ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Newborn jaundice

Newborn jaundice

Causes and Risks:
Physiologic jaundice of the newborn, the most common cause of newborn jaundice, is present to some degree in almost all newborns. The jaundice is caused by an elevated bilirubin level in the blood. This results from the immaturity of liver function combined with the destruction of red blood cells present in the newborn infant. The jaundice usually appears between the 2nd and 5th days of life and clears by 2 weeks.

Non-physiologic, prolonged, or pathogenic jaundice in the newborn may have many causes. Risk factors for a greater degree of jaundice include prematurity and different races. Other conditions may cause pathologic (disease-related) jaundice in the newborn and should be ruled out if the jaundice persists, or if other symptoms are present. These disorders include:

biliary atresia
ABO incompatibility (similar to a transfusion reaction , caused when fetal and maternal blood mingle before birth)
Rh incompatibility ( Anti-Rh antibodies )
galactosemia (see galactosemia screen )
cephalhematoma
polycythemia
glucose-6-phosphate dehydrogenase deficiency
neonatal sepsis
congenital cytomegalovirus infection (CMV)
congenital toxoplasmosis
congenital syphilis
congenital herpes
congenital rubella
late pregnancy administration of sulfa drugs to the mother
Crigler-Najjar syndrome
spherocytosis (congenital hemolytic anemia )
cystic fibrosis
breastmilk jaundice
pyruvate kinase deficiency
thalassemia
Gilbert's syndrome
congenital hypothyroidism
Lucey-Driscol syndrome
Gaucher's disease
Niemann-Pick disease

Prevention:
Physiologic jaundice is a normal occurance and probably not preventable. Prevention of disease-related jaundice is related to the specific disease (see the specific disease).

Symptoms:

yellow color of the skin ( jaundice )
poor feeding (may be present)
lethargy (may be present)

Signs and Tests:

elevated serum bilirubin level

Treatment:
Usually treatment is unnecessary. Sometimes artificial lights (called bili lights) are used on infants whose levels are very high, or in premature infants. The infant is placed naked under artificial light in a protected isolette to maintain constant temperature. The eyes are protected from the light.

Prognosis:
The jaundice resolves without treatment within 1 to 2 weeks.

Complications:
Kernicterus , brain damage from very high bilirubin levels is rare.

Call Your Healthcare Provider:
Call for an appointment with the infant's health care provider if jaundice is severe (the skin is bright yellow), if jaundice lasts longer than 1 or 2 weeks, or if other symptoms develop.

Antibodies from an Rh negative mother may enter the blood stream of her unborn Rh positive infant, damaging the red blood cells (RBCs). The infant responds by increasing RBC production and sending out immature RBCs that still have nuclei. This photograph shows normal RBCs, damaged RBCs, and immature RBCs that still contain nuclei.

Newborn jaundice (producing yellow skin) can have many causes, but the majority of these infants have a condition called physiological jaundice, a natural occurrence in the newborn due to the immature liver. This type of jaundice is short term, generally lasting only a few days. Jaundice persisting longer than 3 to 4 days, or worsening rapidly, should be evaluated by a physician until decreasing or normal levels of bilirubin are measured in the blood.