Your baby is finally born but then he or she turns out to have jaundice. Another term is hyperbilirubin, a high level of bilirubin in the blood, or icterus. This occurs in about 60% of all babies born. But what is the cause of this and, more importantly, is it preventable?
There is often no question of jaundice just after birth, only after 2 to 7 days a baby starts to see yellow due to a high level of bilirubin in the blood. The bilirubin will then pile under the skin and this gives the yellow color.
Why do babies sometimes see yellow?
Babies have a surplus of red blood cells in their blood after delivery. This has to be aborted and bilirubin is released as waste. This bilirubin is broken down by the liver but you can imagine that the organs of a newborn baby still have to start and often still not function at full force.
If the liver can not break down these large quantities of bilirubin, it will remain in the body and will begin to accumulate. This can discolour the skin and sometimes also the eye-white of your child. This usually disappears again after a few days in most cases. However, if the values rise above a certain level, this can cause permanent brain damage. This condition is called kernicterus and is fortunately very rare in this modern age (1: 100,000).
Will the baby see yellow within 24 hours instead of after a few days? This may indicate the poor functioning of the liver or a deviating blood group between mother and child. In these cases, it is important that the baby is examined as quickly as possible by a pediatrician and treated if necessary.
Risk factors for developing jaundice
You can not avoid jaundice as mother and parents. The chance of (severe) jaundice increases when:
- the baby was born prematurely. More than two weeks early or before the 37th week of pregnancy.
- the breastfeeding does not start and the baby gets too little milk.
- the baby has contracted bruises or bruises during childbirth. For example, when giving birth by means of a pair of pliers or a vacuum pump. )
- Blood group antagonism: the baby's blood is incompatible with that of the mother. For example, mother has blood group O and the baby A or B. Or the mother is rhesus negative and the baby rhesus positive.
- The child is ill.
- A previous child also had jaundice.
- There is an inherited disease that increases blood breakdown (G6PD deficiency or spherocytosis)
- There is gestational diabetes.
Whipping out the umbilical cord
You will probably have read about letting the umbilical cord out. This does mean that the umbilical cord is not cut right after birth but is waited for about 3-4 minutes. In this way, some extra blood can flow from the mother to the child, about 50-100 ml. This brings many benefits, more stem cells reach the baby and he or she gets an extra dose of iron that reduces the risk of anemia.
A disadvantage, which according to many does not outweigh the benefits, is that because of this extra blood the chance of jaundice increases.
What can you do to make the jaundice disappear as quickly as possible?
Make sure your baby drinks enough. Bilirubin leaves the body through the faeces and urine. So by feeding regularly, you ensure that bowel action accelerates and the bilirubin is not re-absorbed into the blood.
Jaundice is more common in nursing babies, especially when breastfeeding does not start well. Therefore, place your baby 8 to 12 times a day in the first days, encouraging the start of breastfeeding.
The jaundice of breast-fed infants may be longer than that of bottle-fed infants. This is normal and in most cases does not mean that breastfeeding should be stopped.
It is best to put the box or cradle at the window, sunlight can reduce this form of jaundice.
My child has jaundice, what now?
In almost all cases this is nothing to worry about, but it is checked very carefully by medical staff. This check can take place by the midwife, nurse or by a doctor. They look at how yellow the baby is and which parts of the body have turned yellow. Such as the whites of the eye, the mucous membranes of the mouth, just the face or the whole body.
It can be printed on the skin. If the pressure point remains white, the bilirubin content is not yet that high. We will also look at the alertness of the baby and whether he or she is drinking well and adequately.
The bilirubin content can be measured via a skin test. The device resembles a type of ear thermometer and is printed on the body of the baby in 3 places. From this comes a certain value.
To get more certainty, blood is taken from the heel and examined in the laboratory. You can expect the results after one hour.
Jaundice is one of the most common complications in the baby after delivery
Treatment of jaundice
The bilirubin content that your baby may have depends, among other things, on age, birth weight, gestational age and any risk factors or complications. Phototherapy is started when the bilirubin level threatens to become too high. This is a non-painful therapy in which the baby, with only a diaper on, is placed on a mat or under a lamp. This mat or lamp provides a specific light that converts the bilirubin into a water-soluble variant and can thus be excreted via faeces or urine.
Your child is therefore placed on the bili bed or under the lamp with only a diaper. He or she is provided with a clothed glasses to protect the eyes from the light. To feed you may take your baby under the lamp, but the moments without light should be kept as short as possible.
An advantage of the bili bed (mattress) is that it can be folded. So you can keep your baby with you with the mat under him or her. So you can continue the phototherapy during feeding or because you want your newborn baby to sleep with you.
Usually the therapy lasts 24 hours and afterwards it will be checked how effective it was. On the basis of the new blood values, it is decided whether the bilirubin has dropped sufficiently or that a session may be started.
Helps phototherapy not or not enough then it can be decided to perform an exchange transfusion. A part of the baby's blood is replaced by that of a donor. This takes about 2 to 3 hours and then the baby gets phototherapy again.
Jaundice in newborns: Is it dangerous?
All in all, jaundice alone is not a problem, but doctors keep a close eye on yellow babies so that a possible kernicterus is prevented. Our Elin stayed in the hospital for a week for which I was very happy afterwards.
With a gestational age of 36 weeks, knocking out the umbilical cord and a birth by means of a vacuum pump, our little girl certainly belonged to a risk group. She saw yellow in a few days. She has undergone two sessions of phototherapy and had 9 pricks in her little hands. But fortunately everything is going well again and she has a healthy pink color on her cheeks!