Things to know about neonatal jaundice

Jaundice is the medical term for a yellowish tinge of the skin. The yellow colour is caused by a substance called bilirubin, which is made normally in the body. Babies with higher than normal blood levels of bilirubin, a condition called "hyperbilirubinemia", gets this yellow colour when bilirubin builds up in the skin.

How common is jaundice in neonates?

Nearly 60-70 per cent of newborns have jaundice. The majority of babies have physiological jaundice which doesn't need treatment. It usually starts after 24 hours of birth and then increases progressively to 10-14 mg/dl till the 5th day of life. Usually comes down to normal on the 7th to 10th day.

Peak levels of jaundice come on the 5th day of life, so when should one see the doctor again?

Usually, babies are discharged from the hospital with the mother within 24 to 72 hours of birth. First, follow-up should be after 2 to 3 days of discharge. The majority of hospitals nowadays assess transcutaneous bilirubin before discharge. Depending upon risk factors present in the baby and the level of transcutaneous bilirubin before discharge, a doctor may call you earlier than 2 to 3 days post-discharge.

What precautions to take at home so that jaundice doesn't rise fast?

The baby should be fed appropriately at home. Jaundice increases in a subset of babies who lose weight excessively. This kind of jaundice is called breastfeeding jaundice, it is not due to breast milk. It is because of inadequate intake of breast milk in the first few days.

The point to note here is that babies lose 7-10 per cent weight in the first 4 to 5 days after birth which is normal.

Will sunlight help in curing jaundice?

Exposure to sunlight is not recommended due to the risk of sunburn unless ultraviolet rays are filtered out. Sunburn does not occur with the lights used in phototherapy.

Are there any side effects of phototherapy?

Phototherapy is very safe, but it can have temporary side effects, including skin rashes and loose stools. Overheating and dehydration can occur if a baby does not get enough breast milk or formula. Therefore, a baby's skin colour, temperature, and the number of wet diapers should be closely monitored.

Should the mother stop breastfeeding during phototherapy?

No, Breastfeeding should continue during phototherapy. Only when baby's bilirubin is so high that baby needs exchange transfusion or in babies with serious dehydration, intravenous (IV) fluids may be given for some time.