What is jaundice?

If your newborn baby’s face or eyes have taken on a yellowish tint, do not be alarmed. Your baby may be suffering from jaundice, a mild medical condition that affects about 50 per cent of full term babies in the first week of life and about 80 per cent of premature babies. Jaundice in newborn babies usually begins on the second or third day after birth. It may last for a week and will clear up on its own.

“Jaundice begins at the head and progresses downwards. It is usually detected first in the whites of the eyes or face, then progresses to the chest and stomach and finally to the legs,” says Dr Christina Ong, Head and Consultant, Gastroenterology Service, KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.

Jaundice that progresses rapidly or persists beyond 14 days requires further evaluation to rule out a serious underlying condition. Dark urine and pale stools may be alarming symptoms of jaundice in newborn babies and need to be highlighted to a doctor.

What causes jaundice in newborn babies?

Jaundice in newborn babies is caused by excess bilirubin in the blood. Bilirubin is a product of the normal breakdown of red blood cells, and typically passes through the liver into the intestines, where it is excreted as bile.

“Jaundice occurs when the bilirubin increases faster than a newborn's liver can break it down and remove it from the body,” explains Dr Ong.

Common causes of jaundice in newborn babies include the following:

  • The liver may be immature and unable to remove adequate bilirubin from the bloodstream.
  • More bilirubin is produced because of a higher turnover of red blood cells.
  • The amount of bilirubin reabsorbed from the intestines may be more than the baby can excrete.
  • Substances in breast milk may block protein in the liver from breaking down bilirubin. This is known as breast milk jaundice.

“Breast milk jaundice occurs in about 2 per cent of breastfed infants. It may start within the first week and improve over 1-2 months,” says Dr Ong.

When can jaundice be severe and lead to complications in newborn babies?

Jaundice in newborn babies may be severe if the baby is premature or if there is blood-group incompatibility between the mother and her baby. Infections and inherited blood disorders and deficiencies, e.g. G6PD deficiency, can also place additional stress on the liver, causing severe jaundice in newborn babies.

Severe jaundice in newborn babies may lead to damage to the brain, a condition known as kernicterus.

Now that we know more about jaundice in newborn babies, what about older children? Also, what treatments are available for jaundice? Read on to find out.

Ref: R14