Infant jaundice: Causes, symptoms, and treatments

Infant jaundice is a condition where a baby’s skin, and the white part of their eye, appear yellow. Jaundice is a common condition in infants, affecting over 50 percent of all newborns.

Jaundice is particularly common in premature babies – boys more often than girls. It usually appears within the baby’s first week of life.

In an otherwise healthy baby born at full term, infant jaundice is rarely a cause for alarm; it tends to go away on its own. However, if treatment is necessary, infants tend to respond to non-invasive therapy.

In rare cases, untreated infant jaundice may lead to brain damage and even death.

Causes

red blood cells
The cause of jaundice is excess bilirubin, a waste product produced when red blood cells are broken down.

Infant jaundice is caused by an excess of bilirubin. Bilirubin is a waste product, produced when red blood cells are broken down. It is normally broken down in the liver and removed from the body in the stool.

Before a baby is born, it has a different form of hemoglobin. Once they are born, they very rapidly break down the old hemoglobin. This generates higher than normal levels of bilirubin that must be filtered out of the bloodstream by the liver and sent to the intestine for excretion.

However, an underdeveloped liver cannot filter out the bilirubin as fast as it is being produced, resulting in hyperbilirubinemia (an excess of bilirubin).

Infant jaundice with breast-feeding is common. It occurs in newborns that are breast-fed in two separate forms:

Breast-feeding jaundice – occurs in the first week of life, if the baby does not feed well, or if the mother’s milk is slow to come in.

Breast milk jaundice – this is due to how substances in the breast milk interfere with the breakdown process of bilirubin. It occurs after 7 days of life, peaking at 2-3 weeks.

Some cases of severe infant jaundice are linked to an underlying disorder; these include:

liver disease

sickle cell anemia

bleeding underneath the scalp (cephalohematoma) – caused by a difficult delivery

sepsis – a blood infection

an abnormality of the baby’s red blood cells

blocked bile duct or bowel

rhesus or ABO incompatibility – when the mother and baby have different blood types, the mother’s antibodies attack the baby’s red blood cells

higher numbers of red blood cells – more common in smaller babies and twins

enzyme deficiency

bacterial or viral infections

hypothyroidism – underactive thyroid gland

hepatitis – an inflammation of the liver

hypoxia – low oxygen levels

some infections – including syphilis and rubella

Risk factors

Common risk factors for infant jaundice are:

Premature birth – premature babies have severely underdeveloped livers and fewer bowel movements, this means there is a slower filtering and infrequent excretion of bilirubin.

Breast-feeding – babies who do not get enough nutrients or calories from breast milk or become dehydrated are more likely to develop jaundice.

Rhesus or ABO incompatibility – when a mother and baby have different blood types, the mother’s antibodies go through the placenta and attack the red blood cells of the fetus, causing accelerated break down.

Bruising during birth – this can make red blood cells break down faster, resulting in higher levels of bilirubin.

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Symptoms

The most pervasive sign of infant jaundice is yellow skin and sclerae (the whites of the eyes). This typically starts at the head, and spreads to the chest, stomach, arms, and legs.

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