Jaundice in newborns involves:
Hyperbilirubinemia: An excess of bilirubin in the blood, which is a byproduct of the normal breakdown of red blood cells.
Immature Liver Function: Newborns have an immature liver that is less efficient at processing and excreting bilirubin.
Increased Red Blood Cell Turnover: Newborns have a higher rate of red blood cell turnover, leading to increased production of bilirubin.
Bilirubin Deposition: Excess bilirubin deposits in the skin and mucous membranes, causing a yellow discoloration.
Complications: Severe jaundice can lead to kernicterus, a form of brain damage resulting from very high levels of bilirubin.
Clinical Evaluation
Symptoms: Assessment of symptoms such as yellowing of the skin and eyes, poor feeding, lethargy, and high-pitched crying.
Physical Examination: Examination findings include visible jaundice, especially in the sclera of the eyes and skin, and possibly signs of dehydration or poor feeding.
Diagnostic Tests: Bilirubin level measurements via blood tests (total serum bilirubin), and transcutaneous bilirubinometry for non-invasive screening.
Yellowing of the skin and the whites of the eyes (scleral icterus).
Poor feeding or difficulty feeding.
Lethargy or low activity levels.
High-pitched crying.
Dark urine and pale stools in severe cases.
Irritability and arching of the back (in severe cases).
Treatment aims to reduce bilirubin levels and prevent complications:
Phototherapy: Use of special blue spectrum lights to convert bilirubin into a form that can be more easily excreted by the body.
Exchange Transfusion: In severe cases, replacing the baby's blood with fresh donor blood to rapidly reduce bilirubin levels.
Feeding Support: Encouraging frequent feedings to promote hydration and regular bowel movements, which help eliminate bilirubin.