Jaundice In Newborns: Hospital Testing Methods And Procedures

Jaundice is a common condition in newborns that causes yellowing of the skin and eyes. It occurs when there is a buildup of bilirubin—a yellow substance that the body creates when it replaces old red blood cells—in the baby's blood. While jaundice usually goes away on its own, it can sometimes require treatment to lower bilirubin levels. Hospitals typically test newborns for jaundice by performing a visual examination and checking the baby's bilirubin levels through blood tests or the use of a bilirubinometer. This involves pricking the baby's heel to obtain a small amount of blood. If jaundice is detected, treatment options include phototherapy, exchange transfusion, and changes in feeding habits.

Bilirubin blood tests

Jaundice is a common condition in newborns, characterised by a yellow colouring of the skin and eyes. It occurs when there is a build-up of bilirubin in the blood due to the liver not being developed enough to get rid of it effectively. While jaundice usually resolves on its own within a couple of weeks, severe cases can lead to brain damage if left untreated. Therefore, it is important for healthcare providers to check newborns for jaundice before they leave the hospital and again within a few days of birth.

One method of checking for jaundice is through bilirubin blood tests, which are usually performed if the baby developed jaundice within 24 hours of birth or if the bilirubin reading is particularly high. During the test, a small sample of blood is taken by pricking the baby's heel with a needle. This sample is then used to measure the level of bilirubin in the serum, which is the liquid part of the blood. The total serum bilirubin (TSB) level is then determined.

The TSB level is used to decide whether any treatment is needed and whether there is an underlying cause for the elevated bilirubin levels. Treatment options may include phototherapy, where the baby is exposed to a special type of light that helps convert bilirubin into a form that can be more easily excreted through stool or urine. In rare cases of severe jaundice that does not respond to other treatments, exchange transfusion may be necessary, which involves repeatedly withdrawing small amounts of blood and replacing it with donor blood to dilute the bilirubin.

It is important for parents to monitor their newborns for signs of jaundice after returning home from the hospital. This can include observing the colour of the baby's skin, eyes, and tongue, as jaundice may be more difficult to detect in newborns with darker skin tones. If jaundice is suspected or persists beyond two weeks, further blood tests may be necessary to guide treatment decisions and ensure the baby's health.

Overall, bilirubin blood tests play a crucial role in the diagnosis and management of jaundice in newborns, helping healthcare providers make informed decisions about treatment options and ensuring the well-being of the baby.

Phototherapy treatment

Jaundice is a common condition in newborns, characterised by a yellow colouring of the skin. It occurs when there is a build-up of bilirubin in the baby's blood due to their underdeveloped liver, which is not yet able to effectively eliminate bilirubin. While jaundice usually resolves on its own, some cases may require treatment, particularly if the condition worsens or persists.

Phototherapy is a standard treatment option for jaundice in newborns. This treatment method involves the use of light therapy to help break down the bilirubin in the baby's body, allowing for easier excretion through urine or stool. There are two main types of phototherapy:

Traditional Phototherapy:

For this method, the baby is placed in an enclosed plastic crib or incubator, where they are exposed to a special type of fluorescent light. This light falls within the blue-green spectrum and works to alter the shape and structure of bilirubin molecules, making them easier for the baby's body to eliminate. During this process, the baby wears only a diaper and protective eye patches to shield their eyes from the light.

Fiber-optic Phototherapy:

This approach involves wrapping the baby in a fiber-optic blanket or band, which can be used both in the hospital and at home. This method is equally effective but typically takes longer than traditional phototherapy due to the more targeted application of light.

The choice between these two types of phototherapy depends on various factors, including the severity of the jaundice, the baby's overall health, and the availability of medical resources. In some cases, doctors may recommend a combination of both methods to ensure effective treatment.

It is important to closely monitor a baby's condition during and after phototherapy treatment. While phototherapy is generally safe, proper eye protection is crucial to prevent any potential eye damage from the intense light. Additionally, follow-up bilirubin tests may be necessary to ensure that the jaundice is improving and that the baby's liver is functioning properly.

Risk factors and prevention

Jaundice is a common condition in newborns, characterised by a yellow discolouration of the skin and eyes. It occurs when there is a buildup of bilirubin—a yellow pigment produced during the breakdown of red blood cells—in the baby's blood. While jaundice usually resolves on its own as the baby's liver matures, it can be dangerous if left untreated.

Jaundice is more common in babies born before 38 weeks' gestation (preterm babies) and some breastfed babies. It is also more likely to occur if the mother has certain risk factors during pregnancy, such as advanced age or perinatal diseases. Premature delivery, in particular, can lead to delayed feeding, insufficient breast milk, infant nutritional disorders, and reduced feeding frequency, all of which can increase bilirubin levels in the newborn's blood.

Maternal-fetal ABO blood group incompatibility and G6PD deficiency are also risk factors for jaundice, as they can cause hemolysis, leading to increased bilirubin levels. Additionally, the risk of pathological jaundice increases from 1% without risk factors to 59% with risk factors.

To prevent jaundice in newborns, adequate feeding is essential. Breastfed infants should be fed eight to twelve times a day during their first week of life, while formula-fed infants should be given one to two ounces (30 to 60 milliliters) of formula every two to three hours, ensuring at least eight feeds in a 24-hour period. Frequent feedings stimulate regular bowel movements, helping the baby eliminate bilirubin.

Hospitals typically examine newborns for jaundice before discharge, and the American Academy of Pediatrics recommends checking bilirubin levels at least every eight to twelve hours during hospitalisation. If a baby is discharged within 72 hours of birth, a follow-up appointment to check for jaundice within two days is advised. Close monitoring and prompt treatment, such as phototherapy, can help prevent complications associated with severe jaundice.

Visual examination

Jaundice is a common condition in newborns, characterised by a yellowing of the skin and whites of the eyes. It occurs when there is a build-up of bilirubin in the blood due to the liver's inability to break it down effectively. While most cases of jaundice resolve on their own, it is important to monitor for any signs of the condition. Visual examination is a crucial aspect of detecting jaundice in newborns and can be performed by healthcare professionals or family members.

During the visual examination, it is important to look for specific signs and symptoms associated with jaundice. In addition to the yellow discolouration, other indicators may include the baby's level of alertness and feeding habits. Babies with high bilirubin levels may exhibit sleepiness, fussiness, or floppiness. They might also experience difficulty feeding, which can further contribute to the build-up of bilirubin.

In summary, visual examination for jaundice in newborns involves a careful observation of the skin and eyes for any yellow discolouration. This examination is typically performed under good lighting conditions to ensure accuracy. By conducting thorough visual assessments, healthcare providers and family members can play a vital role in detecting jaundice early on, enabling prompt medical attention and reducing the risk of potential complications.

Exchange transfusion

Jaundice is a common condition in newborns, characterised by a yellow colouring of the skin and eyes. It occurs when there is a build-up of bilirubin in the baby's blood due to their underdeveloped liver being unable to get rid of the chemical, which is produced during the breakdown of red blood cells.

In most cases, jaundice is mild and resolves on its own within a few weeks. However, in some cases, treatment may be required. The most common treatment for jaundice is phototherapy, which involves the use of light wavelengths to break down bilirubin into a form that can be easily excreted by the body.

In rare cases of severe jaundice that does not respond to other treatments, an exchange transfusion may be necessary. This procedure involves repeatedly withdrawing small amounts of the baby's blood and replacing it with donor blood, thereby diluting the bilirubin and maternal antibodies. Exchange transfusion is performed in a newborn intensive care unit, with the baby's blood being slowly removed through a catheter inserted into the umbilical vein.

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