Doc Talk: Dangers of jaundice and what parents need to know
In our weekly feature, 'Doc Talk,' we're discussing a medical condition that almost all newborns have, to some extent, it's jaundice.
Doctor Clint Pollack from Valley Children's Hospital talks about when it becomes a medical concern and how it's treated.
Dr. Pollack says jaundice is caused by elevated bilirubin in the blood.
He says newborns have more red blood cells which have a shorter life span than older children and adults. Bilirubin is produced during the breakdown of hemoglobin from these red blood cells. Newborns also are unable to remove the bilirubin from their blood efficiently due to the lack of an important enzyme.
Dr. Pollack says almost all newborns have some jaundice.
He says in most cases of jaundice in newborns is "physiologic", but it can also be caused by dehydration, mismatch with the mother's blood type, abnormalities in the baby's red blood cells, infection, or liver dysfunction.
Dr. Pollack says breastfed babies may have increased jaundice for longer periods of time.
He says bilirubin levels always increase for the first few days of life and usually peak around day 4-7.
Symptoms of jaundice include yellowing of the skin and eyes.
Bilirubin is removed from the body in bile excreted by the liver.
The cutoff for admission and treatment with phototherapy is (bilirubin measured in mg/dL):
-12 at 1 day of age
-15 at 2 days of age
-18 at 3 days of age
-These numbers are lower for premature or high-risk babies.
Dr. Pollack says Encephalopathy and kernicterus are the most serious complication of severely elevated bilirubin and can occur at levels > 25.
He says it may be reversible or cause permanent brain damage or death.
Dr. Pollack says babies with mild jaundice can be treated at home and followed closely by a pediatrician.
He says supplementing breastfed babies with formula can help reduce bilirubin.
Dr. Pollack says brief periods of skin exposure to sunlight may also help.
He says patients with more severe hyperbilirubinemia will be admitted for phototherapy treatment with special blue LED lights.
Dr. Pollack says patients with very severe hyperbilirubinemia may need to be admitted for blood exchange transfusion.
