When To Seek Help
Where To Seek Treatment
Jaundice (also known as neonatal jaundice) is the yellow discoloration of babies’ skin in the first week after they are born. It is due to the presence of a pigment called bilirubin that is produced when red blood cells break down. In mild cases, jaundice can be seen on the face or body. In more serious cases, the palms and soles of the baby are yellow. Jaundice usually appears in Asian babies three to five days after birth.
Babies develop jaundice because of several reasons. Some babies get jaundice from the breakdown of blood due to bruising at birth or superficial blood clots on the scalp. These blood clots are due to unavoidable pressure on the scalp as the baby passes through the birth canal. Others have a blood group that is different from the mother’s; the antibodies present in the mother may attack the baby’s own red blood cells, causing the baby to be jaundiced.
Some babies have an inherited glucose-6-phosphate dehydrogenase (G6PD) deficiency that predisposes them to onset jaundice. G6PD is an enzyme in the body that helps red blood cells function normally (see G6PD deficiency). Occasionally, babies develop jaundice because of an infection of the urinary system or blood.
Prolonged jaundice lasting for more than two weeks could be due to an infection, breast-milk jaundice, abnormal bile ducts or a metabolic disease. Some metabolic diseases are detected with metabolic screening.
In many babies, an underlying cause may not always be found. It is common for the doctor to take further blood samples from your baby even after knowing the bilirubin level, in order to find out the cause of jaundice.
Jaundice is most obvious when you lightly press on the skin of your baby’s face to drain away the red colour. When your finger is released, the underlying yellow in the skin becomes evident. Other symptoms include poor feeding.
Premature births – A premature baby’s liver may not be as well developed to quickly remove the bilirubin from the bloodstream as full term babies.
Blood group – If the mother’s blood group is different from the baby’s, the antibodies from the mother may attack the baby’s blood cells and cause them to break down more quickly.
Breast-feeding – Breastfeeding jaundice has been found in babies who are completely breastfed and who develop jaundice with no other apparent causes. It often depends on how hydrated the baby is. Sufficient milk supply to the baby, with breastfeeding on demand, will usually reduce this risk. Babies who are exclusively breast-fed may develop jaundice lasting for up to three months. Breastfeeding jaundice is not harmful to the baby; you may continue to breast feed your baby. It is not necessary to stop breastfeeding if the diagnosis of breast milk jaundice has been made and other causes for prolonged jaundice have been excluded.
Primary risk factors:
Risk factors are premature births and if the blood type of baby is different from the mother’s.
In most cases, jaundice is not preventable. Sufficient milk will keep your baby well hydrated and reduce the risk of jaundice. The baby should not be ‘sunned’ as there is no evidence of benefit; instead, it can be harmful to the newborn baby (see Treatment)
If you suspect that your baby is jaundiced, bring he or she to see a doctor.
Your doctor will take a small sample of the baby’s blood to check the bilirubin level. The result will be known within an hour. Your doctor will explain why your baby is jaundiced and discuss treatment options based on the bilirubin level.
Jaundice may be treated with phototherapy where special fluorescent lights are placed over your baby’s cot. During phototherapy, your baby will be exposed to the lights naked (except for wearing of diapers) so that bilirubin level drops quickly. Ask your doctor about your baby’s bilirubin level daily.
It is not recommended to expose your baby to bright sunlight every day instead of phototherapy. Sunlight contains harmful rays that damage delicate skin. Furthermore your baby may get over-heated and develop a fever.
Jaundice in babies usually improves when they are about two weeks old. If your baby is yellow for two weeks or more, consult your doctor immediately.
The medical institutions within SingHealth that offer consultation and treatment for this condition include:
1. Singapore General Hospital
Department of Neonatal and Developmental Medicine (Block 6, Level 5)
Outram Road, Singapore 169608
Tel: (65) 6321 4377 (Office Hours)
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