Neonatal Jaundice (Jaundice in Infants):

- Neonatal jaundice occurs in the first few days of life in infants, where their skin and the whites of their eyes turn yellow. This condition can be alarming for many mothers, but usually neonatal jaundice is not dangerous. Jaundice can occur at any age due to a malfunction in the liver's ability to eliminate bilirubin. But what causes jaundice? Jaundice results from an increase in the level of bilirubin in the blood. Bilirubin, a yellow substance, is produced by breaking down old red blood cells that are no longer able to transport gases and oxygen. Therefore, they are broken down in the spleen, and some components are transferred to the liver to be eliminated and excreted in the stool and urine. This process occurs normally in individuals with healthy liver function, but in some infants, their liver may not be fully developed to filter the body from bilirubin and may need assistance to eliminate this substance and prevent its accumulation in the baby's tissues. In other cases, the cause of jaundice may be an increase in the number of red blood cells within the newborn's body, exceeding the liver's capacity to eliminate bilirubin, leading to its accumulation and causing jaundice. Some conditions that can increase the number of red blood cells and cause jaundice include:
1- Abnormal forms of red blood cells such as sickle cell anemia.
2- Incompatibility of the Rh factor between the mother and the child resulting in hemolysis of the newborn's blood.
3- Bleeding under the scalp due to the birthing process.
4- Certain infections and loss of some proteins like enzymes.

What are the symptoms of jaundice in newborns:

- Skin yellowing is one of the most important symptoms that appear on the infant, and it has become common among mothers to monitor the infant's skin color during the early days after birth. It is also important to monitor the whites of the eyes and the mucous membranes of the mouth, which should be pink in a healthy state. If you press gently on your baby's skin and it appears white, but if it appears yellow, it may indicate jaundice. If jaundice starts spreading from the baby's head to the chest and then to the extremities, it may indicate more severe jaundice. Inform the doctor directly if you notice discoloration in any of these areas directly. It may be difficult to notice skin discoloration if the baby's skin tone is dark.
- When does jaundice appear? Jaundice typically appears from two days up to a week after birth. The child should be examined in daylight and in a sunny room; sometimes you may be misled if you are using fluorescent lights.

What are the types of jaundice:

1- Physiological Jaundice (Normal): This type of jaundice occurs in many newborns and is not dangerous. It usually resolves within two weeks.
2- Early Jaundice: This type occurs in preterm infants (born before 38 weeks) whose livers are not fully developed to handle normal levels of bilirubin. Therefore, these babies may often require treatment even with normal bilirubin levels.
3- Breastfeeding Jaundice: Infants who do not receive enough breast milk due to feeding difficulties or delayed onset of mother's milk may develop this type of jaundice. They may suffer from dehydration and lack of nutrients, leading to poor bowel movements. Ensure to feed your baby at least once daily to help them have regular bowel movements.
4- Breast Milk Jaundice: Some infants may have elevated bilirubin levels due to certain substances in breast milk, which can start a few days after breastfeeding and last for weeks.

Jaundice Diagnosis:

The doctor diagnoses jaundice by measuring the bilirubin levels in the blood. If your baby is premature, they will be monitored in an incubator as jaundice is expected. The doctor will observe the skin color using a probe and confirm the diagnosis by analyzing the bilirubin levels in the blood. Several tests may be required to confirm the results, such as a complete blood count, Coombs test (evaluates antibodies directed against red blood cells that may cause their destruction), and reticulocyte count. Some of these tests are routinely done in many hospitals within the first 24 hours after birth.

Jaundice Treatment:

Most types of jaundice resolve spontaneously within two weeks. It is important to consult a pediatrician to assess the severity of jaundice based on the bilirubin levels. Avoid home remedies randomly as they may harm the baby. If jaundice is severe, the doctor may recommend hospitalizing the baby for light therapy treatment.
Light Therapy Treatment: This involves exposing the baby's naked body to light or using a light-emitting blanket, covering the baby's eyes and providing intravenous fluids if necessary. It is preferable to continue breastfeeding during light therapy if possible. The excess bilirubin is eliminated from the body through light therapy, which usually lasts for one to two days. If the baby's condition is moderate, the doctor may recommend at-home light therapy. Follow the pediatrician's instructions to ensure the baby's well-being. The baby's bilirubin levels should be checked approximately 24 hours after treatment.
Expected side effects of light therapy treatment include skin rash, dryness, and watery diarrhea, which usually disappear immediately after stopping treatment. If the baby receives light therapy at home, it is important to monitor them daily, especially regarding weight, breast milk/formula intake, wet and soiled diapers, skin condition, and bilirubin levels.
If the bilirubin levels remain high in some jaundiced infants, the doctor may request a blood transfusion for the newborn to improve their condition and prevent other complications such as kernicterus (known as nuclear jaundice). Finally, if the cause of jaundice is bleeding or another issue, the bleeding or infection is treated, addressing the underlying cause of the jaundice.

Some risk factors that increase the likelihood of jaundice occurring in your child:

1- Premature birth (birth before 38 weeks): The liver of premature infants is less mature than those born at full term, increasing the likelihood of jaundice. Additionally, these infants may receive less nutrition and have fewer bowel movements, leading to reduced bilirubin elimination.
2- Exposure to bruising during birth, especially during natural delivery, where infants' skin is more fragile and can lead to greater red blood cell breakdown.
3- Blood type difference between mother and baby: Abnormal red blood cell breakdown may occur due to some antibodies passing through the placenta to the baby, causing some hemolytic conditions.
4- Breastfeeding: Despite the benefits of breastfeeding, some infants may face difficulties in breastfeeding or getting enough nutrition during feeding due to dehydration and lower calorie intake.
5- Ethnicity: Studies suggest that some children from specific ethnicities may have a higher incidence of jaundice, such as children of East Asian descent.

Some important instructions regarding jaundice:

It is important to consult a pediatrician if:
1- The newborn's yellow color disappears and then returns once treatment is completed.
2- The yellow color persists for more than 2-3 weeks.
3- The child is lethargic, difficult to wake up easily, or seems irritable throughout the day.
4- The child is experiencing diarrhea or weight loss.
5- The child refuses feeding for more than two consecutive feedings.
6- Feeding the child frequently helps regulate bowel movements to increase elimination of bilirubin.