4 Different Types of Jaundice in Newborns: A Comprehensive Guide for New Parents
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As a former HCPC registered paramedic, I’ve witnessed countless newborn babies grappling with jaundice, their little bodies tainted by a yellow hue. In this guide, I’ll walk you through the four different types of jaundice in newborns, from the common physiological to the more sinister hemolytic and pathological varieties. There are other less common types of jaundice but we will discuss the 4 main ones.
Jaundice is a common condition that affects over half of all newborns. Armed with insights from the American Academy of Pediatrics and my own experiences, we’ll discuss bilirubin levels, treatment options, and the critical role of breastfeeding.
By gaining insight into this condition, parents can better navigate the early days of their baby’s life and ensure their little one receives the best possible care.
The 4 different types of jaundice in newborns
| Type of Jaundice | Prevalence | Severity | Urgency of Treatment |
|---|---|---|---|
| Physiological Jaundice | Very Common | Mild to Moderate | Usually Not Urgent (Monitored by Healthcare) |
| Breast Milk Jaundice | Less Common | Mild to Moderate | Usually Not Urgent (Monitored by Healthcare) |
| Hemolytic Jaundice | Less Common | Variable (Can Be Severe) | May Be Urgent, Depending on Severity and Cause |
| Pathological Jaundice | Less Common | Variable (Can Be Severe) | Urgent – Requires Prompt Medical Evaluation and Treatment |
Newborn jaundice occurs when there is a buildup of bilirubin in the baby’s blood, which causes the baby’s skin and eyes to turn yellow. Bilirubin is a yellow substance that is produced when red blood cells break down. It is common with the prevalance of neonatal jaundice appoximately 55%.
In most cases, newborn jaundice is not a cause for concern and resolves on its own within a few weeks.
Please note that the prevalence, severity, and urgency of treatment may vary from one case to another, and it’s crucial for parents to work closely with healthcare providers to assess and manage their baby’s jaundice. Mild cases of physiological and breast milk jaundice often do not require immediate treatment but should be monitored. Hemolytic and pathological jaundice cases may require more urgent attention, especially if very high bilirubin levels are detected or there are underlying medical conditions. Always consult with a healthcare professional for personalized guidance and care for your newborn.
1. Physiological jaundice
Physiological jaundice is the most common type of newborn jaundice. It occurs when the baby’s liver is not yet fully developed and is unable to process bilirubin efficiently. This type of jaundice usually appears within the first few days of life and resolves on its own within a few weeks.
2. Breast milk jaundice
Breast milk jaundice is a type of newborn jaundice that occurs in breastfed babies. It is caused by a substance in breast milk that can interfere with the liver’s ability to process bilirubin. This type of jaundice can appear in the first few days of life or may not appear until the baby is a few weeks old. Breast milk jaundice usually resolves on its own within a few weeks but may require treatment in some cases.
3. Hemolytic jaundice
Hemolytic jaundice is a genetic disorder and rare type of newborn jaundice that occurs when there is an increased breakdown of red blood cells. This can be caused by a variety of factors, including blood type incompatibility between the mother and baby, infections, or genetic disorders. Hemolytic jaundice can be more severe than other types of jaundice and may require treatment.
4. Pathological jaundice
Pathological jaundice is a serious type of newborn jaundice that can be caused by underlying medical conditions such as infections, liver disease, or metabolic disorders. This type of jaundice usually appears within the first 24 hours of life and requires prompt medical attention.
Causes and risk factors
- Increased bilirubin production:
- Bilirubin, a yellow pigment, forms during the breakdown of a baby’s red blood cells.
- Newborns have immature livers, leading to a buildup of bilirubin in the blood.
- Decreased bilirubin elimination:
- Newborns’ livers are not fully developed, impairing bilirubin processing.
- Physiologic jaundice:
- Most common in healthy newborns within the first week of life.
- Caused by normal red blood cell breakdown and immature liver.
- Blood type incompatibility:
- Blood type differences between mother and baby can lead to hemolysis (red blood cell destruction) and jaundice.
- ABO and Rh incompatibility are common culprits.
- Infections:
- Certain infections, like rubella, can cause jaundice in newborns.
- Birth trauma:
- Bruising or cephalohematoma (blood collection under the scalp) during birth can increase bilirubin production and cause jaundice.
- Liver diseases:
- Conditions such as biliary atresia (blocked bile ducts) and hepatitis (liver inflammation) can lead to jaundice.
- Biliary atresia prevents bilirubin elimination from the body.
- Genetic factors:
- Crigler-Najjar syndrome is a rare genetic disorder that impairs bilirubin processing in the liver.
- Spherocytosis, another genetic condition, causes red blood cell destruction and elevated bilirubin levels.
Symptoms and diagnosis
Jaundice in newborns is a common condition characterized by the yellowing of the skin and whites of the eyes, resulting from an elevated level of bilirubin in the bloodstream. Understanding its symptoms and obtaining a prompt diagnosis are crucial for ensuring the well-being of your baby.
Visual signs of jaundice
- The most apparent sign is the yellowing of the skin and eyes, often noticeable within the first week of life. This is not the same are a flushed or red face.
- Mild jaundice is common and typically resolves within a few weeks.
Serious symptoms
Be vigilant for signs of severe jaundice or underlying medical issues, such as:
- Fever
- Lethargy (unusual tiredness or lack of responsiveness)
- Poor feeding
- Vomiting
- Seizures
When to seek medical attention
If a parent suspects that their newborn may have jaundice, they should contact their pediatrician immediately.
The pediatrician will perform a physical evaluation and may order a blood test to measure the levels of bilirubin in the baby’s blood. In addition to blood tests, the pediatrician may also examine the baby’s urine and stool to check for signs of infection or dehydration.
Premature babies and full-term babies of certain races, such as those of Asian or African descent, may be at a higher risk for developing jaundice and may require closer monitoring.
If the pediatrician suspects that the jaundice is caused by an underlying condition, they may refer the baby to a specialist for further evaluation and treatment. In some cases, severe jaundice can lead to complications such as cerebral palsy or damage to the bloodstream, so it is important to seek medical attention promptly if symptoms of jaundice are present.
Treatment and management of newborn jaundice
Jaundice in newborns is usually not a cause for concern and resolves on its own within a few weeks. However, in some cases, treatment may be necessary to prevent complications. Treatment options for newborn jaundice depend on the severity of the condition and the underlying cause.
| Treatment Options | Description |
|---|---|
| Increased Feeding | Recommended for mild jaundice. Increases the frequency of feedings to help the baby pass more stool and urine to eliminate bilirubin. Especially important for breastfed infants. |
| Phototherapy Treatment | Used for moderate to severe jaundice. Involves exposing the baby to special lights that break down bilirubin in the skin. Baby wears only a diaper and protective eye patches. Blood tests monitor the baby’s bilirubin level. |
| Exchange Transfusion | Rarely used, a blood transfusion is reserved for severe jaundice not responding to other treatments. Involves replacing the baby’s blood with donor blood to reduce bilirubin levels. |
Most cases of newborn jaundice do not require treatment and resolve on their own. However, in some cases, treatment may be necessary to prevent complications.
Parents should follow their healthcare provider’s guidelines for the management and treatment of newborn jaundice.
Feeding and care for jaundiced newborns
Feeding and care are crucial for newborns with jaundice. In most cases, jaundice is a normal physiological process that resolves on its own within a few days or weeks. However, in rare cases, it can lead to complications such as bilirubin encephalopathy, a serious condition that can cause brain damage.
Here are some tips for feeding and caring for jaundiced newborns:
Feeding
Breastfeeding is recommended for most newborns, including those with jaundice. Breast milk is the best source of nutrition for babies and can help reduce bilirubin levels. However, in some cases, breastfeeding can cause or exacerbate jaundice.
Breastfeeding jaundice occurs when the baby does not get enough milk and becomes dehydrated, leading to a buildup of bilirubin in the blood.
Breast milk jaundice, on the other hand, is caused by substances in breast milk that interfere with the breakdown of bilirubin.
To prevent breastfeeding jaundice, newborns should be fed frequently, at least 8-12 times a day. Breastfed babies should have at least six wet diapers and three bowel movements a day. If the baby is not getting enough milk, a lactation consultant can help with breastfeeding techniques and positions, or suggest supplementing with formula.
Care
In addition to feeding, care is also important for jaundiced newborns. Keeping the baby well-hydrated can help reduce bilirubin levels. Newborns should be fed on demand and offered fluids such as water or glucose water between feedings. However, water should not be given to newborns younger than six months old, as it can interfere with electrolyte balance and cause hyponatremia.
Jaundiced newborns should also be monitored for signs of complications such as bilirubin encephalopathy. Symptoms of this condition include lethargy, poor feeding, high-pitched crying, and seizures. If any of these symptoms are present, the baby should be evaluated by a healthcare provider immediately.
Finally, diapers are a good way to monitor the baby’s hydration and bilirubin levels. Parents should keep track of the number of wet and dirty diapers and report any changes to their healthcare provider.
Conclusion
In closing, as a former HCPC registered paramedic and mother of two, I know how alarming jaundice can be. Armed with this knowledge, parents can navigate potential challenges with confidence. Remember, each baby’s journey is unique, and early detection and intervention are key.
With the right support from healthcare providers and informed decisions, addressing the different types of jaundice in newborns becomes clearer.
