds and adequate hydration, regular bowel movement is enhanced and bilirubin is removed from the body, as it is excreted mainly in stools, with a smaller proportion in the urine.
However, Dr Griffith said that in mild cases, treatment in the form of phototherapy (light therapy) is also practised, while more aggressive treatments are used to manage more severe conditions.
“In severe cases where the levels are very high or are increasing rapidly, exchange transfusion may have to be performed which will require baby’s blood to be exchanged for donor blood,” Dr Griffith advised.
