Jaundice, or hyperbilirubinemia, is a condition that can develop in newborns within the first two to four days of life. It results from high levels of bilirubin, or bile, in the blood.
Fully mature livers can filter and eliminate bilirubin, but immature livers found in many newborns can cause jaundice to develop.
While there is no sure way to completely prevent the risk of jaundice, knowing the risk factors can help.
Most risk factors are unavoidable, but knowing whether or not these factors apply to your pregnancy can help you determine what lengths you need to go in your attempts to prevent and prepare for newborn jaundice.
Causes
Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow colour of jaundice, is a normal part of the pigment released from the breakdown of “used” red blood cells.
Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract.
A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin.
Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.
Other causes
An underlying disorder may cause jaundice. In these cases, jaundice often appear much earlier or much later than physiologic jaundice. Diseases or conditions that can cause jaundice include:
• Internal bleeding (hemorrhage)
• An infection in your baby’s blood (sepsis)
• Other viral or bacterial infections
• An incompatibility between the mother’s blood and the baby’s blood
• A liver malfunction
• An enzyme deficiency
• An abnormality of your baby’s red blood cells that causes them to break
Risk factors
Major risk factors for jaundice, particularly severe jaundice that can cause complications, include:
Premature birth – A baby born before 38 weeks may not be able to process bilirubin as quickly as full-term babies do.
Also, he or she may feed less and have fewer bowel movements, resulting in less bilirubin eliminated through stool.
Significant bruising during birth – If a newborn gets bruises from the delivery, he or she may have a higher level of bilirubin from the breakdown of more red blood cells.
Blood type – If the mother’s blood type is different from her baby’s, the baby may have received antibodies through the placenta that cause his or her blood cells to break down more quickly.
Breast-feeding – Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition from breast-feeding, are at higher risk of jaundice.
Dehydration or a low calorie intake may contribute to the onset of jaundice. However, because of the benefits of breast-feeding, experts still recommend it.
It’s important to make sure your baby gets enough to eat and is adequately hydrated.
Steps to prevent jaundice
Take blood tests during pregnancy – Certain blood incompatibilities can cause more blood cells to break down, producing more bilirubin.
Mothers with Rh negative blood or O+ blood type should consider having additional blood work taken for their babies since Rh incompatibility and ABO incompatibility are among the highest risk factors.
Genetic enzyme deficiencies, like glucose-6-phosphate dehydrogenase deficiency, can also lead to a higher risk of blood cell destruction.
Reduce the risk of a Pre-term birth – The liver of a pre-mature baby is even less developed than that of a full-term baby, making it even more difficult for the newborn’s liver to eliminate bilirubin.
Some pre-term risk factors, such as age or multiple births, cannot be remedied. Many environmental risks can be.
Keep up-to-date on your prenatal care. Early and consistent prenatal care will ensure that you and your baby stay as healthy as possible during the pregnancy.
Avoid chemical contaminants. Tobacco, alcohol, street drugs, and some medications can increase your chances of delivering early. Environmental pollutants can also contribute a risk.
Stay as calm as possible. Stress is a major factor in early births. Lack of social support, work that is physically or emotionally demanding, and domestic violence, whether physical or emotional, can all contribute.
Reduce the drugs you take during labour – Some studies suggest that drug use during labor can increase an infant’s chances of developing jaundice, though many studies are somewhat inconclusive.
Regardless, you may want to consider minimising drug use.
Some studies suggest that the glucose/dextrose IV given during oxytocin induction, a process in which labor is sped up, is one culprit that increases the odds of jaundice.
Bupivicaine, a type of epidural anesthesia, may also have some connection to the development of jaundice, but this idea is still debated and unproven.
Begin breastfeeding early – Mothers who begin breastfeeding within the first few hours after a newborn’s birth are more likely to have success than those who wait.
Early weight gain can help a baby’s development, making it easier for the liver to do its job.
Moreover, the colostrum a mother produces early on prompts the baby’s digestive system to eliminate waste, which helped to expel excess bilirubin from the intestines.
Feed your baby frequently – A steady supply of milk will increase your baby’s weight and development, including the development of the liver. This is true for both breastfed and formula fed babies.
Ideally, newborns should eat at least eight to 12 times daily for the first several days, especially if they are at risk of developing jaundice.
If you decide to breastfeed your baby, work with a lactation specialist to improve your breastfeeding technique. These professionals can help new mothers learn how to encourage proper latching so that newborns can receive enough milk.
Expose your baby to light – Light reacts with bilirubin, changing it into a form that does not need to pass through the liver in order to be expelled, thereby reducing the risk of jaundice.
Expose a naked baby to sunlight for no more than five minutes at a time, once or twice a day. Do not exceed this amount, since prolonged sun exposure can cause a baby to burn very easily and create further complications.
Alternatively, try placing the baby’s bed near a sunny window with curtains. Curtains and windows filter out many of the UV rays that can cause problems, allowing your baby to take in sunlight without burning.
• Culled from www.planbwellness.com
