Neonatal Jaundice: Causes and Treatment

 Within the first 48 hours after birth, many newborns develop jaundice. Without proper treatment, the child may become permanently disabled. 

Neonatal jaundice is a very common condition that appears in almost all newborns to some extent. Usually, within the first week after birth, many babies develop a slight yellowish tint on the skin and the whites of the eyes. This is called jaundice. Seeing this, many parents become frightened, but not all types of jaundice are dangerous. In most cases, it is a normal physiological process that resolves on its own within a few days without treatment. However, in some cases, it can become severe and pose serious risks to the baby. Therefore, it is very important to understand the causes, types, and treatments of neonatal jaundice.

Causes of Neonatal Jaundice

Neonatal jaundice occurs mainly due to a pigment called bilirubin. When red blood cells break down, bilirubin is produced. In adults, the liver processes bilirubin and removes it from the body. But since the liver of a newborn is not fully developed, it cannot process bilirubin quickly. As a result, bilirubin levels rise in the blood, causing yellow discoloration of the skin and eyes.

A newborn's body contains a higher number of red blood cells at birth. When these excess cells start to break down, bilirubin production increases. On the other hand, the newborn’s immature liver cannot process the excess bilirubin efficiently. This causes physiological or normal jaundice, which usually appears 2–3 days after birth and resolves within 7–10 days.

However, not all jaundice is normal and some cases require medical attention, such as:

• Blood group incompatibility: If the mother’s and baby’s blood groups are incompatible (e.g., Rh or ABO incompatibility), the baby’s red blood cells break down rapidly, increasing bilirubin levels.
• Premature babies: Preterm infants have even more immature livers, making them more prone to jaundice.
• Infection: Infections during or after birth may decrease liver function, leading to jaundice.
• Breast milk jaundice: Sometimes due to breastfeeding irregularities or hormonal effects in breast milk, jaundice may occur.

Symptoms of Neonatal Jaundice

The first symptom is a yellowish tint on the skin and the whites of the eyes. Initially, it appears on the face and eyes, then spreads downward across the body. In severe jaundice, symptoms may include excessive sleepiness, poor feeding, lethargy, reduced crying, and even seizures. If these symptoms appear, medical attention should be sought immediately.

Diagnosis of Neonatal Jaundice

When examining the baby, if the doctor notices yellowing of the skin, they may gently press the baby’s forehead, face, or chest to observe the color changes. Yellowing in the palms and soles also indicates jaundice.

Doctors usually diagnose jaundice based on skin color, but to confirm, a bilirubin test is done. This test measures the bilirubin level in the blood. Modern hospitals also use a “transcutaneous bilirubin meter,” which can measure bilirubin through the skin—safe and painless for the baby.

Treatment of Neonatal Jaundice

If bilirubin spreads excessively, it can cross into the brain and damage brain tissues. This may cause permanent neurological damage. Therefore, it is important to identify the type of jaundice and treat it properly.

The World Health Organization does not recommend placing the baby under direct sunlight. Prolonged exposure can burn the baby’s skin. However, some studies suggest that mild sunlight through a window can help reduce jaundice. Additional measures include:

1. Breastfeeding:

Frequent breastfeeding is the most important treatment. Jaundice can dehydrate the baby, so regular feeding helps eliminate bilirubin through urine and stool.

2. Sunlight exposure:

Exposing the baby to mild morning sunlight (for 20–30 minutes) while covering the eyes, face, and private parts may help.

3. Phototherapy:

At healthcare centers, babies are treated with blue light under phototherapy. This breaks down bilirubin, allowing the baby to recover.

4. Exchange transfusion:

In very severe cases, the baby may need a blood exchange transfusion to rapidly reduce bilirubin levels.

What You Should Never Do

In many countries, home remedies or traditional treatments are used for jaundice, which often cause more harm than good. These should be strictly avoided. Only follow the doctor’s instructions. With proper care, neonatal jaundice is completely treatable—so do not delay in seeking medical advice.

Prevention and Care

• Monitor the baby’s skin and eyes regularly after birth.
• Ensure the baby is well-hydrated through adequate breastfeeding.
• Observe the baby’s urine and stool frequency.
• Mild sunlight before 8 AM or after 5 PM may help reduce bilirubin.
• Avoid using medicines or home treatments without professional guidance.

Conclusion

In most cases, neonatal jaundice is normal and temporary. However, if neglected, it can become severe and cause brain damage, known as Kernicterus. Therefore, parents must stay alert from the moment the baby is born, seek medical help at the first sign of symptoms, and follow the doctor’s advice. With timely care and treatment, neonatal jaundice is fully curable, ensuring the baby’s healthy development.