jaundice in new born infants

jaundice in new born infants

jaundice in new born infants

The liver has many functions. One of the liver's functions is to produce and secrete bile into the intestines to help digest dietary fat. Another is to remove toxic chemicals or waste products from the blood, and bilirubin is a waste product. The liver removes bilirubin from the blood. After the bilirubin has entered the liver cells, the cells conjugate (attaching other chemicals, primarily glucuronic acid) to the bilirubin, and then secrete the bilirubin/glucuronic acid complex into bile. The complex that is secreted in bile is called conjugated bilirubin. The conjugated bilirubin is eliminated in the feces. (Bilirubin is what gives feces its brown color.) Conjugated bilirubin is distinguished from the bilirubin that is released from the red blood cells and not yet removed from the blood which is termed unconjugated bilirubin. Jaundice in babies usually occurs because their immature livers are not efficient at removing bilirubin from the bloodstream.

Causes; Neonatal jaundice will be seen in cases of maternal-fetal blood type incompatibility. The mother's body will actually produce antibodies that attack the fetus's blood cells. This causes a breakdown of the red blood cells and thus an increased release of bilirubin from the red cells. A large scalp bruise called a cephalohematoma can occur during the birthing process. Such a bruise is really a collection of clotted blood just beneath the skin surface. As the body naturally breaks down this clotted blood, a large amount of bilirubin is released at once. This sudden excess in serum bilirubin may be too much for the baby's liver to handle, and jaundice will develop. Sometimes a baby swallows blood during birth. This swallowed blood is broken down in the baby's intestines and absorbed into the bloodstream. Just as the excess blood from a blood clot will cause a rise in serum bilirubin, so will this. A condition called carotenemia also causes a yellowish discoloration of the skin. The skin color in this condition tends to be a darker orange than seen with jaundice. Eating a lot of yellow vegetables causes this condition. Children with carotenemia have normal bilirubin levels. Unlike jaundice, carotenemia does not cause a discoloration of the white part of the eyes. This condition causes no harm and requires no treatment.

Physiologic jaundice is the most common form of newborn jaundice. The baby's liver plays the most important part in bilirubin breakdown. The type of bilirubin that causes the yellow discoloration of jaundice is called unconjugated bilirubin. This form of bilirubin is not easily removed from the baby's body. The baby's liver changes this unconjugated bilirubin into conjugated bilirubin, which is easier for the baby's body to remove. The livers of newborn babies are immature. They are not able to perform this job very efficiently at first. Treatment; With the exception of the treatments for specific causes of jaundice mentioned previously, the treatment of jaundice usually requires a diagnosis of the specific cause of the jaundice and treatment directed at the specific cause, e.g., removal of a gallstone blocking the bile duct.

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