Infant jaundice

How to recognize and treat jaundice in infants?

It most often results from a simple transient immaturity of the liver. More rarely, jaundice can be due to incompatibilities between the mother’s blood and that of the fetus, birth defects and birth defects, or even neonatal infections. 50% of term babies and 90% of premature babies have jaundice. Update on this disease which is also called jaundice of the newborn.

Jaundice 24 to 48 hours after birth is common

Jaundice is only the translation of a normal coping mechanism after birth. Explanation: In the mother’s womb, the fetus needs a lot of red blood cells. After birth, she will have to destroy some of them because they are no longer useful to her. This destruction leads to the formation of the famous yellow pigment, bilirubin, which the liver must eliminate. But the newborn’s liver is not yet working at full capacity. Bilirubin builds up in the blood and the baby is said to have “jaundice”, or “jaundice”.

Due to the mother’s milk, she doesn’t matter

In some mothers’ milk, there is a heat-sensitive substance that is believed to prevent the baby’s liver from metabolizing bilirubin. In this case, the jaundice is not serious and the mother can continue to breastfeed.

Jaundice to reabsorb an effusion of blood

Jaundice can result from a hematoma following breech presentation, the use of a suction cup or forceps at the time of birth, or even a benign blood effusion from the vault of the skull (a “cephalhematoma”) … In In this case, the baby’s liver still has to work harder to destroy these red blood cells and therefore produces more bilirubin.

Jaundice, before the end of the first day: more serious

Jaundice in newborns is caused by the very rapid and massive destruction of the baby’s red blood cells (hemolytic anemia). Hence a pathological rise in bilirubin. The cause: the action of anti-rhesus antibodies or irregular agglutinins produced by the mother’s blood.

More rarely, the blood incompatibility in question does not depend on the rhesus factors, but on the blood group. When a mother is group 0 (universal donor), she also has anti-A and anti-B antibodies. The baby’s jaundice is usually milder. But this incompatibility is much rarer because it can be prevented during pregnancy and immediately after childbirth.

Finally, there are other severe jaundices, linked to damage to liver cells, due to malformation of the bile ducts or neonatal infections.

How long will your baby have jaundice?

In the vast majority of these cases, the “jaundice” will disappear in less than three weeks. But if it is more pronounced, it will be necessary to measure the level of bilirubin in the blood. Indeed, from a certain level, it can become toxic for the brain. In the extreme, it is kernicterus, a very serious but fortunately exceptional neurological disease.

The best treatment for jaundice: phototherapy

Depending on the severity of the jaundice, the maternity pediatrician will decide whether the baby should be treated with light (“phototherapy”). The procedure: the baby is exposed naked in a special cradle, eyes protected by a mask, to compact fluorescent tubes. These emit blue or white light. The yellow pigment of jaundice, made soluble in water by this special light, will be transformed in the skin. This will then allow its faster elimination by the liver and kidneys. In most cases, this phototherapy is done in the mother’s room, in cures of three or four hours. Sometimes phototherapy is combined with a drug to activate the hepatic metabolism of bilirubin.

In very serious cases, which have become rare, the treatment will consist of changing the newborn’s blood from birth, or even through the umbilical vein, when it is still in the mother’s womb. This is called exsanguino-transfusion.