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Jaundice in babies

by Dr Kerry Robinson
It’s alarming when your newborn turns yellow but over 60% of infants get jaundice. Usually, there’s no need to worry, says paediatrician, Dr Kerry Robinson

There’s your beautiful baby, perfect in every way, but within three days her skin and the whites of her eyes turn yellow. This discoloration is called jaundice and it’s caused by the breakdown of red blood cells. But don’t fret, in most cases it’s physiological jaundice and that’s normal. Though, occasionally, jaundice is a sign of deeper problems, your baby will usually show other symptoms that indicate an illness.

Physiological Jaundice

Two things cause yellow discolouration – an immature liver and an absence of bacteria in the gut.

Newborn babies are born with a surplus of red blood cells and after birth the excess cells are broken down in the spleen. One of the breakdown products of red blood cells is bilirubin, which is responsible for the yellow colour. Bilirubin normally travels in the blood from the spleen to the liver where it is processed with no problems. But many newborns’ livers are immature and can’t process all the bilirubin delivered, thus the bilirubin passes into the gut.

In older children and adults the gut is full of bacteria that break down any incoming bilirubin. In newborns, the gut hasn’t built up enough healthy bacteria (its normal flora) to cope with the bilirubin. So it’s reabsorbed from the gut back into the blood stream making the skin and whites of the eyes go yellow. It doesn’t usually have an adverse effect on any other organs. Though, in extreme cases, the brain can be affected, in this country, treatment for jaundice is started well before there is any danger.

Physiological jaundice usually starts after 48 hours of age, reaching a peak by 4–5 days, and can last for up to two weeks. It’s more common in breastfed babies (although no-one really knows why) but this does NOT mean you have to stop breastfeeding.

If jaundice is present with certain other symptoms, it may indicate another underlying illness.

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