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Over half of all newborns develop some amount of jaundice, a yellow coloring in their skin, during the first week. This is usually a temporary condition, but may be a more serious sign of another illness. Jaundice is caused by the breakdown of red blood cells. As the old cells are broken down, hemoglobin is changed into bilirubin and removed by the liver. The build-up of bilirubin in the blood is called hyperbilirubinemia. Because bilirubin has a pigment, or coloring, it causes a yellowing of the baby's skin and tissues. As liver function matures, the jaundice goes away. A premature infant is more likely to develop jaundice. The yellow tint to the skin can often be seen by gently pressing on the baby's forehead or chest and watching the color return.
There are several types of jaundice:
Although low levels of bilirubin are not usually a concern, large amounts can circulate to tissues in the brain and may cause seizures and brain damage. This is a condition called kernicterus.
The following are the most common symptoms of jaundice. However, each baby may experience symptoms differently. Symptoms may include:
Symptoms of jaundice may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.
The timing of the appearance of jaundice helps with the diagnosis. Jaundice appearing in the first 24 hours is quite serious and usually requires immediate treatment. When jaundice appears on the second or third day, it is usually "physiologic." However, it can be a more serious type of jaundice. When jaundice appears on the third day to the first week, it may be due to an infection. Later appearance of jaundice, in the second week, is often related to breast milk feedings, but may have other causes.
Laboratory testing for hyperbilirubinemia may include:
Specific treatment for jaundice will be determined by your baby's physician based on:
Treatment depends on many factors, including the cause of the jaundice and the level of bilirubin. The goal is to keep the level of bilirubin from increasing to dangerous levels. Treatment may include:
While jaundice cannot be totally prevented, early recognition and treatment are important in preventing bilirubin levels from rising to dangerous levels. If your baby's color is turning more yellow, promptly call your baby's physician.
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