<p style="text-align: justify;"><strong><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Contents</span></span></strong></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Causes</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Symptoms</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Exams and Tests</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Treatment</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Outlook (Prognosis)</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Possible Complications</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">When to Contact a Medical Professional</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Prevention</span></span></em></p>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Newborn jaundice is&nbsp;when a baby has&nbsp;high levels of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can&nbsp;be removed from the body in the stool.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">High levels of&nbsp;bilirubin makes your baby&#39;s&nbsp;skin and whites of the eyes&nbsp;look yellow. This is called jaundice.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><img alt="" src="https://www.zdrav.kz/images/refs3/zheltuha.jpg" /></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Newborn jaundice (producing yellow skin) can have many causes, but the majority of these infants have a condition called physiological jaundice, a natural occurrence in the newborn due to the immature liver. This type of jaundice is short term, generally lasting only a few days. Jaundice should be evaluated by a physician until decreasing or normal levels of bilirubin are measured in the blood.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="1" name="1">Causes</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">&nbsp;It is normal for a baby&#39;s bilirubin level to be a bit higher after birth.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">When the baby is growing in the mother&#39;s womb, the placenta removes bilirubin from the baby&#39;s body. The placenta is the organ that grows during pregnancy to feed the baby. After birth, the baby&#39;s liver starts doing this job. This can take a while.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Most newborns have some yellowing of the skin, or jaundice. This is called&nbsp;&nbsp;&quot;physiological jaundice.&quot; It&nbsp;is harmless, and usually is worst when the baby is 2&nbsp;- 4&nbsp;days old. It goes away within 2 weeks and doesn&#39;t usually cause a problem.&nbsp;&nbsp;</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Two types of jaundice may occur in newborns who are breast fed. Both types are usually harmless.</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Breastfeeding jaundice is seen in breastfed babies during the first week of life, especially in babies who do not nurse well or if the mother&#39;s milk is slow to come in.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Breast milk jaundice may appear&nbsp;in some healthy, breastfed babies after day 7 of life. It usually&nbsp;peaks during weeks 2 and 3. It may last at low levels for a month or more. It may be due to how substances in the breast milk affect how bilirubin breaks down in the liver. Breast milk jaundice is different than breastfeeding jaundice.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Severe&nbsp;newborn jaundice may occur if your baby has a condition that increases the number of red blood cells that need to be replaced in the body, such as:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Abnormal blood cell shapes</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Blood type mismatch between the mother and the baby</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Bleeding underneath the scalp (cephalohematoma) caused by a difficult delivery</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Higher levels of red blood cells, which is more common in small-for-gestational-age babies and some twins</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Infection</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Lack (deficiency) of certain important proteins, called enzymes</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Things that make it harder for the baby&#39;s body to remove bilirubin may also lead to more severe jaundice, including:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Certain medications</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Congenital infections, such as&nbsp;rubella, syphilis, and others</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Diseases that affect the liver or biliary tract, such as&nbsp;cystic fibrosis&nbsp;or hepatitis</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Low oxygen level (hypoxia)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Infections (such as sepsis)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Many different genetic or inherited disorders</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Babies who are born too early (premature) are more likely to develop jaundice than full-term babies.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="2" name="2">Symptoms</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Jaundice causes a yellow color of the skin. The color sometimes begins on the face and then moves down to the chest, belly area, legs, and soles of the feet.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Sometimes, infants with significant jaundice have extreme tiredness and poor feeding.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="3" name="3">Exams and Tests</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Doctors, nurses, and family members will watch for signs of jaundice at the hospital, and after the newborn goes home.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Any infant who appears jaundiced should have bilirubin levels measured right away. This can be done with a blood test.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Many hospitals check total bilirubin levels on all babies at about 24 hours of age. Hospitals use probes that can estimate the bilirubin level just by touching the skin. High readings need to be confirmed with blood tests.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Tests that will likely be done include:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Complete blood count</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Coomb&#39;s test</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Reticulocyte count</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Further testing may be needed for babies who need treatment or whose total bilirubin levels are rising more quickly than expected.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="4" name="4">Treatment</a></span></span></p>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Treatment is usually not needed.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">When determining treatment, the doctor must consider:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The baby&#39;s bilirubin level</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">How fast the level has been rising</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Whether the baby was born early (babies born early are more likely to be treated at lower bilirubin levels)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">How old the baby is now</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Your child will need treatment if the bilirubin level is too high or is rising too quickly.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Keep the baby well hydrated with breast milk or formula. Frequent feedings (up to 12 times a day) encourage frequent bowel movements, which help remove bilirubin through the stools. Ask your doctor before giving your newborn extra formula.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Some newborns need to be treated before they leave the hospital. Others may need to go back to the hospital when they are a few days old. Treatment in the hospital usually lasts 1 to 2 days.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Sometimes special blue lights are used on infants whose levels are very high. This is called phototherapy. These lights work by helping to break down bilirubin in the skin.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The infant is placed under artificial light in a warm, enclosed bed to maintain constant temperature. The baby will wear only a diaper and special eye shades to protect the eyes. The American Academy of Pediatrics recommends that breastfeeding be continued through phototherapy, if possible. Rarely, the baby may have an intravenous (IV) line to deliver fluids.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">If the bilirubin level is not too high or is not rising quickly, you can do phototherapy at home with a fiberoptic blanket, which has tiny bright lights in it. You may also use a bed that shines light up from the mattress.</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">You must keep the light therapy on your child&#39;s skin and feed your child every 2 to 3 hours (10 to 12 times a day).</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">A nurse will come to your home to teach you how to use the blanket or bed, and to check on your child.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The nurse will return daily to check your child&#39;s weight, feedings, skin, and bilirubin levels.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">You will be asked to count the number of wet and dirty diapers.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">In the most severe cases of jaundice, an exchange transfusion is required. In this procedure, the baby&#39;s blood is replaced with fresh blood. Treating severely jaundiced babies with intravenous immunoglobulin may also be very effective at reducing bilirubin levels.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="5" name="5">Outlook (Prognosis)</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Usually newborn jaundice is not harmful. For most babies, jaundice usually gets better without treatment within 1 to 2 weeks.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Very high levels of bilirubin can damage the brain. This is called&nbsp;<a href="http://www.nlm.nih.gov/medlineplus/ency/article/007309.htm">kernicterus</a>. However, the condition is almost always diagnosed before levels become high enough to cause this damage.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">For babies who need treatment, the treatment is usually effective.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="6" name="6">Possible Complications</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Rare, but serious, complications from high bilirubin levels include:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Cerebral palsy</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Deafness</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Kernicterus -- brain damage from very high bilirubin levels</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="7" name="7">When to Contact a Medical Professional</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">All babies should be seen by a health care provider in the first 5 days of life to check for jaundice.</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Those who spend less than 24 hours in a hospital should be seen by age 72 hours.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Infants sent home between 24 and 48 hours should be seen again by age 96 hours.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Infants sent home between 48 and 72 hours should be seen again by age 120 hours.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Jaundice is an emergency if the baby has a fever, has become listless, or is not feeding well. Jaundice may be dangerous in high-risk newborns.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Jaundice is generally NOT dangerous in term, otherwise healthy newborns. Call the infant&#39;s health care provider if:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Jaundice is severe (the skin is bright yellow)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Jaundice continues to increase after the newborn visit, lasts longer than 2 weeks, or other symptoms develop</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The feet, especially the soles, are yellow</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="8" name="8">Prevention</a></span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">In newborns, some degree of jaundice is normal and probably not preventable. The risk of significant jaundice can often be reduced by feeding babies at least 8 to 12 times a day for the first several days and by carefully identifying infants at highest risk.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">All pregnant women should be tested for blood type and unusual antibodies. If the mother is Rh negative, follow-up testing on the infant&#39;s cord is recommended. This may also be done if the mother&#39;s blood type is O+, but it is not needed if careful monitoring takes place.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Careful monitoring of all babies during the first 5 days of life can prevent most complications of jaundice. Ideally, this includes:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Considering a baby&#39;s risk for jaundice</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Checking bilirubin level in the first day or so</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Scheduling at least one follow-up visit the first week of life for babies sent home from the hospital in 72 hours</span></span></p>
	</li>
</ul>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong>Source:</strong><a href="http://www.nlm.nih.gov/medlineplus/ency/article/001559.htm"><strong>http://www.nlm.nih.gov/medlineplus/ency/article/001559.htm</strong></a></span></span></p>
