Jaundice in Babies When to Worry? | Jaundice Newborn

Treatment of neonatal jaundice

If the neonatal jaundice is physiologic, only medical care is needed in the form of phototherapy, intravenous immunoglobulin, and exchange transfusion in a few cases, while if the jaundice is pathologic, the treatment can be either medical or surgical depending on the condition. Causes such as biliary atresia and intestinal obstruction need emergency surgical care.

Regarding medical care, the following options are viable:

• Phototherapy: phototherapy is one of the oldest and most effective methods of managing hyperbilirubinemia. Ultraviolet light can change the chemical structure of unconjugated (indirect) bilirubin, causing it to be water soluble, enhancing its excretion by the kidneys and preventing it from crossing the blood-brain barrier, which prevents any neurological damage. Your baby will be placed in a special cubicle with blue iridescent light and protection for their eyes. During that period, their temperature will be monitored closely to prevent any damage to their skin.
• IVIG: Intravenous immunoglobulin is a viable option to prevent or reduce the need of transfusion therapy. It is most effective in jaundice that resulted from autoimmune hemolytic anemia or Rh incompatibility.
• Exchange transfusion: Exchange transfusion is the most effective therapy of newborn jaundice. It is usually reserved when other modalities of treatment fail or when the level of bilirubin is very high (above 20mg/ dL). It is also indicated in severe anemia. Exchange transfusion is a safe process, and all blood and blood products are screened for viral infections. Exchange transfusion can be life-saving when the case of jaundice is extreme and can be commenced before other modalities according to the condition of the baby.

Regarding breast milk, it is known to contain chemicals that alter the liver’s ability to process bilirubin. Therefore, babies recovering from jaundice may benefit from 1-2 days of break from breast milk and using formula milk instead to help their livers mature. Afterwards, breast milk can be introduced. Your baby will be examined once more once the episode of jaundice goes away for any neurological problems that persist. Your doctor may also need to see your baby within a week of their discharge to re-examine them and check that jaundice is gone for good.