Neonatal Jaundice - phototherapyperth.com.au

What is jaundice?

Jaundice is a yellowing of the skin, and sometimes the whites of the eyes or the gums. If your baby has dark skin, the main sign may be a yellowing in the whites of their eyes or the gums. Mild jaundice is quite common in newborn babies and is usually a temporary condition that causes no problems. However, severe cases of jaundice can be harmful, so if you think your baby has jaundice, it is always best to let your doctor or nurse know.

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What causes jaundice?

Jaundice is caused by bilirubin (a yellow substance) accumulating in the blood. Bilirubin is a normal waste product produced when red blood cells are broken down. It is normally passed out of the body in urine and faeces (poo). Newborn babies produce and break down a large amount of red blood cells very quickly and in the first few days it can be hard for their bodies to get rid of the bilirubin. Usually, as soon as the liver matures and functions more effectively, the jaundice will go away. In rare cases there can be other underlying problems such as blood type incompatibility or infection. If the jaundice persists past a few weeks your doctor may consider other causes such as thyroid or liver problems.

Signs and symptoms

The yellow colour of the skin is the main symptom of jaundice, usually beginning on the baby’s face and moving down to the chest, abdomen, legs and finally to the palms of the hands and soles of the feet. The whites of the eyes or the inside of the mouth or gums may also look yellow. Babies with jaundice may also be sleepy and not feed well.

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How is it diagnosed?

Your child’s doctor will look for signs of jaundice, and ask questions about birth weight, weight gain and feeding.
A screening test with a specialised light called a transcutaneous bilirubinometer is sometimes used on your baby’s chest to get an approximate measure of the jaundice.
A blood test to measure the level of bilirubin in your baby’s blood, called serum bilirubin level (SBR), may be ordered. This is the most accurate way to measure an SBR and involves collecting a small amount of blood from the arm, hand or heel. Additional blood tests or urine tests may be ordered if there is evidence your baby’s jaundice is caused by an underlying disorder that will need treatment.

Treatment

Mild jaundice often goes away without treatment, however babies with high levels of bilirubin may need treatment. Treatment may include phototherapy, exchange transfusion or medication.

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Phototherapy

Phototherapy is safe and effective in reducing SBR levels. As bilirubin absorbs light, jaundice and increased bilirubin levels usually decrease when the baby is exposed to these special blue coloured lights. The lights help the bilirubin in the blood to change so it can easily be removed from the body in the urine and faeces. Phototherapy may take several hours to begin working and is used throughout the day and night. Your baby will receive phototherapy from overhead lights or through a specially designed phototherapy blankets.

1. Overhead lights

Your baby will be placed in a special cot called an isolette to keep him/her warm while a certain type of light is shone onto them. This light helps to break down the bilirubin, which will then be passed out of your baby’s body in their urine and stools. Your baby will be placed under the light naked, apart from their nappy, to make sure that the light shines on as much of their skin as possible. Eye pads will be placed over your baby’s eyes to protect them.

2. Phototherapy blankets

A phototherapy blanket with a special type of light that breaks down the bilirubin is placed directly against your baby’s back to make sure that the light shines on as much of their skin as possible. Your baby may still wear clothing and wraps over the outside of the pad as normal. Your baby can feed while the treatment is taking place.