Medicos say that approximately 60 per cent of term and 80 per cent of preterm (born <37 weeks) develop jaundice in the first week of birth. 10 per cent breast-fed babies still suffer from jaundice in the first month of their birth.
“Babies develop jaundice due to various factors including low birth weight, prematurity, infant of diabetic mother and previous sibling with jaundice requiring phototherapy. Jaundice is first visible on face and forehead. Blanching reveals the underlying colour.
Jaundice then gradually becomes visible on trunk and extremities. More intense jaundice is associated with drowsiness, poor feeding and excessive sleepiness,” says Dr Latha Kanchi Parthasarathy, consultant neonatologist at Apollo Childrens’ Hospitals.
Doctors say that altered crying, change in muscle tone, abnormal movements and irritability – requires immediate attention to avoid brain damage (Kernicterus). Other causes of jaundice – Blood group incompatibility, congenital infections, sepsis, haemolytic anaemia and liver disorders, etc.
Biliary atresia or the surgical cause of jaundice where babies have pale stools and dark urine, usually present around third week of birth. Usually a total and split serum bilirubin is the only test required to treat a moderately affected infant, i.e. been down with jaundice for 2 or 3 days. Nevertheless, it is important to look deep into the condition of any baby that has been unwell for more than 24 hours to know more about its prolonged condition.
Phototherapy is a light treatment uses light to reduce the amount of bilirubin. Phototherapy is safe and effective. This is the main treatment done for any baby suffering from jaundice.
A chart is used to see if the bilirubin is high enough to go further with the treatment. Babies receiving phototherapy need as much skin that is exposed to the light.
If bilirubin levels are very high, they would require blood transfusion to bring down bilirubin level as soon as possible. Other treatments can be done, only if there are any underlying causes. If the level of bilirubin is quite high, it can damage the baby’s brain and cause problems like cerebral palsy, learning difficulties and hearing problems. This is called Kernicterus.
Prognosis depends on the underlying cause for jaundice, while prognosis for physiological jaundice and breast milk jaundice is suggestible and will not cause any problems.