Definition:
Neonatal jaundice pertains to the yellowing of a newborn infant's skin due to a buildup of indirect unconjugated bilirubin in the skin.
Diagnosis:
Neonatal jaundice is diagnosed on the basis of the affected infant's physical manifestations.
Treatment:
Neonatal jaundice in infants is treated with phototherapy, a blue colored light that breaks down and consequently reduces excessive amounts of bilirubin in the blood. With phototherapy, isomerization occurs, transforming the bilirubin in the infant's blood into water soluble isomers that can be excreted. In addition, an increase in feeding frequency helps move the excess bilirubin through the infant's metabolic system.
Symptoms and Signs:
A distinctive yellow color appearing on the skin of newborn infant is the primary symptom of neonatal jaundice. Neonatal jaundice that appears in the second day after birth (called physiological jaundice) is usually harmless and resolves on its own on the eight day of life in normal births and fourteenth in premature births. On the other hand, neonatal jaundice that appears on the first day of birth is invariable pathologic and requires specific treatment to resolve.
Causes:
Neonatal jaundice is caused by an abnormal buildup of unconjugated bilirubin in the skin as a result of elevated bilirubin levels in the blood. Two factors have been known to play a role: the breakdown of fetal hemoglobin as it is being replaced with adult hemoglobin; and the inability of the infant's hepatic metabolic pathways to conjugate and excrete bilirubin. Other possible causes are underlying conditions such as: bile duct paucity, PFIC, biliary atresia, Alagille's syndrome, alpha 1 and a number of other pediatric liver diseases.
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