Jaundice In New Born Baby -Symptoms, Causes, Pathophysiology

Jaundice is a common condition that affects many newborns within the first week of life. If you’ve noticed a yellow tint to your baby’s skin or eyes, it’s natural to feel concerned.

While it is often harmless and temporary, understanding its causes and knowing when to seek help is crucial.

In this guide, we’ll break down everything you need to know about jaundice in newborn babies, including symptoms, causes, pathophysiology, diagnosis, treatment options, and prevention tips. Whether you’re a new parent or a healthcare provider, this article will help you understand it more clearly and take the right steps for your baby’s health.

What Is Jaundice In Newborns?

Jaundice in newborns refers to the yellowing of the skin and eyes due to high levels of bilirubin in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells.

In newborns, the liver may not be mature enough to efficiently process and eliminate bilirubin, leading to a temporary buildup.

Most cases are considered physiological jaundice, which usually resolves without treatment. However, pathological jaundice can indicate underlying issues and may require immediate medical attention.

Common Symptoms In Newborn Babies

Newborn babies (from birth to 28 days old) go through many physical changes as they adjust to life outside the womb.

Many symptoms that may seem unusual to new parents are often completely normal. Below are some common symptoms you might notice in newborns:

1. Spitting Up Milk

• Newborns often spit up small amounts of milk after feeding.
• This happens due to an immature digestive system (called gastroesophageal reflux).
• It is usually harmless if the baby is gaining weight and not showing signs of discomfort.

2. Slight Fever or Cold Hands and Feet

• Newborns may have slightly cold hands and feet due to immature blood circulation.
• Mild variations in body temperature are common.
• But if the baby’s temperature goes above 100.4°F (38°C) or below 97.7°F (36.5°C), seek medical advice.

3. Sleepiness and Long Sleeping Hours

• Newborns sleep a lot—around 16 to 18 hours a day in short intervals.
• This is completely normal and necessary for growth and brain development.
• Wake the baby up for feeding every 2–3 hours if needed.

4. Irregular or Strange-Colored Poop

• Newborn poop may be green, yellow, mustard-colored, or seedy in texture.
• Breastfed babies may poop after every feed or once in a few days.
• If you see red, white, or black stools (not the first meconium), consult a doctor.

5. Sneezing and Hiccups

• Frequent sneezing helps clear the nose and is not always a sign of a cold.
• Hiccups are also common and usually go away on their own.
• No treatment is needed unless the baby appears uncomfortable.

6. Fussiness and Crying

• All babies cry—sometimes for no clear reason.
• It’s their way of expressing hunger, discomfort, tiredness, or needing a diaper change.
• If crying is constant and high-pitched or if the baby seems in pain, consult your pediatrician.

7. Breathing Noises

• Newborns may make snorting, grunting, or occasional wheezing sounds.
• Their airways are small and still developing.
• If the baby is breathing rapidly, flaring nostrils, or showing signs of chest indrawing, get medical help.

8. Puffy Eyes and Milia

• Mild eye swelling or white spots on the nose and face (called milia) are common.
• These usually go away on their own without treatment in a few weeks.

Causes Of Jaundice In Newborns

Physiological

• Normal in most newborns
• Caused by immature liver function and rapid breakdown of fetal red blood cells

Breastfeeding

• Occurs in the first week due to insufficient milk intake
• Leads to dehydration and slower elimination of bilirubin

Breast Milk

• Appears after the first week
• Certain substances in breast milk may inhibit bilirubin breakdown

Hemolytic Disorders

• Blood type incompatibility (ABO or Rh incompatibility)
• G6PD deficiency leading to rapid red blood cell breakdown

Other Medical Conditions

• Liver disease
• Infections (e.g., sepsis)
• Genetic or metabolic disorders

Pathophysiology Of Jaundice In Newborns

Bilirubin is a byproduct of hemoglobin breakdown. After birth, newborns experience a surge in red blood cell breakdown.

The liver processes bilirubin by conjugating it into a water-soluble form to be excreted in bile and urine.

In neonates, the liver’s conjugating enzyme (UGT1A1) is underdeveloped, causing a buildup of unconjugated bilirubin.

High levels can cross the blood-brain barrier and cause kernicterus, a serious and irreversible condition affecting the brain.

How Jaundice In Newborns Is Diagnosed

Physical Examination

• Visual assessment under natural lighting
• Monitoring of skin and eye coloration

Bilirubin Testing

• Transcutaneous bilirubinometer: Non-invasive skin test
• Total serum bilirubin (TSB) test: Blood test to measure bilirubin levels

Additional Diagnostic Tests

• Coombs test (to identify blood incompatibility)
• Liver function tests
• CBC and reticulocyte count

Treatment Options For Neonatal Jaundice

When Is Treatment Needed?

• Based on age in hours and bilirubin level
• Rapidly rising levels or underlying disease may require prompt intervention

Common Treatment Methods

• Phototherapy: Light exposure breaks down bilirubin into water-soluble forms
• IV Fluids: For hydration in severe cases
• Exchange Transfusion: In critical cases, blood is replaced to reduce bilirubin

Home Care & Monitoring

• Ensure regular and adequate breastfeeding
• Follow-up bilirubin checks if needed

Risks and Complications Of Untreated Jaundice

• Kernicterus (bilirubin-induced brain damage)
• Hearing loss
• Intellectual disabilities
• Muscle tone abnormalities

How To Prevent Jaundice in Newborn Babies

• Begin breastfeeding within the first hour of life
• Feed at least 8-12 times a day in the first few days
• Monitor for signs of dehydration or poor feeding
• Early follow-up with a pediatrician

When To Seek Medical Help For Jaundice

• Yellowing increases or persists beyond 2 weeks
• Baby is not feeding well or is very sleepy
• Urine is dark or stools are pale
• Jaundice appears within the first 24 hours of life

FAQs

Conclusion

Jaundice is a common yet manageable condition in newborn babies. Knowing the difference between physiological and pathological jaundice, understanding its symptoms, and seeking timely medical care can prevent serious complications.

Always consult your paediatrician if you notice any signs of jaundice to ensure your baby receives the best care possible.