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  • Naninilaw Ang Balat Ni Baby? Learn To Detect Jaundice Because It Can Lead To Brain Damage

    Most cases of jaundice resolve on their own.
    by Rachel Perez .
Naninilaw Ang Balat Ni Baby? Learn To Detect Jaundice Because It Can Lead To Brain Damage
PHOTO BY Vidal Balielo Jr. from Pexels
  • Have you noticed newborns' skin looking a little yellowish? We've all heard the term jaundice from doctors or moms who have just given birth. It's a condition in newborns or babies that usually resolves on its own. However, that's not always the case.

    What is jaundice, and how do newborns get it?

    Bilirubin is a yellow chemical substance derived from the breakdown of "used" red blood cells. The liver removes this from the blood and passes it on to the intestines so it can leave the body through bowel movement. Jaundice in babies occurs when bilirubin in an infant's blood builds up faster than the liver can break down and be removed from the body.

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    During pregnancy, the pregnant mother's liver removes bilirubin for the baby. But after birth, the infant's liver takes charge of removing the bilirubin in the blood. If the baby's liver is still developing at birth, it may not remove bilirubin effectively. 

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    In some cases, infant jaundice can be a sign of an underlying condition or disease. These include internal bleeding, infection in the baby's blood, abnormality in the baby's red blood cells, viral or bacterial infections, incompatibility between mother's and baby's blood, liver malfunction, or enzyme deficiency. 

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    If left untreated, babies with jaundice may accumulate high levels of bilirubin in the blood, which may be passed into the brain and cause significant brain damage. The condition is called bilirubin encephalopathy.  

    Causes and risk factors of jaundice

    Newborns produce more bilirubin than adults because infants produce and break down more red blood cells during the first few days of life. Studies show that babies of East Asian descent have an increased risk of developing jaundice.

    Still, not all babies have it. Below are the factors that put your baby at higher risk for developing jaundice.

    Premature birth

    Jaundice is more common in pre-term babies or infants born before full-term or 38 weeks gestation. Preemies' liver may not yet be mature enough to get rid of bilirubin efficiently. Premature babies are also more prone to having difficulty feeding and fewer bowel movements. 

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    Bruising during birth

    Babies who become bruised during delivery or born with a large bruise on the head (cephalohematoma) may have higher bilirubin levels, which causes the break down of more red blood cells.

    Babies who have difficulty feeding

    Babies who have difficulty nursing or feeding may not be getting enough nutrition and are at a higher risk. Dehydration can be a factor in developing jaundice.

    Breastfed babies could also develop breast milk jaundice, wherein breast milk prevents the liver from quickly removing bilirubin. It occurs during the first week of life but should improve over three to 12 weeks.

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    Incompatibility of mom's and baby's blood

    Sometimes, the mother's blood type is different from her baby's. In that case, the baby may have received antibodies through the placenta that caused abnormally rapid breakdown of red blood cells.

    Genetic conditions

    Babies with genetic and/or blood conditions, such as glucose-6-phosphate dehydrogenase (G6PD) deficiency and polycythemia (high red blood cell count), are also at risk for jaundice. G6PD deficiency makes red blood cells more fragile and breaks down more quickly. Polycythemia, on the other hand, may cause low oxygen levels in the baby's blood.

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    Signs and symptoms of jaundice in babies

    Jaundice is not easy to detect by parents or persons with an untrained eye, especially in babies with darker skin tones, so it's best to consult a doctor. Below are the symptoms of jaundice:

    • Having yellowish skin which starts in the face and spreads to the chest, stomach, and legs
    • The whites of the baby's eyes also have a tint of yellow
    • An infant with very high bilirubin levels may also be sleepy, fussy, limp, or have trouble feeding

    One way to self-check for infant jaundice is by pressing on your baby's forehead or nose. Do this under good lighting conditions and preferably under natural daylight. The skin color where you pressed your finger should look slightly lighter than its natural skin color for a moment. If the skin area where you pressed your finger appears yellow, it's likely your baby has mild jaundice. 

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    When should you alert your doctor about jaundice

    Doctors check for jaundice before sending you or your baby home. The American Academy of Pediatrics (AAP) recommends that newborns are examined for jaundice at least every eight to 12 hours while in the hospital. The two main signs of jaundice — yellowish skin and eyes — typically show up on the second and fourth days after birth.

    According to the Mayo Clinic, if you and your baby are discharged from the hospital earlier than three days, call your doctor if:

    • Your baby's skin becomes more yellow and has spread to the abdomen, arms, and legs.
    • The whites of your baby's eyes look more yellow.
    • Your baby seems sick and is difficult to wake up.
    • Your baby is feeding or suckling poorly and isn't gaining weight.
    • Your baby makes high-pitched cries and arches his neck and body backward.
    • Your baby develops other symptoms, such as fever.

    Treatment for jaundice in babies

    Doctors may easily detect jaundice in babies by looking at the skin or eyes, and a light machine that measures bilirubin in the skin or a blood test can confirm it. Treatment depends on the cause of jaundice, the infant's age, and his or her bilirubin levels.

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    Many babies born at 35 weeks or after do not need treatment. Mild jaundice usually resolves itself on its own after one to two weeks as the baby's body gets used to removing bilirubin more efficiently. Newborns who have difficulty feeding or with breast milk jaundice should feed more often to prevent dehydration. 

    Babies with severe cases of jaundice need immediate treatment, which includes: 

    • Phototherapy. Babies lie naked (except for diapers) under lights, transforms bilirubin into a form that can easily pass out of the body. Light-therapy blankets may also be used.
    • Exchange blood transfusion. This is an emergency procedure where a baby's blood is replaced with blood from a donor. It is performed on babies with very high bilirubin levels that don't go down through phototherapy.
    • Intravenous immunoglobulin (IVIg). This is a type of treatment for babies with blood type incompatibilities. IVIg blocks antibodies that attack red blood cells and reduces the need for an exchange transfusion.

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