Neonatal Jaundice Blood Test

What is Neonatal Jaundice?

Neonatal jaundice is a condition affecting newborns characterized by yellowing of the skin and eyes due to elevated bilirubin levels in the blood. It occurs because a newborn's immature liver cannot efficiently process and eliminate bilirubin, a yellow pigment produced from the breakdown of red blood cells. The Bilirubin, Total test is the most important test for diagnosis as it directly measures the level of bilirubin accumulation in the bloodstream.

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What causes neonatal jaundice?

Neonatal jaundice is caused by elevated levels of bilirubin, a yellow pigment produced when red blood cells break down naturally in the body. In newborns, the liver is often too immature to efficiently process and eliminate bilirubin through the digestive system, leading to its accumulation in the blood and tissues. This causes the characteristic yellowing of the skin and whites of the eyes that typically appears within the first few days after birth.

What is the best test for neonatal jaundice?

The Bilirubin, Total test is the most important test for neonatal jaundice because it directly measures the total amount of bilirubin in your baby's blood, which is essential for confirming the diagnosis and determining severity. This test tells doctors exactly how high the bilirubin levels are and whether treatment such as phototherapy is needed. The Glucose-6-Phosphate Dehydrogenase Quantitative test is also essential if doctors suspect an underlying cause, as G6PD deficiency can lead to increased breakdown of red blood cells and more severe jaundice. Together, these tests provide a complete picture of why jaundice occurred and how to best manage it.

When should I get my baby tested for neonatal jaundice?

You should get your baby tested if you notice yellowing of the skin or whites of the eyes, especially if it appears within the first 24 hours after birth or extends below the chest to the abdomen and legs. Testing is also important if your baby seems unusually sleepy, is not feeding well, or if the yellow color appears to be getting darker rather than improving. Most hospitals routinely check bilirubin levels before discharge, but if jaundice develops or worsens after going home, contact your healthcare provider immediately as high bilirubin levels require prompt treatment to prevent complications.

What are the symptoms of neonatal jaundice?
The primary symptom of neonatal jaundice is yellowing of the skin and the whites of the eyes, typically starting on the face and progressing downward to the chest, abdomen, and legs as bilirubin levels rise. Babies with jaundice may also be more sleepy than usual, have difficulty waking for feedings, or feed poorly. In severe cases, a baby may be unusually fussy, have a high-pitched cry, or arch their back, which are signs that require immediate medical attention.
Who is at risk for neonatal jaundice?
Babies born prematurely are at higher risk because their livers are even less developed than full-term infants. Newborns with blood type incompatibility with their mother, bruising from birth, or a family history of G6PD deficiency are also more likely to develop jaundice. Additionally, babies who are not feeding well or are breastfed exclusively in the first week of life may be at increased risk due to dehydration and fewer bowel movements, which help eliminate bilirubin from the body.
What happens if neonatal jaundice is left untreated?
If severe neonatal jaundice is left untreated, extremely high bilirubin levels can lead to a serious condition called kernicterus, where bilirubin deposits in the brain cause permanent neurological damage. This can result in cerebral palsy, hearing loss, developmental delays, and intellectual disabilities. However, when detected early through blood testing and treated appropriately with phototherapy or other interventions, neonatal jaundice is highly manageable and most babies recover completely without any long-term effects.
Can neonatal jaundice be diagnosed with a blood test?
Yes, neonatal jaundice is definitively diagnosed with a blood test that measures total bilirubin levels in your baby's blood. While doctors can visually observe the yellowing of skin and eyes, a blood test is essential to determine the exact bilirubin level and assess the severity of the condition. Some hospitals also use a transcutaneous bilirubinometer, a device that measures bilirubin through the skin, but blood testing remains the gold standard for accurate diagnosis and treatment decisions.
How is neonatal jaundice treated?
Mild neonatal jaundice often resolves on its own as the baby's liver matures and they begin feeding well and having regular bowel movements. More significant jaundice is treated with phototherapy, where the baby is placed under special blue lights that help break down bilirubin in the skin so it can be eliminated more easily. In severe cases or when jaundice is caused by blood type incompatibility, exchange transfusion may be necessary, where small amounts of the baby's blood are replaced with donor blood to rapidly lower bilirubin levels.
How can I prevent neonatal jaundice?
While you cannot completely prevent neonatal jaundice since it is related to normal newborn physiology, you can reduce the risk and severity by ensuring your baby feeds frequently in the first days of life, ideally 8-12 times per day. Adequate feeding promotes bowel movements, which help eliminate bilirubin from the body. If you know you have a blood type incompatibility with your baby or a family history of G6PD deficiency, inform your healthcare provider so they can monitor your baby more closely after birth.
What can I do at home for neonatal jaundice?
At home, focus on feeding your baby frequently every 2-3 hours to help their body eliminate bilirubin through urine and stool. Make sure your baby is getting enough milk by counting wet diapers (at least 6 per day) and watching for adequate weight gain. Place your baby near a well-lit window for indirect natural light exposure, though this is not a substitute for medical phototherapy if needed. Most importantly, monitor the yellowing closely and contact your healthcare provider if it worsens, spreads, or if your baby becomes lethargic or refuses to eat.
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