As we all know jaundice is seen when the skin and the sclera (white of the eye) becomes yellow.

Jaundice is fairly common in newborns and is seen in 90% of the babies. This is 'normal physiological jaundice' seen usually on second or third day of life and disappears by the 7th – 10th day.

Q: Why does jaundice occur in a baby?
A: In a newborn, the red cells in the blood are broken earlier and faster as compared to the adults. As a result 'bilirubin' (pigment causing jaundice) which is produced from these broken red cells accumulates in the body causing jaundice. When the body is in the womb, this bilirubin is washed away by the placenta into the mother's circulation and removed. The liver (which removes the bilirubin from the blood) in the newborn is a little immature and takes some days to start functioning properly. Hence jaundice in the baby occurs commonly.

Q: What are the warning signs of jaundice in baby?
A: Though 90% of the times, jaundice in a newborn is the physiological jaundice, some features may be suggestive of another disease. If the following signs appear, consult your doctor immediately-

• Jaundice appearing within first 24 hours of life.
• Jaundice persists even after 14 days of life
• Baby is not feeding well.
• Baby's urine becomes yellow in color
• The stools of the baby are pale or clay colored (almost whitish)
• Baby appears lethargic, irritable.

Prolonged jaundice may be seen in premature babies (due to immature liver), some red cell defect, infection, thyroid disorder, liver disorder etc. Hence if the baby is still jaundiced after two weeks after birth, some blood and urine tests are required to determine the cause and early treatment.

Some babies may have prolonged jaundice inspite of being completely well. This is usually seen in breast fed babies. Breast-feeding is continued and the jaundice will disappear over time.

Q: Is any treatment required for newborn jaundice? Is jaundice in the newborn harmful?
A: Usually jaundice in newborn is not at all dangerous. However if the baby shows any of the warning signs given above, consult your doctor as soon as possible.

Since, jaundice in babies is not usually harmful and disappears by the 10 th day, no treatment is required. However some babies may require treatment in the form of light (phototherapy). This is done after the doctor checks the baby's blood for high bilirubin levels. It is given with the help of a special light. Baby is placed under this light completely naked except for presence of eye pads (to shield the eyes) and cloth to cover the genitals. Phototherapy helps to remove bilirubin faster from the baby. The baby should be fed properly and adequately during phototherapy to ensure a good urine output. Phototherapy is usually given for few days.

Babies with hypothyroidism may have prolonged jaundice beyond 2 weeks and they should be screened for thyroid disorder and if detected, appropriate treatment should be given. Babies with red cell defects may require further treatment. If liver disease is the cause of jaundice (though very rare), early treatment should be initiated to prevent further damage to the liver.