Q: Good evening Doc. Thanks for your advice etc. I gave birth at 38weeks through C -S because the water was flowing and there was no labour. The doctor refused to induce me. Thank God we are both okay. The first day, her eyes were bright but after a few days, her eyes became a little yellowish. I took her back to the hospital, they
ran full blood test on her and her blood was okay they also tested for jaundice,
which they said that they really didn’t detect, and her face and body
complexion is still normal. What could be the problem? She suckles well, she
cries well unless when she cries a long time, she tends to be weak. Please I
need your advice. God bless you ma’am
A: Hello dear. Congratulations on your new bundle of joy!
What could be the problem? It would appear that there is none…from what your baby’s doctors have told you 😀 Let me break it down for you though.
Jaundice is a condition in which there is yellowing of the eyes or the skin. It can happen in both children and adults. Usually, when old red blood cells are broken down, a yellow pigment, bilirubin is released as part of that process. The bilirubin is removed from the body through urine and stool. It is the bilirubin that gives rise to that yellow colour seen in jaundice.
Other symptoms of jaundice include deep yellow urine and pale stools.
In new born babies, there are two types of jaundice (neonatal jaundice) that can occur: Physiological jaundice and pathological jaundice.
Physiological jaundice occurs as a natural process of life. While in the uterus, the baby’s bilirubin is removed through the placenta. Once the baby is born, he/she has to handle this bilirubin business by himself/herself J (talk about responsibility immediately after touching down in planet earth!) because his organs are unable to deal with all the bilirubin released from breakdown of red blood cells. As the bilirubin accumulates in blood, jaundice results. Typically, this jaundice appears about 24hours after birth, actually gets worse until the 3rd or 4th day. It would usually have disappeared by the end of one or two weeks.
Pathological jaundice is due to a disease condition like infection, mother and baby’s blood groups not being compatible etc. This is typically present before 24 hours of birth. Indeed, this is the main difference between the two types of jaundice. The one that occurs naturally is seen after 24 hours while the one due to disease is seen before 24 hours…rule of thumb
Jaundice may be mild, disappearing on its own, especially physiologic jaundice. However, sometimes, the yellowness deepens, the baby may develop a high-pitched cry and/or develop arched back. These are dangerous signs and this child should be in a hospital. Indeed, if you observe jaundice in your baby after you have left the hospital, please get it checked out in the hospital just to be sure. Most babies are able to deal with this excess bilirubin on their own without needing treatment. However, some other babies may be put under special lights called phototherapy or in more serious conditions, an exchange blood transfusion may be done (literally, this involves practically exchanging the baby’s bilirubin-filled blood with ‘new’ blood).
The main focus in jaundice is to bring down the level of the bilirubin. If this is not done, it could cross the blood/brain barrier and stain the brain leading to brain damage, a condition called Kernicterus. More frequent feeding is usually suggested as this helps the baby get rid of more bilirubin.
So, from your description, it would appear your baby had physiological jaundice but is right as rain now! 😀 As I always say, whenever in doubt, please see your baby’s doctor for another consultation.
All the best.
Merry Christmas everyone 😀