Newborn jaundice
Alternate Names : Jaundice of the newborn, Neonatal hyperbilirubinemia
Treatment
Treatment is usually not necessary. Keep the baby well-hydrated with breast milk or formula. Frequent feedings encourage frequent bowel movements, which helps remove bilirubin through the stools. (Bilirubin is what gives stool a brown color). Sometimes special blue lights are used on infants whose levels are very high. This is called phototherapy. These lights work by helping to break down bilirubin in the skin. The infant is placed naked under artificial light in a protected isolette to maintain constant temperature. The eyes are protected from the light. The American Academy of Pediatrics recommends that breastfeeding be continued through phototherapy, if possible.
In the most severe cases of jaundice, an exchange transfusion is required. In this procedure, the baby's blood is replaced with fresh blood. Treating severely jaundiced babies with intravenous immunoglobulin may also be very effective at reducing bilirubin levels.
Prognosis (Expectations)
Usually newborn jaundice is not harmful. For most babies, jaundice usually resolves without treatment within 1 to 2 weeks. However, if significant jaundice is untreated, very high levels of bilirubin can damage the brain. For babies who require treatment, the treatment is usually quite effective.
Complications
Rare, but serious, complications from high bilirubin levels include: - Cerebral palsy
- Deafness
- Kernicterus -- brain damage from very high bilirubin levels
Calling Your Health Care Provider
All babies should be seen by a health care provider in the first 5 days of life to check for jaundice. - Those who spend less than 24 hours in a hospital should be seen by age 72 hours.
- Infants sent home between 24 and 48 hours should be seen again by age 96 hours.
- Infants sent home between 48 and 72 hours should be seen again by age 120 hours.
Jaundice is an emergency if the baby has a fever, has become listless, or is not feeding well. Jaundice may be dangerous in high-risk newborns. Jaundice is generally NOT dangerous in term, otherwise healthy newborns. Call the infant's health care provider if jaundice is severe (the skin is bright yellow), if jaundice continues to increase after the newborn visit, lasts longer than 2 weeks, or if other symptoms develop. Also call the doctor if the feet, particularly the soles, are yellow.
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