Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and whites of the eyes due to high bilirubin levels. It is commonly associated with itchiness. The feces may be pale and the urine dark. Jaundice is a symptom, not a disease and there are many reasons for it happening. It is recognized primarily by the yellow discoloration of the skin.
Screening all newborns for excessive bilirubin in the blood can significantly decrease the incidence of severe jaundice which, in extreme cases, can lead to seizures and brain damage
In the womb, baby does not breathe but rely on a high level of red blood cells to receive enough oxygen from the mother. After birth, the extra red cells are broken down. One of the waste products is a substance called bilirubin which is fat soluble (unconjugated bilirubin) that is, it dissolves in fat. This bilirubin must be taken to the liver to be changed into water soluble bilirubin (conjugated bilirubin) which is then passed out through the urine, stools and sweat.
If for some reason the fat soluble bilirubin is not converted, it will attach itself to fatty tissues that it comes into contact with, mainly in the skin and brain. If too much bilirubin attaches itself to fatty tissues in the brain it may cause brain damage.
Physiological jaundice is due to the above process and is the most common. It usually appears on the 3rd day and disappears by 7th day. It is not dangerous as long as the bilirubin level does not go up too high.
Early feeding after birth may reduce the prevalence of jaundice therefore try putting baby to the breast in the delivery room. This also stimulates the breast to start producing milk.
It is best to check for jaundice during the day using natural light. Hold the baby near a door or window.
There is NO place for traditional treatment. I have seen too many children with permanent brain damage which is very sad as nowadays medical treatment is so effective in preventing brain damage due to jaundice.
Bathing the baby in kunyit water is definitely not recommended because the skin becomes more yellow in colour, therefore making it difficult to assess the true jaundice level from looking at the skin.
Do not give baby any herbal medicine as it may interfere with the bilirubin conversion thereby increasing the levels of fat soluble bilirubin and by the time the baby is taken to hospital, it may be too late.
Once your baby is admitted to hospital, the paediatrician will take some blood to check the bilirubin levels which, together with the baby's age and general condition will determine the need for further treatment.
Phototherapy is the use of fluorescent lights to break down bilirubin in the skin making it water soluble which can be easily excreted. It can be given continuously or intermittently at 3-4 hourly intervals. During phototherapy treatment the baby is naked except for the nappy in order to expose as much of the skin to the lights. The eyes are covered with eye pads to protect them. Baby must be given extra fluids to prevent dehydration. It is normal if the baby develops skin rashes and has loose green stools. Baby's bilirubin will be monitored regularly during the treatment.
Exchange blood transfusion is done to remove the bilirubin and maternal antibodies from the baby's circulation and replacing it with fresh blood from a donor. It is normally done if the bilirubin level rises to a dangerous level which cannot be reduced by phototherapy or there is severe Rhesus incompatibility. Remember if at any time you are not sure about your baby's jaundice always check with the paediatrician.