Jaundice in Newborns: Diagnosis and Treatment

Jaundice Test provides precise information about all the bilirubin levels in newborn blood. Learn from expert pediatrician Dr. Manjit Singh Sekhon.

How is jaundice diagnosed? 

Jaundice like I said is mostly diagnosed by looking at it visually. Visually it appears to be a little higher than it actually is. Next, we take a blood sample and then it clarifies what the bilirubin levels are. 

How do the parents know that the baby has jaundice? Or symptoms of jaundice

What we tell the parents when we are discharging their baby from the hospital after delivery. We tell them that they should bring the baby every day for a visual check to the hospital so that the doctor can have a look at the baby. 

Because very often when we leave the baby to the parents who are not trained to see jaundice, by the time they come to the doctor it would be a very high level of jaundice (bilirubin levels). This could be very difficult to treat then. So the best thing to do here is that it should be checked by someone who knows what he’s doing. 

What the parents can do is to check for the yellowness, which starts from the tip of the nose. Because this will not make the baby restless or cause fever, there would be no other symptom than that. It would just be the color of the skin. 

We often hear that these babies should be exposed to light. At home, we expose the baby to sunlight and with that, we are certain that the jaundice is going to be treated. 

This what we hear is called the half-truth. While sunlight has all the wavelengths of light even the wavelength used to treat jaundice. But for this to be effective, all the other wavelengths should be removed, the baby’s clothes should be removed and he should be exposed to sunlight for a maximum number of hours. Which is not possible. If it is summertime and you put the baby in the sun without clothes, that baby might get a heat stroke. Not jaundice but the baby might get a heat stroke. And in the wintertime, if you remove all the baby’s clothes he will catch a cold. And in the rainy season, there is no sun, it is cloudy. This can be done where phototherapy is not available. But when there is phototherapy available, this is not the way to go about it. 

How do I get rid of jaundice in a newborn? Or Neonatal jaundice

Exactly how we discussed it. And then reassure the parents once the baby is discharged. When the baby is discharged the jaundice levels of bilirubin levels are down to 10 or 12. At that time also we should remember that the skin is yellow. The skin turns yellow anything above 2. So if it’s more than 2 the skin would be yellow. when it is 10 and we say that the bay is safe. But you go home and see the skin is yellow, yes, it is yellow. But it is a safe yellow, as 10 is a safe yellow. 

As it is said prevention is better than cure, so is there any way to prevent jaundice in the baby? Or jaundice precautions

Like I said it is a very natural phenomenon. And all one has to remember is to monitor it. There are a few pathological things I should talk about. Sometimes the jaundice is very high and there are reasons behind it. One is physiological, that it’s less than 15. And one reason is there is an incompatibility between the mother and the baby’s blood. For example, the mother’s blood is O and the baby’s blood is A. so the mother’s blood already has anti-A antibodies present, which can pass over to the baby at the time of delivery.

And they would start breaking up the RBC (red blood cell)of the baby at a much faster rate. So because of this, there would be more jaundice. Similarly, there is something called Rh incompatibility. For example, the mother’s blood is negative and the babies are positive, then also the blood would break up at a faster rate. 

Sometimes the baby gets infections the moment he’s born. Not a liver infection but a general infection. This may also result in jaundice coming on very fast and crossing 20 or threatening to cross 20. Those are the things that can be diagnosed in the hospital. As far as the parents are concerned, the take of the point here is, we should bring the baby to a hospital as soon as possible. 

Precautions a pregnant lady can take to avoid the risk of jaundice in the newborn 

The precaution here is that she should have her blood group tested. Which if she is coming for regular checkups, she would be getting her blood group tested. It is the responsibility of the obstetrician to do that. 

But if she is not getting the regular checkups done, what she can do is get her blood group tested. So that if she has a blood group tested that is associated with frequent jaundice in baby’s, for example, RH-negative, so we should know in time. And the bay should be monitored more closely. 

Should a healthy diet be maintained? 

Diet is general advice for every mother. This will have no direct bearing on jaundice or the lack of it. But to go checkups and get the blood group tested and if it’s RH negative then we can do an anti-RH factor antibody in the mother, to see the level of antibodies of RH. and if the level is high the baby is likely to get jaundice. 

Thank you.