Each year more than 6 million newborns in low resource areas around the globe do not receive adequate phototherapy to treat jaundice - Donna Brezinski
image by: The Belleville Intelligencer
In developing regions of the world, neonatal jaundice is a persistent nemesis. It stands apart from other threats to newborn health, like pneumonia, that present with clear and immediate symptoms. The very nature of jaundice, its onset and progression, expose the gaps in existing patterns of newborn health care that help to explain the residual high death and disability rates:
It is deceptive. Many of the newborns that ultimately succumb to severe neonatal jaundice are born at full term and appear healthy.
It is common. About 60% of all term newborns have some degree of jaundice. The fact that most will recover without intervention can…
In developing regions of the world, neonatal jaundice is a persistent nemesis. It stands apart from other threats to newborn health, like pneumonia, that present with clear and immediate symptoms. The very nature of jaundice, its onset and progression, expose the gaps in existing patterns of newborn health care that help to explain the residual high death and disability rates...
The term jaundice is from the French word "jaune," which means yellow. Neonatal jaundice in most newborns is a mild and transient event. It is however imperative to identify newborns with jaundice that do not follow this pattern as failure to do so may lead to long-term sequelae.
Any baby can get jaundice. Severe jaundice that is not treated can cause brain damage. Your baby should be checked for jaundice in the hospital and again within 48 hours after leaving the hospital. Ask your doctor or nurse about a jaundice bilirubin test.
Physiologic jaundice is the most common form of newborn jaundice. The baby's liver plays the most important part in bilirubin breakdown. The type of bilirubin that causes the yellow discoloration of jaundice is called unconjugated or indirect bilirubin. This form of bilirubin is not easily removed from the baby's body. The baby's liver changes this unconjugated bilirubin into conjugated or direct bilirubin, which is easier to excrete. The liver of a newborn baby is immature, so the job of conjugating and removing bilirubin is not done completely well.
Parents also should watch their baby for jaundice. Jaundice can be hard to see, especially in babies with dark skin. If you're unsure, gently press the skin on your baby's nose or forehead — if jaundice is present, the skin will appear yellow when you lift your finger.
Most newborns have some yellowing of the skin, or jaundice. This is called "physiological jaundice." It is often most noticeable when the baby is 2 - 4 days old. Most of the time it does not cause problems and goes away within 2 weeks.
Jaundice is one of the most common conditions that can affect newborn babies. It is estimated that 6 out of every 10 babies will develop jaundice, including 8 out of 10 babies born prematurely (babies born before the 37th week of pregnancy). However, only around 1 in 20 babies has a high enough level of bilirubin in their blood to need treatment.
Hyperbilirubinaemia is either unconjugated (which is potentially toxic but may be physiological or pathological) or conjugated (not toxic but always pathological). Without treatment, high levels of unconjugated bilirubin may lead to kernicterus.
Jaundice in full-term, healthy newborns is considered physiologic because hyperbilirubinemia occurs in all neonates.
Breast milk jaundice is thought to be due to the infant’s immature liver and intestines. It typically begins the first week after birth, peaks within two weeks after birth, and declines over the next few weeks. Breast milk jaundice is not a reason to stop breastfeeding as long as the baby is feeding well, gaining weight, and otherwise thriving. Infants with breast milk jaundice rarely need treatment unless severe hyperbilirubinemia develops.
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