JAUNDICE OF THE NEWBORN: CASE
Mild jaundice in babies is very common, and will occur in one out of two newborn babies. It is most noticeable from the third day after birth. It is usually harmless and resolves after a week or two without problems. Nonetheless, all cases of jaundice in newborn babies should be checked and monitored by a nurse or doctor. Some babies have severe jaundice, which very occasionally can lead to deafness and even brain damage if not treated promptly.
Cause
Jaundice is caused by the breakdown of red blood cells. This process releases a chemical called bilirubin which gives the skin its yellow colour. In babies the process of breakdown of red blood cells is very rapid, and the system in the liver of disposing of bilirubin is relatively immature. This overload causes what is termed physiological jaundice.
Another cause of jaundice in the newborn is breastmilk jaundice, in which a chemical secreted in the mother’s milk interferes with the breakdown of bilirubin. This usually resolves itself after several weeks and does not require treatment.
A rare cause of jaundice in the newborn is due to incompatibility of the mother’s and the baby’s blood groups. This is not usually a problem during a first pregnancy because the mother’s and the baby’s bloodstream do not mix. The problem arises after the delivery during which some of the baby’s blood may have mixed with the mother’s blood. The mother then develops antibodies which become active during the next pregnancy and cross the placenta to attack that baby’s red blood cells. If this has happened, it usually becomes apparent in the first 24 hours after birth. In this situation the mother develops antibodies (immunity), which recognise the baby’s red blood cells as foreign and attack them. Their destruction leads to the release of bilirubin into the baby’s bloodstream, and the subsequent appearance of jaundice.
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