Neonatal jaundice affects around 60% of full-term infants and 80% of premature infants. The condition occurs when there is an excess of the pigment bilirubin in the blood, causing a yellowish tinge in the skin and eyes. Bilirubin, which is a waste produced by the breakdown of red blood cells, is usually processed by the liver so that it can be cleared from the bloodstream.
In neonates, the liver is often still maturing, and it can take several days or weeks to process substances effectively. This lag can lead to the accumulation of bilirubin, resulting in jaundice. But most commonly, jaundice is mild and self-limiting. In this blog, we take a closer look at the normal jaundice level in newborn and provide key takeaways for parents.
To determine the jaundice level, which is unhesitating in newborns, we should see how jaundice is measured. Bilirubin levels are evaluated via a blood test or by using a transcutaneous bilirubin meter, which generates a reading in milligrams per deciliter (mg/dL). Normal values for bilirubin generally range from 1 to 12 mg/dL but vary based on the infant's age in hours or days.
It is normal for bilirubin levels to be less than 6 mg/dL in the first 24 hours after birth. As the baby's liver develops, these levels could increase and peak around the third to fifth day of life. This stage means that bilirubin levels can rise to 12 mg/dL and still be within newborns' normal limits of jaundice.
After this peak the levels slowly decline as the baby’s liver matures and removes the bilirubin efficiently. Jaundice in newborns normally has a value that should be less than 10 mg/dL in the first week and less than 5 mg/dL in the second week.
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Though mild jaundice is normal and temporary in most newborns, it’s important to be aware that there are several types of jaundice, and some may need medical attention:
Physiological Jaundice: It is the most common type of jaundice in newborns and occurs within two to four days after birth and peaks at about the fifth day. Physiological jaundice involves a rise in bilirubin levels within the normal jaundice levels of newborns, which resolves spontaneously without treatment.
Breastfeeding Jaundice: Rarely, jaundice may be associated with insufficient breastfeeding in the first week. This happens when a baby is dehydrated because he or she is not receiving enough milk, and the bilirubin level rises. However, this phenomenon typically remains within the physiologic range of jaundice seen in infants and can be managed with better breastfeeding techniques.
Breast Milk Jaundice: Breast milk jaundice happens later, generally after 1 week of life. It’s linked to some substances in the mother’s breast milk that can raise bilirubin levels. Although the type of jaundice may increase the levels slightly above the abnormal value in all newborns, it usually is not harmful and resolves independently without treatment.
Pathological Jaundice: Pathological jaundice is more severe and marked by a rapid increase in bilirubin level that is well above the usual range seen in newborns. Some babies have it within the first 24 hours of life, but it may be due to underlying problems like blood type incompatibility, liver issues, or infections. In this instance, you should get medical help right away.
The baby’s jaundice levels should be closely monitored, especially during the first week of life. Although the majority of cases of jaundice are within the limits of normal for jaundice in the newborn, some signs may suggest that the condition is worse, and we should seek medical attention.
Here are some of the important signs that should help you understand that jaundice may not be the normal jaundice level in newborns:
If any of those signs are present, the healthcare provider will most likely suggest more tests to check bilirubin levels. If newborns have above-normal levels of jaundice, treatments such as phototherapy or, rarely, blood transfusions may be needed.
Doctors routinely do a bilirubin test in the first few days after birth to ensure a newborn’s jaundice is within the normal value of jaundice in newborns. There are two primary ways to measure bilirubin levels:
Blood Test: A drop of blood will be drawn from the baby’s heel to measure the bilirubin levels in the bloodstream. This is a more precise test and is generally used if the jaundice level is higher than the normal level in a newborn.
Transcutaneous Bilirubinometer: This device places a sensor on the baby’s skin to measure bilirubin levels. It is more convenient than a blood test, so it is usually performed first as a screening test to determine whether the bilirubin level is within the normal jaundice level in babies.
When a baby’s bilirubin levels rise higher than the normal level of jaundice in newborns, medical intervention may be needed to prevent complications such as kernicterus, a rare but serious condition resulting from excessive bilirubin reaching the brain. The base treatment options are:
Phototherapy: This is the commonest method of treating jaundice In phototherapy, the baby is put under special blue lights that help break bilirubin down in the skin so that the body can excrete it more easily. Phototherapy is a safe and effective treatment, and the bilirubin levels of most babies drop to the normal value for newborns with jaundice within a few days of the treatment.
Exchange Transfusion: If phototherapy alone fails to sufficiently reduce the bilirubin levels, a blood exchange transfusion may be performed in severe cases. This procedure involves exchanging the baby’s blood for blood from a donor, which helps to remove excess bilirubin. This treatment is only done after jaundice is much worse than normal newborn jaundice.
Manage Feeding: If the baby has breastfeeding jaundice, improving feeding frequency and effectiveness can help decrease bilirubin levels. More feeding makes the baby pass more bilirubin in the stool and urine.
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In most babies, jaundice clears up within two to three weeks and does not lead to any long-term problems. However, if the bilirubin levels exceed the normal range of jaundice in newborns and are not treated, there can be complications. Kernicterus, which can cause hearing loss or, in some cases, cerebral palsy or other neurological issues, can occur with very high levels of bilirubin.
Jaundice is common in newborns, and most cases are considered normal ranges of jaundice seen in babies, resolving without or needing hospitalization. But parents should watch their baby’s jaundice during the first few days of life. Knowing the normal values of jaundice in newborns and abnormal jaundice signs can help decide whether proper treatment is necessary.
By knowing about what the normal jaundice level in newborn is and how it progresses, parents can feel empowered to act accordingly to help them transition from that there into those early days of life. Always consult your pediatrician if you have concerns about your baby’s jaundice levels. With proper care and treatment, complications can be avoided, and your newborn can have a healthy beginning
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