Types of Jaundice
Physiologic jaundice affects nearly all newborns to some
degree. It is more prevalent in certain ethnic groups, such as
Chinese, Japanese, Korean, Hispanic and Native Americans. If
you define jaundice as bilirubin levels of greater than
10mg/dl, one study found that Japanese newborns were more than
three times as likely to be jaundiced as white newborns. Babies
who are premature or are low birth weight are more likely to
become jaundiced. Babies who don't feed often enough during the
early days, and who don't stool often, are also more likely to
become jaundiced. This underscores the importance of early,
frequent feedings. Colostrum (the sticky yellow fluid produced
before the milk comes in) acts as a laxative. Bilirubin
accumulates in the baby's stools, and if it isn't excreted, it
re-circulates in his system. Frequent stooling helps lower
bilirubin levels.
In the baby with physiologic jaundice, bilirubin levels will usually peak between the third and fifth days of life and are usually less than 12mg/dl. Occasionally they will go higher than 15mg/dl. Most doctors will monitor levels closely during this time, checking the baby's levels with a blood test, pricking his heel, toe or finger. If the levels are rapidly rising, or are 20mg/dl or higher (lower levels are used with premature infants), phototherapy is often suggested. This is a treatment which involves exposing skin to blue range light which breaks down the bilirubin and makes it more easily excreted.
Years ago, nurses found that babies who were in beds near sunny windows had lower bilirubin levels. Researchers then found that phototherapy can make bilirubin levels drop quickly. Until the past few years, babies with high bilirubin levels had to be in the hospital for phototherapy treatments. Now, with new technology, babies can receive phototherapy at home using bili-blankets, provided by home health care providers. In most cases, bilirubin levels drop rapidly after phototherapy is initiated, and once the levels begin to go down, they almost always continue to decline. Usually only a day or two or therapy is needed. Most cases of physiologic jaundice will resolve without the use of phototherapy.
About the author: Anne Smith may be contacted at BreastfeedingBasics.com. She is an International Board Certified Lactation Consultant (IBCLC) and has been a La Leche League Leader since 1978. More importantly, she is a mother to six breastfed kids with 20 plus years experience of counseling nursing mothers. Her site, BreastfeedingBasics.com, provides expert advice and solutions to breastfeeding problems and gives basic information on how to breastfeed. Anne also features her recommended breastfeeding products and breast pumps. Copyright © Anne Smith.
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