Jaundice

Jaundice

In the case of jaundice, the skin, the inside of the mouth and the white of the eye will have a yellowish tinge. This is a common condition in newborn babies.

What is jaundice?

Jaundice is a condition caused by too much of the reddish-yellow pigment bilirubin in the blood. If there is too much bilirubin in the blood, this will pass into the tissues and color them yellow. Jaundice is not a disease in itself, but rather a symptom of another disease.

Newborns can have jaundice without an underlying disease, so-called physiological jaundice. Physiological jaundice affects many newborns, and is usually a harmless condition caused by slightly to moderately elevated bilirubin values in the body.

Causes of Jaundice?

• Overproduction of bilirubin when red blood cells are destroyed. This can be due to injuries, blood transfusion with the wrong blood type or some forms of anemia.

• Chronic liver disease and liver damage. The liver ensures that bilirubin is excreted from the body, and therefore problems with the liver can lead to jaundice. Liver inflammation, high alcohol consumption, harmful effects from medicines, herbal preparations or illegal substances can lead to liver problems that can cause jaundice.

• Gilbert syndrome. A harmless condition that runs in families.

• Blockage of bile ducts. Closed bile ducts can lead to jaundice because bilirubin is further excreted from the body via the bile from the liver. Possible causes of blocked bile ducts can be cancer and gallstones.

• Problems with the pancreas. Acute pancreatitis can cause jaundice.

• Infections. Hepatitis A, Hepatitis B and Hepatitis C are contagious viral infections that can damage the liver and cause jaundice.

• After operations.

• Common in newborns. This is because they produce two to three times more bilirubin than adults. Newborns produce more bilirubin because more red blood cells break down immediately after birth. Bilirubin will also be removed more slowly than in adults because the liver and intestines in newborns are not fully developed.

• Breast milk jaundice. A harmless condition with an unknown cause where the amount of bilirubin in the blood increases when babies consume breast milk.

Symptoms of jaundice

• Yellow eyes, skin and mucous membranes.

• Dark urine.

• Light stools.

Adults:

• Itch.

• Depression.

• Fatigue.

• Lack of appetite.

• Lethargy.

• Emaciation.

Newborns with severe jaundice:

• Loud cry.

• Difficult to wake up.

• Dissatisfied.

• Relax.

• Eating less than usual.

• Bends/bends the body or neck backwards.

Disease course in jaundice

In the case of jaundice in newborns, the skin will first turn yellow on the face. It can then progress to the chest, abdomen, arms, and then the legs. Feet and hands turn yellow last on the body. Then the whites of the eyes are also colored yellow. In some people, you will not notice this gradual development, and it will seem as if the whole body is colored yellow at once. The yellow color will often disappear in the opposite order, i.e. first in the hands and feet, then finally in the face.

In the case of physiological jaundice, the condition will develop from 72 to 96 hours after birth, and then usually last for one to two weeks after birth.

Good advice

In newborns with jaundice, it is important to provide enough fluids. Enough fluid ensures that the baby breaks down extra bilirubin that causes jaundice.

Signs that the baby is getting enough fluids:

• Six or more wet diapers a day.

• Satisfied after meal.

• Faeces change color from dark green to yellow.

Adults with jaundice should make sure to:

• Get enough rest.

• Limit alcohol consumption.

• Avoid certain types of medication.

Treatment

In most newborns with jaundice, no treatment is needed, and the condition will go away on its own. Exceptions are premature babies with jaundice, and babies with high levels of bilirubin. These often require treatment.

Jaundice is treated with light therapy. The light treatment breaks down bilirubin so it becomes easier for the body to remove it. The child will then be placed in a light box where they will be illuminated with blue light. The baby will wear a mask to protect the eyes from being damaged by the light. One to two days of treatment is sufficient for most people. This is an effective form of treatment with very few side effects.

There is also a type of light treatment where the baby is wrapped in a fibre-optic blanket which will work in the same way. If this type of treatment is ineffective, the baby is given a blood transfusion, but this is rarely needed.

Adults are treated depending on the cause of jaundice. It may be that treatment is not needed as in Gilbert syndrome, or it may be an underlying disease that requires medication or another type of treatment.

When should you contact a doctor for jaundice?

Jaundice can be both serious and harmless. If you suspect jaundice, you should always see a doctor quickly to find out the cause, as it may be due to a serious or infectious disease.

It is important that newborns are examined for jaundice because very high bilirubin levels can lead to brain damage if left untreated. Fortunately, this is very rare. A doctor should generally be contacted if the baby shows symptoms of severe jaundice, if the baby's jaundice develops for the worse, or if jaundice is suspected and the general condition is reduced at the same time.

Signs of worsening jaundice in babies:

• Difficulty eating.

• Bends/curves the body or neck backwards.

• Irritable or difficult to comfort.

• Difficult to wake up.

• Yellow skin on or below the knees.

• Intense yellow color – from lemon yellow to orange yellow.

• If the white of the eye turns yellow.