While you gear up to welcome your newborn into your life, you also need to gear up for a few health issues that could occur within the first few days of her birth. You will agree that being well-prepared will keep you well-equipped to navigate the twists and turns of your newly acquired parenthood journey.

Some of these concerns could be neonatal jaundice or breast milk jaundice. These particular jaundices are not like the adult jaundice and yet, it is a common occurrence in several newborns and infants. Understandably, if your baby is diagnosed with either of them, the joy of your baby’s entry into the world gets overshadowed with worry. But once you are aware about it, you will deal with it in the best possible way with the guidance of your baby’s health expert.

Neonatal Jaundice

Neonatal Jaundice, If you notice a yellowish pallor to your baby’s skin or in the white part of her eyes, it’s likely that your little one has neonatal jaundice. Of course, your worry increases but you will find it heartening to know that almost 90% of newborns get this type of neonatal jaundice within the first 2 to 3 days of birth and it goes away by the time the baby is two weeks old.

The first step is recognising the symptoms of neonatal jaundice. While yellowness is the most prominent symptom (best spotted under bright fluorescent lighting), keep a lookout for other signs like:

• Trouble in sleeping or waking upTrouble in breastfeeding or bottle-feeding
• Few or excessive soiled diapers
• Fussiness

Your baby’s paediatrician will advise a simple blood test which will put your doubts to rest.

You may wonder what causes this jaundice in babies. Well, the reason is straightforward. The baby eliminates its waste products through the placenta while she is in your womb and once she is born, she’s got to do it on her own. So in the early days, as her body is getting used to this elimination, there could be a build-up of a waste matter called bilirubin and too much of it causes this jaundice. Bilirubin is basically made when the old red blood cells are broken down while new ones are made, which is a natural phenomenon.

While neonatal jaundice does not require intensive treatment and is usually known to disappear on its own within a fortnight, nevertheless it does require careful attention and monitoring. Here are a few tips recommended by health experts to help in the healing process:

• Do not stop breastfeeding as it is very beneficial for the baby’s health. It is essential for the baby to pass a lot of urine and thus, hasten the elimination process of bilirubin. So keep it up even if she is fussy!

• Phototherapy might be recommended as the light helps in breaking down the high levels of bilirubin. The baby is kept under a special blue light or under sunlight for a short duration daily, taking care to protect the eyes with an eye pad.

• Keep a check on the colour of your baby’s stools and urine. Usually, the colour of the stool is greenish or mustard yellow and that of urine is colourless. If the stools are pale and the urine is yellow, contact your paediatrician for further information on your child’s treatment against neonatal jaundice.

Sometimes, the jaundice could continue beyond the first two weeks. The reasons could vary – it could be because your baby’s blood cells could be breaking up faster than normal or it could just be present despite your baby being healthy and breastfed. Or it could be because of an underlying liver health concern. Remember to keep your healthcare expert in the loop if you notice any jaundice-like symptoms after the first 15 days from birth.

There are some special instances where neonatal jaundice (also known as physiological jaundice) must not be ignored and immediate medical help should be sought:

• Blood type mismatches like Rh disease. Very often, several babies have a blood group different from their mothers and this causes the red blood cells to have a faster breakdown.

• Internal bleeding inside the baby’s body

• An underlying liver problem in the baby like hepatitis infection or a disease like cystic fibrosis

• A blood infection like sepsis

• Too many red blood cells in a smaller-sized baby or a twin

• Bruising while being born might take longer to heal and thus causing higher bilirubin levels

• Premature babies (born before 37 weeks) too have a tendency to get neonatal jaundice as their livers might not be fully developed

Breast Milk Jaundice

Now that we know that neonatal jaundice occurs due to a build up of bilirubin that does not pass normally from the liver into the intestinal tract of the baby, largely because the liver is underdeveloped, there is another kind of jaundice that is caused a week after the baby’s birth: breast milk jaundice.

As the name suggests, this is a type of jaundice linked with breast milk and the causes of it are not exactly known. So far, medical experts feel it could be due to some substances in breast milk that prevent the breakdown of bilirubin or it could also be a genetic feature in some families.
But while the symptoms are similar to those of neonatal jaundice, breast milk jaundice can continue until 12 weeks without causing any complications, especially in healthy breastfed babies. It usually goes away on its own too.

Most importantly, breast milk jaundice isn’t connected to breastfeeding jaundice. Sounds confusing, right? Well, breast-feeding jaundice only develops in newborns that struggle with breastfeeding and don’t get enough breast milk. Newborns with breast milk jaundice, on the other hand, can properly latch onto her mother’s breast and receive adequate amounts of breast milk. Rest assured, it is completely safe to continue breastfeeding your baby while she has breast milk jaundice. Feeding your baby 10-12 times a day right from the start, especially when she is alert and not crying will make meal times easy on you as well as avoid distress while nursing.

Mom, take heart and be strong

That’s the message that your baby wants you to listen to as many times as you can. It could be that you or even your extended family feels disappointed that the baby is not in the pink of health initially. Many a mother feels guilt when her baby is diagnosed with either neonatal jaundice or breast milk jaundice. After all, wasn’t she the one that produced the baby, right? Wrong! As you have read so far and after a detailed chat with the paediatrician, you will find that these jaundices are purely physiological and Mother Nature has the backing of science to prove it. So take a deep breath, push any self-recrimination out of your mind and remain positive as you ease your little one out of this phase. Remember, maintaining good mental and physical health are equally important while breastfeeding your baby.

If you feel your baby’s colour seems yellow, contact your paediatrician who will prescribe a few tests to check the bilirubin level, the blood type, complete blood count, and perhaps tests to examine the shapes and sizes of the blood cells as well as a reticulocyte count that checks the number of slightly immature red blood cells. As they say, knowledge is indeed power, especially in this case.

Once you have the diagnosis, it will go a long way in helping your baby heal. Remember, the baby picks up on the parent’s stress and you will have a fussier baby to handle, along with the jaundice. Most of all, avoid listening to old-wives tales or following medically unsound advice. Trust your health expert and look forward to getting your baby’s health on track.

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