Jaundice child

Description

Infant jaundice is yellow discoloration of a newborn baby's skin and eyes. Infant jaundice occurs because the baby's blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow pigment of red blood cells.

Infant jaundice is a common condition, particularly in babies born before 38 weeks of gestation (preterm babies) and some breast-fed babies. Infant jaundice usually occurs because the baby's liver is not mature enough to get rid of the bilirubin in the bloodstream. In some babies, an underlying disease may cause jaundice in children.

The majority of babies born between 35 weeks of gestation and full term needs no treatment for jaundice. Rarely, an unusually high blood levels of bilirubin can put a newborn at risk of brain damage, especially in the presence of certain risk factors for severe jaundice.

Symptoms

Yellowing of the skin and the whites of the eyes — the main sign of jaundice in children — usually appears between the second and fourth day after birth.

To check for infant jaundice, press gently on your baby's forehead or nose. If the skin looks yellow where you pressed, it is likely that your baby has mild jaundice. If your baby has jaundice, the color of the skin, you just need to look slightly lighter than your normal color for a moment.

Examine your baby in good lighting conditions, preferably in the natural light of the day.

When to see a doctor

Most hospitals have a policy of examining infants with jaundice prior to discharge. The American Academy of Pediatrics recommends that newborns be screened for jaundice during the routine medical checks and at least every eight to 12 hours, while in the hospital.

Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged before 72 hours after birth, to make a follow-up appointment to look for jaundice within two days of discharge.

The following signs or symptoms that may indicate severe jaundice or complications due to excess of bilirubin. Call your doctor if:

  • Your baby's skin becomes more yellow
  • Your baby's skin in the abdomen, arms, or legs looks yellow
  • The white part of the eyes of the baby looks yellow
  • Your baby seems to be sad or sick, or is hard to wake up
  • Your baby is not gaining weight or is not feeding well
  • Your baby makes high-cries
  • Your baby develops any other signs or symptoms that concern you

Causes

An excess of bilirubin (hyperbilirubinemia) is the main cause of the jaundice. Bilirubin, which is responsible for the yellow color of jaundice, which is a normal part of the pigment that is released from the decomposition of the "usa" red blood cells.

Newborns produce more bilirubin than adults due to the increased production and the rapid breakdown of red blood cells in the first days of life. Normally, the liver filters out the bilirubin from the blood and releases in the intestinal tract. A newborn's immature liver often can't remove the bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions that is called physiologic jaundice, and usually appears on the second or third day of life.

Other causes

An underlying disorder may cause jaundice in children. In these cases, the jaundice appears often much earlier or much later than does the more common form of jaundice in children. Diseases or conditions that may cause jaundice include:

  • Internal bleeding (bleeding)
  • An infection in your baby's blood (sepsis)
  • Other viral or bacterial infections
  • An incompatibility between the blood of the mother and the baby's blood
  • A malfunction of the liver
  • Biliary atresia, a condition in which the baby bile ducts are blocked or scarred
  • A deficiency of the enzyme
  • An abnormality of your baby's red blood cells that causes them to break down quickly

Risk factors

The main risk factors for jaundice, in particular, severe jaundice which can cause complications, which include:

  • The preterm birth. A baby born before 38 weeks of gestation, it may not be able to process the bilirubin as soon as full-term babies do. Premature babies can also feed less and have less bowel movements, resulting in less bilirubin is excreted through the feces.
  • Significant pain during the birth. A newborn that turns into a bruising during birth is presented bruising from the delivery may have higher levels of bilirubin from the breakdown of more red blood cells.
  • The blood type. If the mother is blood type is different from that of her baby, the baby may have received antibodies through the placenta that cause abnormally rapid breakdown of red blood cells.
  • Of breastfeeding. Breastfed infants, particularly those who have difficulty breastfeeding or getting enough nutrition from breastfeeding, are at higher risk of jaundice. Dehydration or low caloric intake may contribute to the onset of jaundice. However, due to the benefits of breastfeeding, experts still recommend it. It is important to ensure that your baby gets enough to eat and is properly hydrated.
  • Of the race. Studies show that babies of East Asian origin have a higher risk of developing jaundice.

Complications

High bilirubin levels that cause jaundice severe, it can result in serious complications if not treated.

Acute encephalopathy bilirubin

Bilirubin is toxic to the brain cells. If a baby has severe jaundice, there is a risk of bilirubin in the brain, a condition called acute encephalopathy bilirubin. Timely treatment can prevent permanent damage.

Signs of acute encephalopathy bilirubin in a baby with jaundice include:

  • Apathy
  • Difficulty waking up
  • Acute crying
  • Low suction or power
  • Backward arching of the neck and the body
  • Fever

Kernicterus

Kernicterus is the syndrome which occurs if acute encephalopathy bilirubin causes permanent damage in the brain. Kernicterus may result in:

  • Involuntary and uncontrolled movements have athetoid cerebral palsy)
  • Permanent upward gaze
  • Hearing loss
  • The inappropriate development of the enamel of the teeth

Prevention

The best prevention of infant mortality, the jaundice is adequate food. Breast-fed babies should have eight to 12 meals a day during the first days of life. Formula-fed infants typically must be 1 to 2 ounces (30 to 60 ml) of formula every two or three hours during the first week.

Jaundice child

Diagnosis

It is likely that your doctor diagnose jaundice in children on the basis of the appearance of the baby. However, it is still necessary to measure the level of bilirubin in your baby's blood. The bilirubin level (severity of jaundice) will determine the course of treatment. Tests to detect jaundice and to measure the bilirubin include:

  • A physical exam
  • A laboratory test of a sample of blood from your baby
  • A skin test with a device called a transcutaneous bilirubinometer, which measures the reflection of a special light shone through the skin

Your doctor may order additional blood tests or urine tests if there is evidence that your baby's jaundice is caused by an underlying disorder.

Treatment

Mild jaundice child often goes away by itself within two or three weeks. For moderate or severe jaundice, your baby may need to stay longer in the newborn nursery or be readmitted to the hospital.

Treatments to lower the level of bilirubin in your baby's blood may include:

  • Improved nutrition. To prevent the loss of weight, your doctor may recommend more frequent feeding or supplementation to make sure that your baby receives adequate nutrition.
  • Light therapy (phototherapy). Your baby may be placed under a special lamp that emits light in the blue-green spectrum. The light changes the shape and structure of the bilirubin molecules in such a way that they can be excreted in the urine and feces. During the treatment, the baby will wear only a diaper and eye protection patches. The light therapy can be supplemented with the use of a light-emitting cushion or mattress.
  • Intravenous immunoglobulin (Ivig). The jaundice may be related to the blood type of the differences between the mother and the baby. This condition causes the baby to the realization of antibodies from the mother that contribute to the rapid breakdown of red blood cells of the baby. Intravenous transfusion of immunoglobulin-a protein in the blood that can reduce the levels of antibodies can decrease the jaundice and decrease the need for exchange transfusion, although the results are not conclusive.
  • The exchange transfusion. Rarely, when severe jaundice that does not respond to other treatments, a baby may need a transfusion of blood exchange. This involves repeatedly the withdrawal of small amounts of blood and replacement of the donors of blood, diluting the bilirubin and maternal antibodies — a procedure that is performed in a neonatal intensive care unit.

Self-care

When the baby's jaundice is not severe, your doctor may recommend changes in eating habits that can decrease the levels of bilirubin. Talk with your doctor if you have any questions or concerns about how much or how often your baby is feeding, or if you are having problems with breastfeeding. The following steps can reduce the jaundice:

  • More frequent feeding. Eating more frequently will provide your baby, the more milk and cause more bowel movements, increasing the amount of bilirubin is eliminated in your baby's stool. Breast-fed babies should have eight to 12 meals a day during the first days of life. Formula-fed infants typically must be 1 to 2 ounces (30 to 60 ml) of formula every two or three hours during the first week.
  • Supplementary feeding. If your baby has difficulty breastfeeding, is losing weight, or are dehydrated, your doctor may suggest giving your baby formula or breast milk to supplement breastfeeding. In some cases, your doctor may recommend the use of formula alone for a couple of days, and then resume breastfeeding. Ask your doctor what power options are right for your baby.

Preparing for your appointment

The levels of bilirubin in the blood tend to peak when your baby is between three and seven days of age. So it is important for your doctor to examine your baby with jaundice during that time.

When your baby is discharged from the hospital, the doctor or nurse will look for jaundice. If your baby has jaundice, your doctor will consider the possibility of severe jaundice based on a number of factors:

  • How much bilirubin in the blood
  • If your baby was born prematurely
  • How well he or she is feeding
  • The age of your baby
  • If your baby has bruises from the delivery
  • If an older sibling also had severe jaundice

Follow-up visit

If the risk factors for severe jaundice are present, your doctor may recommend a visit of a day or two after the baby leaves the hospital.

When you arrive at your follow-up appointment, be prepared to answer the following questions.

  • How well is the feeding of your baby?
  • Is your baby breastfed or formula fed?
  • How often does your baby feed?
  • How often does your baby have a wet diaper?
  • How often there is stool in the diaper?
  • Does your baby wake up with ease for food?
  • Does your child seems ill or weak?
  • Have you noticed any changes in the color of your baby's skin or eyes?
  • If your baby has jaundice, has the color yellow spread to other parts of the body of the face?
  • Has your baby to the temperature steady-state?

You can also prepare questions to ask your doctor at your follow-up appointment, including:

  • Is jaundice serious?
  • What is the cause of the jaundice?
  • What tests will my baby need?
  • Does my baby need to start the treatment for jaundice?
  • I'm going to need to take back to my baby at the hospital?
  • Is jaundice serious?
  • Will my baby need in the hospital?
  • When should my baby have a follow-up visit?
  • Should I keep feeding my baby the way I am now?
  • Do you have any brochures about jaundice and eating right?
Symptoms and treatment of jaundice in Children