physiological jaundice in newborn

Question

I’ve heard that many newborns experience physiological jaundice, but I’m not sure what this means and whether it’s a cause for concern. My baby has been slightly yellowish, especially in the first few days after birth, and I’m wondering if this is a normal condition or if it requires treatment. Could you explain in detail what physiological jaundice in newborns is, why it occurs, and how it’s treated?

From what I understand, physiological jaundice is a common condition that occurs in many newborns due to the liver not being fully mature at birth. How does this affect bilirubin levels in the baby’s blood, and why does this lead to the yellowing of the skin and eyes? Is physiological jaundice something that resolves on its own, or are there treatments that can help speed up the process?

I’ve heard that physiological jaundice is different from jaundice caused by other conditions, like infections or liver diseases. How do doctors differentiate between the two, and what symptoms would indicate that the jaundice is due to a more serious problem that requires medical attention?

What treatments are used for physiological jaundice in newborns? I’ve read that sunlight exposure and breastfeeding can help reduce bilirubin levels, but are there other options, such as phototherapy, that might be needed in more severe cases? How does phototherapy work to lower bilirubin levels, and is it a safe treatment for newborns?

Lastly, if my baby has physiological jaundice, how will the pediatrician monitor their bilirubin levels? Should I be concerned if the jaundice persists for more than a few days, or is it normal for it to last for a week or more in some babies?

Dr. Ayush Varma · Answer

I'm here to provide information on physiological jaundice in newborns, which is indeed a common condition that occurs due to the immaturity of the liver at birth. When babies are born, their liver is not fully developed, leading to an inability to effectively process bilirubin, a substance produced from the breakdown of red blood cells. As a result, bilirubin levels can rise in the bloodstream, causing the yellowing of the skin and eyes known as jaundice. This condition usually appears within the first few days of life and is often seen more prominently in breastfed infants due to the natural changes in feeding patterns and stool output.

Physiological jaundice typically resolves on its own as the newborn's liver matures, usually within the first two weeks of life. Breastfeeding should continue as it helps with hydration and supports the elimination of bilirubin through bowel movements. Sunlight exposure can also be beneficial, as it helps break down bilirubin.

Doctors differentiate physiological jaundice from other forms of jaundice by carefully monitoring bilirubin levels and observing the timing and pattern of jaundice onset. Symptoms that could indicate a more serious issue include jaundice appearing within the first 24 hours of life, high bilirubin levels, or accompanying signs of illness such as poor feeding, lethargy, or a distended abdomen.

In more severe cases of jaundice, treatments like phototherapy may be necessary. This involves placing the baby under special lights that help to convert bilirubin into a form that can be more easily eliminated through urine or stool. Phototherapy is generally considered safe for newborns, but continuous monitoring of bilirubin levels is essential, especially during treatment.

Your pediatrician will typically monitor bilirubin levels through blood tests, observing for patterns in jaundice duration. While mild physiological jaundice is expected to resolve within the first week, persistent jaundice beyond two weeks should be evaluated. If you notice any concerning symptoms or if the jaundice appears to worsen, it’s important to contact your healthcare provider for further evaluation and guidance.

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