Jaundice in Babies When to Worry? | Jaundice Newborn

Diagnosis of newborn jaundice

Diagnosing newborn jaundice and its causes is the job of a neonatologist, who is a specialist in infants in the first month of their lives. They usually examine your baby once they are delivered and record any changes whether in appearance or neurologic function. If your baby needs to be admitted to the neonatal intensive care unit (NICU), the rest of examination and test results will be carried out from there. Clinical examination is also done daily when needed, and lab tests as well as some imaging studies may be requested depending on the condition of the baby.

Some of the lab tests ordered in the newborn with jaundice include:

  • A complete blood test: A complete blood test can help differentiate between jaundice due to blood disorders and that which is physiologic. Knowing the hemoglobin level and hematocrit values is essential to detect hemolytic anemia and anemia at birth.
  • Transcutaneous bilirubinometry: One of the best investigative modalities of the level of bilirubin is transcutaneous bilirubinometry, which uses light to determine the level of bilirubin in the blood. It is better than withdrawing blood for the same purpose, especially durnig follow-up.
  • Coomb’s tests: Coomb’s test is used to detect the presence of an autoimmune destruction of red blood cells and can exclude or confirm autoimmune hemolytic anemia.
  • Rh typing of the baby: One of the now uncommon causes of neonatal jaundice is the Rh mismatch between the mother and the baby. When the mother is Rh negative and the infant is Rh positive, her body produces antibodies that can attack the red blood cells of her baby.
  • Liver function tests: They include liver enzymes, albumin level and prothrombin time. They serve to exclude liver conditions.
  • Tests for congenital infections and parasitic infestations. They include tests for hepatitis viruses and other infections transmitted from the mother including toxoplasmosis, cytomegalovirus, rubella, and herpes.

Imaging studies are limited in case of neonatal jaundice, but liver ultrasound may be indicated to assess the liver and the biliary passages. One of the main conditions that needs to be excluded is biliary atresia, which is the failure of development of a part or all of the biliary tree. For the same purpose, another imaging study called HIDA scan can be done.

Written by Martin Davis