Newborn jaundice

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Almost 60 percent of all infants develop neonatal jaundice (jaundice neonatorum) with yellowish discolored skin and yellow eyes a few days after birth. The dye bilirubin is to blame for the mostly harmless occurrence. The yellowish-brown substance is increasingly formed after birth. If the liver cannot break it down quickly enough, it is deposited in the tissue. Here you can read everything you need to know about newborn jaundice, its causes and treatment options.

Brief overview

Description: Yellowing of the skin and eyes of newborns a few days after birth.
Causes: After birth, babies' bodies break down excess red blood cells to a greater extent. A lot of bilirubin is produced as a by-product. If the yellow-brownish pigment cannot be completely broken down by the not yet fully developed liver, its blood level rises and it is deposited in the tissue.
Forms: jaundice neonatorum (harmless neonatal jaundice that occurs from the 2nd to 3rd day of life and subsides again by the 10th day of life), jaundice prolongatus (newborn jaundice that lasts more than two weeks), jaundice praecox (newborn jaundice that already occurs on the 1st day of life begins), jaundice gravis (jaundice in the newborn with greatly increased bilirubin levels).
Treatment: If the bilirubin concentration in the blood exceeds a certain value, treatment is necessary to prevent neurological damage. Therapy options: phototherapy, exchange transfusion. Breastfeeding can also be helpful.

Newborn jaundice: description

In jaundice (jaundice), the blood level of the so-called bilirubin is significantly increased. Bilirubin is a yellowish-brown dye that is produced when red blood cells are broken down. Above a certain blood concentration, it is deposited in the tissue: the skin, mucous membrane and the whites of the eyes can then turn yellow. Frequent accompanying symptoms are light-colored stools and dark-colored urine.

Jaundice can occur at any age. It is particularly common in newborns: more than half of all babies develop newborn jaundice.

Newborn jaundice: duration and forms

Newborn jaundice usually appears for the first time on the 2nd or 3rd day after birth. It usually peaks around the 5th day of life and then recedes by the 10th day of life. It is then a harmless neonatal jaundice (jaundice neonatorum).

However, various comorbidities can influence newborn jaundice, for example sickle cell anemia or blood group incompatibility between maternal and child blood. Here, severe jaundice already occurs on the first day of life (jaundice praecox).

If the newborn jaundice lasts more than two weeks, jaundice prolongatus is present.

If the values in newborn jaundice rise to over 18 mg / dl (milligrams per deciliter), doctors speak of jaundice gravis. It can lead to dangerous kernicterus with permanent neurological damage and must therefore be treated.

Newborn jaundice: causes

Unlike adult jaundice, neonatal jaundice is usually not due to any medical condition. Rather, it is generally an adjustment disorder: Shortly after the birth, there are excessively many red blood cells in the child's body. These have to be broken down, producing the yellowish-brown pigment bilirubin. This is normally converted by the liver and excreted via stool and urine after intermediate stops in the bile and intestine.

In newborns, however, the liver is usually not fully developed. Therefore, the organ can initially be overwhelmed with the metabolism of bilirubin. Then the dye can be deposited in the tissue, which leads to a yellowish discoloration of the skin and eyes - characteristic signs of newborn jaundice. How long the symptoms last can vary from case to case. In most cases, the newborn jaundice resolves within the first ten days of life (see above).

Newborn jaundice: treatment

Newborn jaundice must be treated if the bilirubin concentration in the blood exceeds 18 mg / dl (milligrams per deciliter) (jaundice gravis). Then there is a risk that what is known as kernicterus will develop: the bilirubin is deposited in the so-called ganglion cells of the brain stem of newborns. Under certain circumstances, this can lead to permanent brain damage and even death of the child.

Therefore, newborn jaundice is treated as a precaution with significantly increased bilirubin levels. The following therapy options are available:

Photo therapy: In light therapy, the baby is irradiated with blue light with a wavelength of 460 nm (nanometers). This splits the indirect bilirubin, which has yet to be converted by the liver, into the direct form. It is excreted in the urine, which relieves the liver. Phototherapy can damage the retina, among other things, which is why the newborn's eyes must be protected with special glasses.
Exchange transfusion: In particularly severe cases of neonatal jaundice, all of the infant's blood is exchanged using blood transfusions. This can prevent further breakdown of red blood cells.
Breastfeeding: The increased feeding and drinking is supposed to stimulate the intestinal activity and thus remove the bilirubin in the bile to a greater extent.

Doctors at the hospital treat newborn jaundice. How long a baby has to stay in the clinic depends on how quickly the bilirubin levels return to normal.

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