Symptoms Of Jaundice In infants And Kernicterus

baby with jaundice
Jaundice in infants. Photo by: true2leo on Flickr.


Jaundice in infants is the yellow coloring of the skin soon after a baby is born, and is more common in premature babies.

Jaundice affects about 3 in 5 babies, is usually harmless and will disappear in a week or two.





Cause of jaundice

You see this yellow coloring usually 2 to 4 days after birth. It can be a great disappointment for new mothers when they think they can leave the hospital and their baby all of a sudden shows symptoms of jaundice.

Babies get this yellow coloring of the skin when they have elevated levels of bilirubin in their blood. Bilirubin is a result of the blood breaking down old red blood cells.

During pregnancy the bilirubin from baby's body is removed through the placenta. After birth your baby has to remove the bilirubin on its own, through urine and stool. This is what we call physiologic jaundice in infants, because it is part of a normal body process.

In young infants the liver is not mature enough to remove the bilirubin from the blood. Too much of this substance in the blood causes the yellow coloring of baby's skin and eyes, or what we call jaundice. Jaundice comes from the French word jaune which means yellow.

It is very important though that we monitor the levels of bilirubin in baby's blood because very high levels ( hyperbilirubine) can cause brain damage (kernicterus).


Breastfeeding jaundice

The lack of enough breastmilk increases the risk of jaundice in infants. This is what we call breastfeeding jaundice.

With breastfeeding jaundice your baby doesn’t get enough milk (fluid) and as a result he cannot get rid of the bilirubin in his body. Breastfeeding jaundice appears usually at one week of age and can last up to two weeks or more.

As long as your baby drinks well and gains weight as expected there is no reason to stop breastfeeding.

Sometimes babies with jaundice are more sleepy and fall asleep halfway breastfeeding making nursing more difficult. Try to breastfeed your baby every 2 to 3 hours even if this means waking up your baby.


Breastmilk jaundice

It is generally believed that this type of jaundice in infants is caused by factors in the breast milk, which block certain proteins in the liver that break down bilirubin.

This type of jaundice happens in breast-fed infants and no kernicterus has ever been reported.

The diagnosis is usually made in a healthy, thriving infant where no other pathological reasons can be found.

Sometimes babies have to stop breastfeeding for 24 to 48 hours to see if bilirubin levels drop, just to make the diagnosis of breast-milk jaundice.


Causes of pathlogical jaundice

  • Blood type incompatibility. When mothers immune system attacks baby’s red blood cells.
  • Bruises or other injuries during the birth process cause a breakdown of red blood cells and therefore more bilirubin release in baby’s blood.
  • Premature born babies.
  • Conditions like Polycytemia, Hemolytic anemia and other blood diseases.
  • Liver diseases like bile duct obstruction or hepatitis.
  • Urine infection.


Kernicterus is a form of brain damage caused by far too high bilirubin levels.

The bilirubin is so high that it can move out of the blood into brain tissue. When bilirubin enters the brain it acts as a neurotoxin causing brain damage.

Serious damage like hearing loss, mental retardation, or even infant death may be the result.


What are the jaundice symptoms of too high bilirubin levels?

  • First of all you can see the yellow coloring getting worse.
  • Your infant may be hard to wake up.
  • Your child may be sluggish and cranky.
  • Bulging soft spot or fontanel.
  • Fever.
  • Very typical sign is the high pitched crying.
  • Your infant arches neck or body backwards.


Jaundice treatment

phototherapy for jaundice
Photo by: Shannonpatrick17


Some infants may be yellow but their bilirubin levels are not that high they require treatment.

At higher levels your doctor may decide your baby needs phototherapy.

With phototherapy they use light to eliminate the bilirubin in baby’s blood.

Because your baby absorbs these light waves through the skin your baby should be naked or just wearing a nappy. Your infant gets to wear eye patches to protect the eyes. When the bilirubin is back to a safer level the phototherapy can be stopped. This may take a few days.

It is also important that baby gets enough fluid during the phototherapy. This helps the body to eliminate the bilirubin through urine and stool. Common side effects of using phototherapy are frequent and loose bowel movements and skin rash.

Some people may recommend taking your baby out in the sunlight. This may help but if baby is in the sun for a prolonged time your baby may get sunburned.


Phototherapy with a biliblanket

phototherapy for jaundice
Biliblanket for jaundice in
infants. Photo by: tillbeetge

An alternative or additional treatment to phototherapy is the Biliblanket. This photo-optic bilirubin blanket is wrapped around the baby and gives the highest level of therapeutic light. The biliblanket consists of a fiber-optic pad, a cable connector, and a light generating box.

The biliblanket offers the possibility of treating jaundice in infants at home as long as the baby is otherwise healthy. You can use the biliblanket 24 hours a day to provide optimal treatment.

You can ask your doctor to give you a prescription to rent a biliblanket for using at home.

Biliblankets can be very expensive. Sometimes you can get a good deal on eBay considering it will be used only for a short time.

You can also get a Ohmeda Biliblanket Plus for Sale or Rent here.


Treatment for blood incompatibility

If jaundice in infants is caused by blood type incompatibility intensive phototherapy may not be sufficient, and exchange transfusion may be necessary to prevent brain damage.

During an exchange transfusion they slowly remove the baby's blood and replace it with fresh donor blood or plasma.

Fortunately exchange transfusions are very rare nowadays because pregnant woman with the potential to develop Rh incompatibility, are given Rh immune-globulin shots. They give these shots at the 28th week of pregnancy, and again within three days after the baby is born.




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