Neonatal Jaundice

Neonatal Jaundice is characterized by jaundice in the first week of life. This jaundice can be physiological or pathological. Physiological jaundice occurs in 60% neonates and starts on the 3^rd or 4^th day of life. It also occurs in 80% premature babies. A bilirubin level of 13 mg/dl or less does not require any treatment. However, if the bilirubin increases more than 5 mg/dl per day it indicates intervention. Physiological jaundice may stay from 10 days to 2 weeks. According to DrMubinaAgboatwalla a child specialist in Karachi,it generally resolves by itself or exposure to early morning sunlight. If it increases slightly, then phototherapy may be indicated. Pathological jaundice may be due to a number of reasons. It starts in the first 24 hours after birth. The reasons maybe Blood Group incompatibility, ABO or RH incompatibility, G6PD deficiency, Trauma or bruising, hypothyroidism, biliary aresia, septicemia, congenital TORCH infections etc.

In cases where the bilirubin increases by 5mg % per day or increases to 25mg% or more intervention is needed. In case of blood group incompatibility, exchange transfusion is indicated. Septicemia needs to be treated. In biliary atresia, conjugated bilirubin increases and surgical intervention may be required. Kernicterus occurs when bilirubin increases to 25mg% or more leading to brain damage. In most cases 2-3 days of physiotherapy suffices. In other cases, investigations to find the cause should be done and appropriate treatment started. G6PD deficiency may cause prolonged jaundice too.