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Neonatal Jaundice

03/19/2025 من خلال: icn
Neonatal Jaundice
Neonatal jaundice is the accumulation of the yellow substance (bilirubin) in the blood, leading to yellowing of the skin and eyes in newborns. It occurs due to the immaturity of the liver, which is not yet fully developed to eliminate bilirubin efficiently. Non-pathological jaundice in infants usually disappears within two weeks without any treatment, requiring only monitoring.

https://www.moh.gov.sa/HealthAwareness/EducationalContent/BabyHealth/Pages/Neonatal-Jaundice.aspx

Definition: Neonatal jaundice is a common condition caused by the accumulation of bilirubin in the blood. Bilirubin is a yellow substance produced when old red blood cells break down and are replaced by new ones. Normally, bilirubin is filtered by the liver and excreted through stool. In newborns, the liver is still developing, making it less efficient at eliminating bilirubin. During pregnancy, the mother’s liver removes bilirubin for the baby, but after birth, the newborn’s liver must take over. Causes: Physiological Jaundice (Normal Jaundice) While in the womb, the placenta removes bilirubin from the baby’s body. After birth, the liver begins performing this function. However, since the liver is still immature, it takes time to efficiently process bilirubin. As a result, most newborns develop mild jaundice between two to four days after birth, which usually resolves within two weeks. Pathological Jaundice Jaundice that appears within the first 24 hours after birth or involves yellowing of the palms and soles is a medical emergency. Some causes include: Congenital hypothyroidism, where the thyroid does not produce enough hormones. Blood type incompatibility between the mother and baby. Urinary tract infections (UTIs). Crigler-Najjar syndrome, a genetic disorder affecting bilirubin metabolism. Bile duct or gallbladder obstruction or abnormalities. Symptoms: Jaundice typically first appears as yellowing of the skin, starting on the face, then spreading to the chest, abdomen, arms, and legs as bilirubin levels rise. The whites of the eyes may also turn yellow. Jaundice can be harder to detect in babies with darker skin tones. When to See a Doctor: Seek medical attention if the newborn exhibits any of the following: Difficulty waking up or extreme drowsiness. Jaundice appearing within the first 24 hours of birth. Fever. Refusal to feed. Fewer than 4-6 wet diapers per day and fewer than 3-4 bowel movements per day by the fourth day. High-pitched crying. Arching of the back, with the head, neck, and heels bent backward. Stiff or rigid body movements. Risk Factors: Newborns with the following risk factors require close monitoring and early management: Dark skin tone. Family history of blood disorders. A sibling who previously had jaundice. Poor feeding during the first few days. Premature birth (before 37 weeks). Bruising during birth. Blood type incompatibility between the mother and baby. Complications: If bilirubin levels become dangerously high, bilirubin can enter the brain, leading to: Acute bilirubin encephalopathy (temporary, treatable brain damage). Kernicterus (permanent brain damage caused by untreated severe jaundice). Severe, untreated jaundice can result in: Brain damage. Cerebral palsy. Hearing loss. Vision and dental problems. Intellectual disabilities. Treatment: The goal of treatment is to reduce bilirubin levels safely and efficiently. In most cases, jaundice resolves on its own within two weeks, but some babies may require treatment, such as: Phototherapy (light therapy), which helps break down bilirubin in the skin. Exchange transfusion (in severe cases) to replace the baby’s blood.
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