Jaundice is yellowish discoloration of the skin

and mucous membrane appears at two or

three days old infant and begins to disappear
towards the end of the first week.

Physiological jaundice is common and

harmless

About six out of ten newborns have jaundice

to varying degrees, while the condition is
more common among premature babies.
During life in the uterus, the RBCs of the fetus
contain fetal hemoglobin that is different than
the adult hemoglobin. When an infant is born,
the infant’s body begins to rapidly destroy the
red blood cells containing the fetal-type
hemoglobin and replaces them with red blood
cells containing the adult-type hemoglobin.
this leads to increase the production of
bilirubin
The liver in a newborn infant is not mature,
and its ability to process and eliminate
bilirubin is limited. As a result of both the
influx of large amounts of bilirubin and the
immaturity of the liver, bilirubin accumulates
in the blood.

Within two or three weeks, the destruction of

red blood cells ends, the liver matures, and
the bilirubin levels return to normal
Breast feeding jaundice :
the mother's breasts produce small amounts
of colostrum in the first few days after
childbirth resulting in dehydration which may
affect the function of the baby's liver.
Breast milk jaundice:
occurs during the second or third week of life,
and may be caused by high levels of beta
glucuronidase which inhibit beta glucuronyl
transferase
The symptoms of jaundice depend on the cause and
severity, but may include:
 Yellowish tinge of the skin, appearing first on the
skin of the face and scalp.
 Yellowish tinge of the sclera.
 In moderate jaundice, the yellowish tinge will
spread to the skin of the body.
 In severe jaundice, the palms of the hands and
soles of the feet will turn yellow.
 Unusual drowsiness.
 Feeding difficulties.
 In some cases, light-colored faeces and dark
urine.
HISTORY:
Onset 2 to 3 days of age
Peaks day 4 to 5, then improves

LABORATORY
Total serum bilirubin concentration usually 5 to
12 mg/dL
Jaundice in the first day of life
Unconjugated bilirubin level exceeds 12.9
mg/dl in full term infant
Unconjugated bilirubin level exceeds 15
mg/dl in preterm infant
Bilirubin level increasing at a rate of
greater than 5 mg/ dl
Conjugated bilirubin more than 2 mg/dl
Clinical jaundice persisting more than
1week in full term or more than 2 weeks in
preterm infants
Mild physiological jaundice
if the baby is healthy and well, no treatment is
necessary. The baby's liver will take only a
few days to process bilirubin properly.
Moderate to severe physiological
jaundice
Phototherapy to transform the bilirubin in skin
into a less harmful chemical.
Breast milk jaundice
breastfeeding is almost always continued.
Phototherapy is usually the primary
treatment.
Presented by :
Sarah Assem
Round 3 – Group 1

References :
http://www.thechildrenshospital.org/
http://www.kidshealth.org/
http://www.pediatriconcall.com/