What causes Jaundice?
When our babies are in their mummies tummies, they have much more haemoglobin than we do. The reason for this is that haemoglobin carries oxygen around our bodies, keeping our tissues, nerves, organs etc. alive. Because babies cannot breathe in oxygen in utero, they need more haemoglobin than us. Makes sense?
When babies are born, they are able to breathe in oxygen, therefore they now have too much haemoglobin, so it begins to die off in large numbers.
Bilirubin is a product of haemoglobin breakdown, therefore a LOT of bilirubin is created.
This makes the baby’s skin and white of the eyes turn yellow tinged. The large majority of newborns will have some degree of jaundice in the 1st week of life. Its normal.
But why does this happen?
Because babies’ livers are not yet mature, it processes bilirubin verrry slowly. The liver converts bilirubin into a substance that can be excreted in the babies wee’s and poops. However if the baby’s intake is poor, the baby reabsorbs the bilirubin he/she should have wee’d or pooped out.
Why are babies put under UV lights as a treatment for jaundice?
Normally, the liver is needed to change bilirubin from its fat-soluble self into a water soluble version that can be wee’d and pooped out. UV lights convert bilirubin into its water soluble version without needing to go through the liver, therefore it speeds up recovery from jaundice. Amazing!!
Why/when is jaundice a problem?
Jaundice, if not monitored and it progresses, causes the newborn to be more lethargic and sleepy, and not wake for feeds. If it progresses further, it can lead to kernicterus (a devastating neurological injury).
This is very rare in the developed world and health care professionals are very vigilant about monitoring for jaundice. This is why parents are advised to wake their babies for feeds every 2-3 hours in the early days and weeks. Learn more about how you can prepare for breastfeeding, which may reduce your baby’s risk of problematic jaundice: I’m Pregnant! So, what do I need to consider to prepare to breastfeed my baby?
There are 3 types:
- Jaundice before 24 hours old is not newborn jaundice: This needs medical evaluation.
- Low-Enteral Intake Jaundice/Starvation Jaundice: as a result of inadequate intake.
- Breastmilk jaundice: this begins after day 5 and is a normal physiological phenomenon, not a disorder. It only happens to breastfed babies, and can cause their skin to look jaundiced for weeks or months with no side effects or cause for concern. These babies should have their bilirubin tested at 2-3 weeks old, but its usually normal.
It is important to note that babies that have a haematoma on their heads as a result of vaccum extraction, or prolonged pressure on their heads in the birth canal, are at an increased risk for jaundice, as the liver has this extra blood from the haematoma to process as it begins to break down over the days postbirth.
Good to know
Babies usually have their bilirubin level checked before discharge, using a bilimeter. When babies go home, PHN’s ask parents to monitor the amount of wee’s and poops their baby’s do, and check for intake by assessing a feed and listening for audible gulping and other signs of milk transfer.
Parents can help reduce jaundice by feeding their baby on demand. It was previously thought that exposing a baby to natural light would help to eliminate the bilirubin more quickly, but this has been disproven. Breastfeeding your baby exclusively and on demand, with no restrictions or routines, is the best way of treating your baby’s jaundice, and giving your baby the very best nourishment and nurturing experience he/she can have.
So, that’s the story with Jaundice.