Should I be worried about jaundice?

Dear Doctor,

My new-born has a mild case of jaundice. However, I’m told it can get worse. How bad can it get and how do I avoid it?

Pat

Dear Pat,

A new-born baby can have jaundice due to the liver of the child not being mature enough to metabolise by product of bile metabolism.  This usually subsides in a day or two, or maximum, seven days. The risk is much more if a baby is premature. There is nothing to worry about as it usually subsides in a few days. Phototherapy is useful in treating this kind of jaundice.

Haematological disorders like presence of abnormal haemoglobin can induce jaundice in a new-born. Bleeding due to any reason in a new-born as due to birth trauma is yet another cause for neonatal jaundice. Similarly, trauma during birth as it happens due to use of forceps is also a cause for neonatal jaundice.

A new-born baby may develop jaundice due to adverse effect of drugs like phenobarbitone.

Sepsis due to any infection can cause neonatal jaundice. Malaria fever is known to cause jaundice in new-born babies as well.  A baby can acquire specific infections of the liver like hepatitis B or C, during delivery, if the mother is infected. Any such infection can be detected by specific clinical features and investigations.  It is treatable by immune globulins as well as anti-viral drugs.

Rarely, jaundice may occur in a new-born due to congenital deficiency of enzymes necessary for handling bilirubin a by-product of bile metabolism.

Mostly, neonatal jaundice is self-subsiding. In case of a specific underlying cause, treatment cures the condition.

However, if not detected early or if severe, it can result in liver failure. This is manifested by yellow discoloration of the eyes, vomiting, loss of appetite, and etcetera. It can lead to coma and even death.

Prevention of neonatal jaundice lies in being careful during pregnancy. A pregnant woman should take all due precautions and undergo regular antenatal check up to ensure that delivery occurs when the baby is full term.

Infections during pregnancy can be avoided by taking due precaution. This includes personal as well as sexual hygiene.

As far as possible, unless strongly indicated, a new-born should not be given any medicines, particularly antibiotics and anticonvulsants.

Dr. Rachna   Pande is a specialist in internal medicine.

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