Materiały źródłowe

• #1 Jaundice in Newborns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22263-jaundice-in-newborns

  Jaundice is caused by a buildup of a bilirubin in your babys blood. […] Jaundice happens when your babys blood has too much bilirubin. Bilirubin is a chemical your body makes when it breaks down old red blood cells. […] If your babys liver hasnt developed enough to get rid of bilirubin, it can start to build up. This buildup of bilirubin causes your babys skin to look yellow. […] Severe jaundice can occur if your baby has: A blood infection (sepsis), A different blood type than you, Bruising from a difficult birth, Too many red blood cells, A low oxygen level (hypoxia), A liver condition such as biliary atresia. […] Jaundice in newborns is a very common condition. Up to 60% of full-term babies develop jaundice during their first week of life. As many as 80% of premature babies develop jaundice during their first week of life.

• #1 Neonatal Jaundice: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/974786-overview

  Physiologic jaundice is caused by a combination of increased bilirubin production secondary to accelerated destruction of erythrocytes, decreased excretory capacity secondary to low levels of ligandin in hepatocytes, and low activity of the bilirubin-conjugating enzyme UDPGT. […] Pathologic neonatal jaundice occurs when additional factors accompany the basic mechanisms described above. Examples include immune or nonimmune hemolytic anemia, polycythemia, and the presence of bruising or other extravasation of blood. […] Decreased clearance of bilirubin may play a role in breastfeeding jaundice, breast milk jaundice, and in several metabolic and endocrine disorders. […] Risk factors for increased neonatal jaundice include the following: Lower gestational age (ie, the risk increases with each additional week less than 40 wk), jaundice in the first 24 hours after birth, predischarge transcutaneous bilirubin (TcB) or total serum bilirubin (TSB) concentration close to the phototherapy threshold, hemolysis from any cause, if known or suspected based on a rapid rate of increase in the TSB or TcB of over 0.3 mg/dL per hour in the first 24 h or more than 0.2 mg/dL per hour thereafter, phototherapy before discharge, parent or sibling requiring phototherapy or exchange transfusion, family history or genetic ancestry suggestive of inherited red blood cell disorders, including G6PD deficiency, exclusive breastfeeding with suboptimal intake, scalp hematoma or significant bruising, Down syndrome, macrosomic infant of a diabetic mother.

• #1 Jaundice in the Newborn – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/gastrointestinal-gi-and-liver-problems-in-newborns/jaundice-in-the-newborn

  Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. […] The most common causes of jaundice in the newborn are physiologic jaundice (most common), breastfeeding, and excessive breakdown of red blood cells (hemolysis). […] Physiologic jaundice occurs for two reasons. First, the red blood cells in newborns break down faster than in older infants, resulting in increased bilirubin production. Second, the newborn’s liver is immature and cannot process bilirubin and get it out of the body as well as in older infants. […] Breastfeeding can cause jaundice in two ways, which are called breastfeeding jaundice (more common) and breast milk jaundice. […] Excessive breakdown of red blood cells (hemolysis) can overwhelm the newborn’s liver with more bilirubin than it can process.

• #1 Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4935699/

  Jaundice attributable to physiological immaturity which usually appears between 2472 h of age and between 4th and -5th days can be considered as its peak in term neonates and in preterm at 7th day, it disappears by 1014 days of life. […] Bilirubin levels with a deviation from the normal range and requiring intervention would be described as pathological jaundice. […] Jaundice in breast fed babies usually appears between 2472 h of age, peaks by 515 days of life and disappears by the third week of life. […] Hyperbilirubinemia is also associated with breast milk of mother in neonates. […] The most common causes of hemolytic jaundice include (a) Rh hemolytic disease, (b) ABO incompatibility and (c) Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and minor blood group incompatibility.

• #1 Hyperbilirubinemia in the Term Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0215/p599.html

  Hyperbilirubinemia is one of the most common problems encountered in term newborns. […] Few term newborns with hyperbilirubinemia have serious underlying pathology. Jaundice is considered pathologic if it presents within the first 24 hours after birth, the total serum bilirubin level rises by more than 5 mg per dL (86 mol per L) per day or is higher than 17 mg per dL (290 mol per L), or an infant has signs and symptoms suggestive of serious illness. […] Hyperbilirubinemia in the newborn period can be associated with severe illnesses such as hemolytic disease, metabolic and endocrine disorders, anatomic abnormalities of the liver, and infections. […] The causes of neonatal hyperbilirubinemia can be classified into three groups based on mechanism of accumulation: bilirubin overproduction, decreased bilirubin conjugation, and impaired bilirubin excretion. […] Pathologic causes include disorders such as sepsis, rubella, toxoplasmosis, occult hemorrhage, and erythroblastosis fetalis.

• #1 Neonatal Jaundice – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532930/

  Neonatal jaundice is a clinical manifestation of elevated total serum bilirubin, termed neonatal hyperbilirubinemia, which results from bilirubin that is deposited into an infant’s skin. […] The two types of neonatal hyperbilirubinemia are unconjugated hyperbilirubinemia and conjugated hyperbilirubinemia. In most neonates, unconjugated hyperbilirubinemia is the cause of clinical jaundice. However, some infants have conjugated hyperbilirubinemia, which is always pathologic and signifies an underlying medical or surgical etiology. […] When neonatal jaundice is clinically identified, the underlying etiology of neonatal hyperbilirubinemia must be determined. […] The causes of pathologic UHB and CHB are numerous and varied. […] The production of bilirubin can increase secondary to immune-mediated hemolysis caused by blood group incompatibilities (eg, such as ABO and Rhesus (Rh) incompatibility) and nonimmune mediated hemolysis, which is caused by RBC membrane defects (eg, hereditary spherocytosis and elliptocytosis), RBC enzyme defects (eg, glucose-6-phosphate dehydrogenase [G6PD], pyruvate kinase deficiencies), sequestration-like cephalohematoma, subgaleal hemorrhage, intracranial hemorrhage, polycythemia, and sepsis.

• #1 Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4935699/

  The incidence of the incompatibility of the ABO blood groups of the mother and fetus, when the mother has the blood group O and the newborn has the A or B blood group, is 1520% of all pregnancies. […] Investigations for G6PD deficiency should be considered in infants with severe jaundice in a family with a history of significant jaundice or in a geographic origin associated with G-6-PD deficiency. […] Decreased bilirubin conjugation resulted from variation in the UGT1A1 and OATP2 genes play an important role in the progression of hyperbilirubinemia in G6PD deficient newborns.

• #1 4 reasons why babies get jaundice and might require immediate treatment | Pediatrics | Your Pregnancy Matters | UT Southwestern Medical Center

  https://utswmed.org/medblog/4-reasons-babies-get-jaundice/

  Babies are at increased risk of developing jaundice if they are: Born prematurely, Of East Asian descent, A sibling of a child who had neonatal jaundice. […] Several types of jaundice have different health risks and treatment options. […] This type of jaundice occurs when the mother has Rh negative blood and the baby has Rh positive blood. The combination causes the mothers blood to make antibodies that break down the babys red blood cells more rapidly, increasing bilirubin levels. […] If you do not get these injections, your baby is at high risk to be: Anemic (low red blood cells) and might require an intrauterine blood transfusion (injecting donor red blood cells into the fetus), Born prematurely, Very sick and need advanced care in the Neonatal Intensive Care Unit (NICU). […] Phototherapy can help lower the babys bilirubin levels. If the amount continues to rise, we might give your baby intravenous immunoglobulin (IVIG), antibodies that slow the breakdown of red blood cells.

• #1 Neonatal Jaundice

  https://patient.info/doctor/neonatal-jaundice-pro

  Bilirubin levels are higher in neonates than in adults because newborn babies have a higher concentration of red blood cells, which also have a shorter lifespan. Red blood cell breakdown creates unconjugated bilirubin which circulates mostly bound to albumin. Unconjugated bilirubin is metabolised by the liver to produce conjugated bilirubin which is excreted in the stool. […] This results from increased erythrocyte breakdown and immature liver function. […] Haemolytic disease: eg, haemolytic disease of the newborn (rhesus), ABO incompatibility, glucose-6-phosphate dehydrogenase deficiency, spherocytosis. […] Infection – eg, urinary tract infection. […] Jaundice lasting for longer than 14 days in term infants and 21 days in preterm infants: […] Infection – eg, urinary tract infection.

• #1 Jaundice – Wikipedia

  https://en.wikipedia.org/wiki/Jaundice

  Jaundice in infants presents with yellowed skin and icteral sclerae. […] The most common cause of jaundice in infants is normal physiologic jaundice. […] Pathologic causes of neonatal jaundice include: Formula jaundice, Hereditary spherocytosis, Glucose-6-phosphate dehydrogenase deficiency, Pyruvate kinase deficiency, ABO/Rh blood type autoantibodies, Alpha 1-antitrypsin deficiency, Alagille syndrome, Progressive familial intrahepatic cholestasis, Pyknocytosis, Cretinism, Sepsis or other infectious causes. […] Transient neonatal jaundice is one of the most common conditions occurring in newborns (children under 28 days of age) with more than 80 per cent experiencing jaundice during their first week of life. […] Normal physiological neonatal jaundice is due to immaturity of liver enzymes involved in bilirubin metabolism, immature gut microbiota, and increased breakdown of fetal hemoglobin (HbF).

• #1 Jaundice in Newborns – Causes, Symptoms & Treatment

  https://www.childbirthinjuries.com/birth-injury/newborn-jaundice/

  Jaundice is a common condition that affects 60% to 80% of newborn babies. It results from a buildup of a substance in the blood called bilirubin, a pigment which yellows the baby’s skin and the whites of their eyes. […] When red blood cells break down as part of their natural lifespan, they create bilirubin. Normally, the liver processes this yellowish, toxic substance, and the body excretes it with other waste. When red blood cells break down too quickly or the liver is not working properly, bilirubin can build up and cause the skin to turn yellow. […] For most babies, jaundice is caused by normal newborn conditions: Newborn livers are still developing and cannot yet keep up with bilirubin production. Blood cells reproduce and break down at a faster rate in newborns than in adults. […] Newborns have a greater chance of jaundice if several risk factors are present, including: Severe Bruising During Birth: Bruises sustained by a baby during a complicated delivery can cause blood cells to break down at a higher rate. Blood Type Differences: When a mother’s blood type is different from her baby’s, she may develop antibodies that attack the fetus’s blood cells. Breast Feeding: Babies who have difficulties feeding or can’t get enough nutrition through breast milk are significantly more likely to have jaundice. Premature Birth: The livers of babies born before 38 weeks of pregnancy cannot process bilirubin as efficiently as those of full-term babies. Premature babies may also be eating too little to assist the excretion of bilirubin from the body.

• #1 Newborn Jaundice: Causes, Treatment, Symptoms & Signs

  https://www.emedicinehealth.com/newborn_jaundice/article_em.htm

  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 mother who has diabetes may cause a baby to develop neonatal jaundice. […] Crigler-Najjar syndrome and Lucey-Driscoll syndrome are also conditions that can cause jaundice.

• #1 Neonatal Jaundice – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532930/

  Exaggerated immune or nonimmune mediated hemolysis is the most common cause of pathologic hyperbilirubinemia. […] Nonimmune causes of UHB include RBC enzyme defects, RBC membrane defects, hemoglobinopathies, sepsis, sequestration, and polycythemia. […] Indirect hyperbilirubinemia due to decreased bilirubin clearance usually results from quantitative or qualitative defects in the uridine diphosphate glucuronosyltransferase (UGT) enzyme. […] Other etiologies of UHG include congenital hypothyroidism, sulfa medications, ceftriaxone, penicillins, intestinal obstruction, pyloric stenosis, breast milk jaundice, and suboptimal intake with breastfeeding. […] The differential diagnoses of jaundice are extensive. […] The onset of neonatal jaundice should prompt a timely evaluation to determine if the underlying etiology is a self-limited physiologic condition or a disease requiring treatment.

• #1 Jaundice in infants and children: causes, diagnosis, and management | HKMJ

  https://www.hkmj.org/abstracts/v24n3/285.htm

  Jaundice is caused by an accumulation of bilirubin in the blood. […] The incidence of infantile jaundice is approximately 1 in 2500 to 5000 live births with a variety of underlying diagnoses ranging from self-limiting breast milk jaundice to aggressive life-threatening diseases such as biliary atresia (BA) and liver failure. […] The aetiology of breast milk jaundice is not clear. […] Glucose-6-phosphate dehydrogenase deficiency associated neonatal hyperbilirubinaemia can manifest in two forms: severe jaundice resulting from acute haemolysis or gradual onset jaundice. […] Gilbert syndrome is the most common inherited disorder of bilirubin glucuronidation. […] The prevalence of Gilbert syndrome has been reported to be 5% to 10% in the Caucasian population, with a similar prevalence (3-7%) in Chinese.

• #1 Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4935699/

  Hyperbilirubinemia, or jaundice, is a life threatening disorder in newborns. […] This review article focuses on a brief introduction to jaundice, its types and causes, measuring the bilirubin level, clinical approaches towards hyperbilirubinemia, different precautionary measures for the parents of babies suffering from hyperbilirubinemia and different remedial therapeutic measures for its treatment. […] Neonatal jaundice due to breast milk feeding is also sometimes observed. Hemolytic jaundice occurs because of the incompatibility of blood groups with ABO and Rh factors, when the fetus and mother blood groups are not compatible and the fetus blood crosses the barrier of the umbilical cord before birth causing fetus blood hemolysis owing to severe immune response. […] The main causes of increased bilirubin mostly are: race, genetic polymorphisms; inherited and acquired defects e.g. spherocytosis, Gilberts syndrome, Najjar 1 and 2 Molecular genetics studies have shown the correlations between neonates hyperbilirubinemia and different genetic variations which can change in enzyme activity.

• #1 Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4935699/

  Variations of 388 GA (Asp130Asn, rs2306283), 521 TC (Val174Ala, rs4149056), 463 CA(Pro155Thr, rs11045819) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) gene which encodes the hepatic solute carrier organic anion transporter 1B1, a putative bilirubin transporter, may dispose subjects to newborns hyperbilirubinemia by the limitation of hepatic bilirubin uptake. […] Furthermore, in a genome wide association study, two polymorphisms of SLCO1B3 gene (rs17680137 CG and rs2117032 CT) were observed to have a strong association with serum bilirubin levels and to contribute to idiopathic mild unconjugated hyperbilirubinemia in healthy adults. […] Several types of Bilirubinemia have been reported in neonates including physiological jaundice, pathological jaundice, jaundice due to breastfeeding or breast milk and hemolytic jaundice including three subtypes due to Rh factor incompatibility, ABO blood group incompatibility and Jaundice associated with Glucose-6-phosphate dehydrogenase (G6PD) deficiency.

• #1

  https://www.nhs.uk/conditions/jaundice-newborn/causes/

  Jaundice is caused by too much bilirubin in the blood. This is known as hyperbilirubinaemia. […] Jaundice is common in newborn babies because babies have a high number of red blood cells in their blood, which are broken down and replaced frequently. […] A newborn baby’s liver is not fully developed, so it’s less effective at processing the bilirubin and removing it from the blood. […] Sometimes jaundice may be caused by another health problem. This is known as pathological jaundice. […] Some causes of pathological jaundice include: an underactive thyroid gland (hypothyroidism) (where the thyroid gland does not produce enough hormones), blood group incompatibility (when the mother and baby have different blood types, which are mixed during the pregnancy or the birth), rhesus disease (a condition that can occur if the mother has rhesus-negative blood and the baby has rhesus-positive blood), a urinary tract infection (UTI), Crigler-Najjar syndrome (an inherited condition that affects the enzyme responsible for processing bilirubin), a blockage or problem in the bile ducts and gallbladder (the gallbladder stores bile, which is transported by the bile ducts to the gut). […] An inherited enzyme deficiency known as glucose 6 phosphate dehydrogenase (G6PD) could also lead to jaundice or kernicterus.

• #1 Jaundice in the Newborn – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/gastrointestinal-gi-and-liver-problems-in-newborns/jaundice-in-the-newborn

  Less common causes of jaundice include severe infections, an underactive thyroid gland (hypothyroidism), an underactive pituitary gland (hypopituitarism), certain hereditary disorders, and obstruction of bile flow from the liver. […] Some hereditary disorders that can cause jaundice include cystic fibrosis, Dubin-Johnson syndrome, Rotor syndrome, Crigler-Najjar syndrome, and Gilbert syndrome. […] Bile flow may be reduced or blocked because of a birth defect of the bile ducts such as biliary atresia or because of a disorder such as cystic fibrosis damages the liver.

• #1 New guidelines on newborn jaundice: What parents need to know – Harvard Health

  https://www.health.harvard.edu/blog/newborn-jaundice-what-parents-need-to-know-2021020421886

  The systems that work to get rid of bilirubin may not be ready yet in babies who are born early. […] Liver diseases. A number of different liver problems can make it harder for the baby’s body to get rid of bilirubin. […] Diseases that affect an important enzyme. One common disease is glucose-6-phosphate dehydrogenase (G6PD) deficiency, which can cause red cells to break down. Other diseases, such as Gilbert syndrome or Crigler-Najjar syndrome, lead to a problem with an enzyme that is important for getting rid of bilirubin. […] Genetic factors. Not all of these factors are well understood. If one baby in a family has jaundice, future babies may have a higher risk too. Babies of East Asian descent, for example, are more likely to have higher bilirubin levels.

• #1 Jaundice in Newborn Babies: Causes, Treatment and More

  https://www.whattoexpect.com/baby-health-and-safety/newborn-jaundice.aspx

  Jaundice due to breastfeeding problems or malnutrition. This type of jaundice occurs in about 5 to 10 percent of newborns due to low breast milk and calorie intake while a new mom and baby are getting acclimated to breastfeeding. […] Jaundice from hemolysis. This rare but serious type of jaundice begins within the first 24 hours after birth. […] Poor liver function. Again, this type of jaundice is rare but serious. The main clues that something is off are light gray or pale yellow stools in a newborn with jaundice that doesn’t go away.

• #1 Breast Milk Jaundice: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/973629-overview

  Breast milk jaundice is a common cause of indirect hyperbilirubinemia. The etiology of breast milk jaundice is not clearly understood, but a combination of genetic and environmental factors may play a role. […] The following factors may contribute: An unusual metabolite of progesterone (pregnane-3-alpha 20 beta-diol), a substance in the breast milk that inhibits uridine diphosphoglucuronic acid (UDPGA) glucuronyl transferase. […] Increased concentrations of nonesterified free fatty acids that inhibit hepatic glucuronyl transferase. […] Increased enterohepatic circulation of bilirubin due to (1) increased content of beta glucuronidase activity in breast milk and, therefore, the intestines of the breastfed neonate and (2) delayed establishment of enteric flora in breastfed infants. […] Defects in uridine diphosphate-glucuronyl transferase (UGT1A1) activity in infants who are homozygous or heterozygous for variants of the Gilbert syndrome promoter and coding region polymorphism.

• #1 Neonatal Hyperbilirubinemia – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/metabolic-electrolyte-and-toxic-disorders-in-neonates/neonatal-hyperbilirubinemia

  Hyperbilirubinemia is an elevated serum bilirubin concentration, causing jaundice (a yellow discoloration of the skin and eyes). […] Almost all hyperbilirubinemia in the immediate neonatal period is unconjugated, which is also termed indirect bilirubin; conjugated bilirubin is termed direct bilirubin. […] Hyperbilirubinemia may be harmless or harmful depending on its cause and the degree of elevation. […] Some causes of jaundice are intrinsically dangerous whatever the bilirubin level. […] Hyperbilirubinemia can be caused by one or more of the following processes: Increased production, Decreased hepatic uptake, Decreased conjugation, Impaired excretion, Impaired bile flow (cholestasis), Increased enterohepatic circulation. […] There are several ways to classify and discuss causes of hyperbilirubinemia.

• #1 Jaundice in infants and children: causes, diagnosis, and management | HKMJ

  https://www.hkmj.org/abstracts/v24n3/285.htm

  Hepatitis A, B, and E are the most common causes of paediatric acute liver failure (PALF). […] Biliary atresia is a rare disorder with an incidence that varies widely among populations (1 in 5000 in Asians to 1 in 18 000 in Caucasians). […] Its aetiology remains largely unknown and the most widely accepted theory is that unknown exogenous factors trigger a series of self-limiting inflammatory events in a genetically predisposed individual during the embryonic or perinatal period. […] Inspissated bile syndrome describes a condition where the bile duct is obstructed due to the impaction of a thick bile plug or sludge during the neonatal or infantile period. […] Choledochal cyst is a congenital disorder characterised by cystic dilatation of the intrahepatic and/or extrahepatic bile duct.

• #1 Neonatal jaundice – Wikipedia

  https://en.wikipedia.org/wiki/Neonatal_jaundice

  Neonatal jaundice tends to develop because of two factors: the breakdown of fetal hemoglobin as it is replaced with adult hemoglobin and the relatively immature metabolic pathways of the liver, which are unable to conjugate and so excrete bilirubin as quickly as an adult. This causes an accumulation of bilirubin in the blood (hyperbilirubinemia), leading to the symptoms of jaundice. […] In other cases it results from red blood cell breakdown, liver disease, infection, hypothyroidism, or metabolic disorders (pathologic). […] If the neonatal jaundice is not resolved with simple phototherapy, other causes such as biliary atresia, Progressive familial intrahepatic cholestasis, bile duct paucity, Alagille syndrome, alpha 1-antitrypsin deficiency, and other pediatric liver diseases should be considered. […] Severe neonatal jaundice may indicate the presence of other conditions contributing to the elevated bilirubin levels, of which there are a large variety of possibilities.

• #1 Jaundice in Children: Causes, Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/jaundice-in-children

  Blood cell diseases, such as sickle cell anemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency […] Infections, usually caused by a virus (such as the CMV virus) or bacteria (such as in a urinary tract infection). Jaundice can also be a sign of a more serious infection, such as herpes simplex or sepsis. […] Endocrine (hormonal) disorders, such as hypothyroidism (underactive thyroid) or hypopituitarism […] Conditions that block the flow of bile out of the liver (cholestasis), such as biliary atresia or choledochal (bile duct) cyst. Some of these conditions are genetic (inborn), for example cystic fibrosis, Alpha-1 antitrypsin deficiency, or Alagille syndrome […] Genetic diseases, such as Gilbert syndrome (a common, harmless condition) or galactosemia (a serious illness that must be treated with a special diet for the baby). There are many other genetic diseases that can cause jaundice, but most of them are extremely rare.

• #1 Neonatal Jaundice: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/974786-overview

  Further risk factors to consider also include race/ethnicity: The incidence is higher in East Asians and American Indians and is lower in Africans/African Americans, geography: A higher incidence occurs in populations living at high altitudes, genetics and familial risk: There is a higher incidence in infants with mutations/polymorphisms in the genes that code for enzymes and proteins involved in bilirubin metabolism. […] Combinations of genetic variants appear to exacerbate neonatal jaundice.

• #1 Jaundice in Newborns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22263-jaundice-in-newborns

  Jaundice in newborns is normal and usually cant be prevented. You can reduce the risk that your baby will develop severe jaundice by feeding them often. Frequent feedings stimulate regular bowel movements which will help your baby get rid of the bilirubin. […] Jaundice in newborns is common. For most babies, jaundice will get better without treatment within one to two weeks. But its important to have your babys bilirubin level checked. A high bilirubin level can lead to serious health conditions if its not treated immediately. These conditions include cerebral palsy, deafness and kernicterus, a type of brain damage.

• #1 Jaundice – Wikipedia

  https://en.wikipedia.org/wiki/Jaundice

  While most cases of newborn jaundice are not harmful, when bilirubin levels are very high, brain damage kernicterus may occur leading to significant disability. […] Kernicterus is associated with increased unconjugated bilirubin (bilirubin which is not carried by albumin). […] Jaundice in newborns is usually transient and dissipates without medical intervention. […] In cases when serum bilirubin levels are greater than 421 mg/dl, infants may be treated with phototherapy or exchanged transfusion depending on the infant’s age and prematurity status.

• #1

  https://reverehealth.com/live-better/neonatal-jaundice/

  One potential complication of neonatal jaundice is kernicterus, which occurs when bilirubin accumulates in the babys brain. If left untreated, kernicterus can lead to seizures, hearing loss, cerebral palsy, developmental delays or, in serious cases, death. […] Treatment for newborn jaundice often includes light therapy (phototherapy). Exposing the newborn to special lighting helps the body process and eliminate excess bilirubin. If jaundice develops due to an underlying medical condition, the doctor will determine the best approach to treatment.

• #1 What are Jaundice and Kernicterus? | CDC

  https://archive.cdc.gov/www_cdc_gov/ncbddd/jaundice/facts.html

  Jaundice happens when a chemical called bilirubin builds up in the babys blood. […] In some babies, the liver might not be developed enough to efficiently get rid of bilirubin. […] When severe jaundice goes untreated for too long, it can cause a condition called kernicterus. […] Kernicterus is a type of brain damage that can result from high levels of bilirubin in a babys blood. […] Early detection and management of jaundice can prevent kernicterus. […] Babies with any of the following risk factors need close monitoring and early jaundice management: […] A baby born to an East Asian or Mediterranean family is at a higher risk of becoming jaundiced. […] A baby who is not eating, wetting, or stooling well in the first few days of life is more likely to get jaundice. […] When severe jaundice goes untreated for too long, it can cause brain damage and a condition called kernicterus. […] Early diagnosis and treatment of jaundice can prevent kernicterus.

• #1 Neonatal Jaundice – Toronto Centre for Neonatal Health

  https://torontocentreforneonatalhealth.com/education-opportunities/elearning/neonatal-jaundice/

  Neonatal jaundice, which usually presents as an unconjugated hyperbilirubinaemia, is one of the most common physical signs observed amongst newborn infants. Approximately 60% of term newborn infants and 80% of preterm infants will have visible jaundice during the first week of life. […] Jaundice may be a sign of pathology, and demands appropriate evaluation and rational management. […] The key root causes that appear to be significant contributors to the reported cases of kernicterus include: failure to recognise important risk factors including gestational age 38 weeks and breast feeding, failure to evaluate jaundice in the first 24 hours of life, underestimation of the severity of the jaundice by visual assessment, failure to respond to parental concerns about jaundice, poor feeding and changes in newborn behaviour, failure to provide timely follow-up.

• #2 Jaundice in Newborns: Facts, Causes & Symptoms

  https://liverfoundation.org/liver-diseases/complications-of-liver-disease/jaundice-in-newborns/

  Jaundice is a condition that can occur in newborns, usually within 2-3 days of birth. […] Jaundice will develop when a baby’s liver is not efficient enough to remove the bilirubin from the bloodstream. […] The most common type of jaundice is called Physiologic Jaundice, which can affect up to 60% of full-term babies in the first week of life. […] Jaundice usually occurs in newborns because their livers are not fully developed. It results from having too much bilirubin in the blood. […] Some other medical conditions that make newborn jaundice worse are: Baby’s blood type does not match with his or her mother’s blood type, Baby is born with too many red blood cells (polycythemia), Baby has an infection in his or her blood (sepsis), Baby has bruises from birth, Baby swallowed blood during birth, Baby’s mother has diabetes.

• #2 Jaundice in Children: Causes, Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/jaundice-in-children

  Jaundice is a very common condition in newborn babies. It usually appears in the first few days or weeks of life. Most cases of jaundice are not caused by any disease or concerning problem and clear up quickly without any treatment. […] Jaundice is caused by a yellow substance (pigment) called bilirubin. The liver, spleen and bone marrow make bilirubin out of red blood cells that have broken down. The liver then passes bilirubin out of the body through bile which flows into the stool. Jaundice occurs when bilirubin cannot be removed from the body fast enough and levels in the blood become too high. The buildup of bilirubin causes the skin and the white part of the eyes to appear yellow. […] There are two main types of jaundice in infants: Physiologic jaundice: This type is quite common. It affects about six out of 10 newborns. Physiologic jaundice happens when bilirubin does not move out of the body fast enough. Most often, it goes away on its own by the time the baby is about 2 weeks old. If it continues, treatment may be needed.

• #2 Infant jaundice – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/infant-jaundice/symptoms-causes/syc-20373865

  Infant jaundice occurs because the baby’s blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow pigment of red blood cells. […] In some babies, an underlying disease may cause infant jaundice. […] Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. […] A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin. […] Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life. […] An underlying disorder may cause infant jaundice. […] Diseases or conditions that can cause jaundice include: Internal bleeding (hemorrhage), An infection in your baby’s blood (sepsis), Other viral or bacterial infections, An incompatibility between the mother’s blood and the baby’s blood, A liver malfunction, Biliary atresia, a condition in which the baby’s bile ducts are blocked or scarred, An enzyme deficiency, An abnormality of your baby’s red blood cells that causes them to break down rapidly.

• #2 Hyperbilirubinemia in the Term Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0215/p599.html

  Hyperbilirubinemia is one of the most common problems encountered in term newborns. […] Few term newborns with hyperbilirubinemia have serious underlying pathology. Jaundice is considered pathologic if it presents within the first 24 hours after birth, the total serum bilirubin level rises by more than 5 mg per dL (86 mol per L) per day or is higher than 17 mg per dL (290 mol per L), or an infant has signs and symptoms suggestive of serious illness. […] Hyperbilirubinemia in the newborn period can be associated with severe illnesses such as hemolytic disease, metabolic and endocrine disorders, anatomic abnormalities of the liver, and infections. […] The causes of neonatal hyperbilirubinemia can be classified into three groups based on mechanism of accumulation: bilirubin overproduction, decreased bilirubin conjugation, and impaired bilirubin excretion. […] Pathologic causes include disorders such as sepsis, rubella, toxoplasmosis, occult hemorrhage, and erythroblastosis fetalis.

• #2 Neonatal Hyperbilirubinemia – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/metabolic-electrolyte-and-toxic-disorders-in-neonates/neonatal-hyperbilirubinemia

  Hyperbilirubinemia is an elevated serum bilirubin concentration, causing jaundice (a yellow discoloration of the skin and eyes). […] Almost all hyperbilirubinemia in the immediate neonatal period is unconjugated, which is also termed indirect bilirubin; conjugated bilirubin is termed direct bilirubin. […] Hyperbilirubinemia may be harmless or harmful depending on its cause and the degree of elevation. […] Some causes of jaundice are intrinsically dangerous whatever the bilirubin level. […] Hyperbilirubinemia can be caused by one or more of the following processes: Increased production, Decreased hepatic uptake, Decreased conjugation, Impaired excretion, Impaired bile flow (cholestasis), Increased enterohepatic circulation. […] There are several ways to classify and discuss causes of hyperbilirubinemia.

• #2 Hemolytic causes of neonatal jaundice: diagnosis and treatment – Bahr – Pediatric Medicine

  https://pm.amegroups.org/article/view/6462/html

  Jaundice is very common in newborns. Hemolysis is a major component in the pathophysiology of hyperbilirubinemia, and newborns with severe hemolysis appear to be at greater risk of developing bilirubin neurotoxicity. […] The risk of developing bilirubin neurotoxicity appears to be increased in neonates with a predominantly hemolytic etiology for their hyperbilirubinemia. […] Increased hemolysis is associated not only with classic choreoathetotic cerebral palsy, but also with neurologic abnormalities and lower IQ. […] Hemolytic conditions continue to top the list of identified etiologies of hyperbilirubinemia and ABE in modern times. […] The Subcommittee on Hyperbilirubinemia of the American Academy of Pediatrics (AAP), in its 2004 guideline, emphasizes the high risk of developing hyperbilirubinemia associated with hemolysis.

• #2 4 reasons why babies get jaundice and might require immediate treatment | Pediatrics | Your Pregnancy Matters | UT Southwestern Medical Center

  https://utswmed.org/medblog/4-reasons-babies-get-jaundice/

  If a mother has type O blood and her baby has type A or B, her immune system will likely make antibodies against her babys blood cells. […] This type of jaundice tends to be more robust, and well typically care for these babies in the nursery, where theyll need earlier and longer phototherapy treatment. […] If immediate treatment for jaundice isnt required, or when your baby starts improving after treatment in the hospital, well ask you to monitor symptoms at home. […] Jaundice typically develops from the head to the feet. The legs and hands are usually last. If you notice jaundice in these areas, we need to see your baby right away because the jaundice has likely spread through their body and bilirubin levels are high.

• #2 New guidelines on newborn jaundice: What parents need to know – Harvard Health

  https://www.health.harvard.edu/blog/newborn-jaundice-what-parents-need-to-know-2021020421886

  Most newborn babies turn at least a little bit yellow. Known as jaundice, this condition is a very common and usually normal part of the newborn period. But in some very rare cases it can lead to, or be a sign of, a more serious problem. […] The yellow color of newborn jaundice is caused by high levels of a substance called bilirubin in the blood. Bilirubin mostly comes from the breakdown of red blood cells. […] Many conditions make it more likely that bilirubin levels will be high, including: […] Dehydration or inadequate calories. This most commonly happens when babies are exclusively breastfed and a problem with breastfeeding goes unrecognized. […] ABO or Rh incompatibility. When mother and baby have differences in their blood types, it can lead to more breakdown of red cells than usual.

• #2 Jaundice in Children: Causes, Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/jaundice-in-children

  Blood cell diseases, such as sickle cell anemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency […] Infections, usually caused by a virus (such as the CMV virus) or bacteria (such as in a urinary tract infection). Jaundice can also be a sign of a more serious infection, such as herpes simplex or sepsis. […] Endocrine (hormonal) disorders, such as hypothyroidism (underactive thyroid) or hypopituitarism […] Conditions that block the flow of bile out of the liver (cholestasis), such as biliary atresia or choledochal (bile duct) cyst. Some of these conditions are genetic (inborn), for example cystic fibrosis, Alpha-1 antitrypsin deficiency, or Alagille syndrome […] Genetic diseases, such as Gilbert syndrome (a common, harmless condition) or galactosemia (a serious illness that must be treated with a special diet for the baby). There are many other genetic diseases that can cause jaundice, but most of them are extremely rare.

• #2 Jaundice in Newborns (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/jaundice.html

  Babies can get jaundice if they: […] Many healthy newborns have physiological („normal”) jaundice. This happens because newborns have more blood cells than adults do. These blood cells don’t live as long, so more bilirubin is made when they break down. This kind of jaundice appears 24 days after the baby is born and goes away by the time a baby is 2 weeks old. […] If mother and baby have different blood types, the mother’s body makes antibodies that attack the baby’s red blood cells. This can happen if: […] has a genetic problem that makes red blood cells more fragile. Red blood cells break down more easily in health problems like hereditary spherocytosis and G6PD deficiency. […] is born with high red blood cell numbers (polycythemia) or a large bruise on the head (cephalohematoma)

• #2 Newborn Jaundice: Causes, Treatment, Symptoms & Signs

  https://www.emedicinehealth.com/newborn_jaundice/article_em.htm

  Neonatal jaundice can 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. […] Healthy red blood cells can be destroyed in a condition called hemolysis. […] Polycythemia is a condition in which a child is born with an excess of red blood 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.

• #2 Kernicterus & High Bilirubin Causes & Treatments | Newborn Jaundice Signs & Symptoms

  https://www.abclawcenters.com/practice-areas/jaundice-and-kernicterus/

  Jaundice is a common and easily-diagnosed condition in newborns caused by elevated bilirubin levels. […] High levels of bilirubin, also known as hyperbilirubinemia, can cause the baby to have yellow-looking skin and eyes (jaundice). […] Risk factors and causes of jaundice and elevated bilirubin levels include the following, among others: Premature birth, Insufficient nutrition (not getting enough breast milk or formula), Blood type mismatch (Rh incompatibility) between mother and baby, Bruising or internal bleeding from birth trauma, Hypoxic-ischemic encephalopathy (HIE), Cephalohematoma (bleeding under the scalp caused by difficult delivery, often involving vacuum extractors or forceps), Liver conditions such as cystic fibrosis or hepatitis, A lack of certain important enzymes, e.g. G6PD deficiency, High red blood cell counts (polycythemia), which is more common in babies who are small for gestational age or twins, Sickle cell anemia, Low levels of oxygen (hypoxia), Infection such as sepsis, Macrosomic (large) babies of diabetic mothers are predisposed to blood cell problems, Certain medications, Having a sibling with jaundice, Mediterranean or East Asian descent. […] If jaundice is severe and improperly treated, it can lead to a form of brain damage known as bilirubin encephalopathy, which can progress to a more serious injury known as chronic bilirubin encephalopathy or kernicterus.

• #2 Jaundice in newborns | Raising Children Network

  https://raisingchildren.net.au/newborns/health-daily-care/health-concerns/jaundice-in-newborns

  Jaundice from delayed cord clamping Doctors might recommend delaying the clamping and cutting of your babys umbilical cord after birth. This allows more red blood cells to enter your babys blood. But it can sometimes lead to jaundice. This is because your babys liver has more red blood cells to process, so bilirubin builds up. […] Jaundice from birth interventions Your baby might get this type of jaundice if theyre bruised because of interventions at birth, like forceps birth. The red blood cells from this bruising break down and bilirubin builds up. […] Blood type incompatibility jaundice This is a rare type of jaundice, which happens when the blood groups of a mother and her baby are incompatible. […] Biliary atresia Biliary atresia is a rare cause of jaundice in babies. […] It happens when the tiny tubes that carry bile from the liver to the intestine are missing, damaged or blocked.

• #2 Jaundice in the Newborn – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/gastrointestinal-gi-and-liver-problems-in-newborns/jaundice-in-the-newborn

  Less common causes of jaundice include severe infections, an underactive thyroid gland (hypothyroidism), an underactive pituitary gland (hypopituitarism), certain hereditary disorders, and obstruction of bile flow from the liver. […] Some hereditary disorders that can cause jaundice include cystic fibrosis, Dubin-Johnson syndrome, Rotor syndrome, Crigler-Najjar syndrome, and Gilbert syndrome. […] Bile flow may be reduced or blocked because of a birth defect of the bile ducts such as biliary atresia or because of a disorder such as cystic fibrosis damages the liver.

• #2

  https://www.nhs.uk/conditions/jaundice-newborn/

  Jaundice is caused by the build-up of bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells, which carry oxygen around the body, are broken down. […] Jaundice is common in newborn babies because babies have a high number of red blood cells in their blood, which are broken down and replaced frequently. […] Also, a newborn baby’s liver is not fully developed, so it’s less effective at removing the bilirubin from the blood. […] In a small number of cases, jaundice can be the sign of an underlying health condition. This is often the case if jaundice develops shortly after birth (within the first 24 hours). […] It’s estimated 6 out of every 10 babies develop jaundice, including 8 out of 10 babies born prematurely before the 37th week of pregnancy. […] But only around 1 in 20 babies has a blood bilirubin level high enough to need treatment. […] For reasons that are unclear, breastfeeding increases a baby’s risk of developing jaundice, which can often persist for a month or longer.

• #2 Jaundice and Breastfeeding | Breastfeeding special circumstances | CDC

  https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/jaundice.html

  Jaundice (yellow discoloration of a baby’s skin and eyes) is a sign of elevated bilirubin levels. It is common during the first weeks of a child’s life, especially among preterm newborns. Bilirubin is a product from the normal breakdown of red blood cells. It is elevated in newborns because they: […] In most newborns, jaundice is termed „physiologic jaundice” and is considered harmless. […] Suboptimal intake jaundice, also called breastfeeding jaundice, most often occurs in the first week of life when breastfeeding is being established. Newborns may not receive optimal milk intake. This leads to elevated bilirubin levels due to increased reabsorption of bilirubin in the intestines. […] Breast milk jaundice most often occurs in the second or later weeks of life and can continue for several weeks. The exact mechanism leading to breast milk jaundice is unknown. Some believe that substances in the mother’s milk may inhibit the ability of the infant’s liver to process bilirubin. […] Jaundice is a possible reason to supplement healthy, term infants with additional feedings.

• #2

  https://www.nhs.uk/conditions/jaundice-newborn/causes/

  Jaundice is caused by too much bilirubin in the blood. This is known as hyperbilirubinaemia. […] Jaundice is common in newborn babies because babies have a high number of red blood cells in their blood, which are broken down and replaced frequently. […] A newborn baby’s liver is not fully developed, so it’s less effective at processing the bilirubin and removing it from the blood. […] Sometimes jaundice may be caused by another health problem. This is known as pathological jaundice. […] Some causes of pathological jaundice include: an underactive thyroid gland (hypothyroidism) (where the thyroid gland does not produce enough hormones), blood group incompatibility (when the mother and baby have different blood types, which are mixed during the pregnancy or the birth), rhesus disease (a condition that can occur if the mother has rhesus-negative blood and the baby has rhesus-positive blood), a urinary tract infection (UTI), Crigler-Najjar syndrome (an inherited condition that affects the enzyme responsible for processing bilirubin), a blockage or problem in the bile ducts and gallbladder (the gallbladder stores bile, which is transported by the bile ducts to the gut). […] An inherited enzyme deficiency known as glucose 6 phosphate dehydrogenase (G6PD) could also lead to jaundice or kernicterus.

• #2 Neonatal Jaundice – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532930/

  Exaggerated immune or nonimmune mediated hemolysis is the most common cause of pathologic hyperbilirubinemia. […] Nonimmune causes of UHB include RBC enzyme defects, RBC membrane defects, hemoglobinopathies, sepsis, sequestration, and polycythemia. […] Indirect hyperbilirubinemia due to decreased bilirubin clearance usually results from quantitative or qualitative defects in the uridine diphosphate glucuronosyltransferase (UGT) enzyme. […] Other etiologies of UHG include congenital hypothyroidism, sulfa medications, ceftriaxone, penicillins, intestinal obstruction, pyloric stenosis, breast milk jaundice, and suboptimal intake with breastfeeding. […] The differential diagnoses of jaundice are extensive. […] The onset of neonatal jaundice should prompt a timely evaluation to determine if the underlying etiology is a self-limited physiologic condition or a disease requiring treatment.

• #2 Jaundice – Wikipedia

  https://en.wikipedia.org/wiki/Jaundice

  Jaundice in infants presents with yellowed skin and icteral sclerae. […] The most common cause of jaundice in infants is normal physiologic jaundice. […] Pathologic causes of neonatal jaundice include: Formula jaundice, Hereditary spherocytosis, Glucose-6-phosphate dehydrogenase deficiency, Pyruvate kinase deficiency, ABO/Rh blood type autoantibodies, Alpha 1-antitrypsin deficiency, Alagille syndrome, Progressive familial intrahepatic cholestasis, Pyknocytosis, Cretinism, Sepsis or other infectious causes. […] Transient neonatal jaundice is one of the most common conditions occurring in newborns (children under 28 days of age) with more than 80 per cent experiencing jaundice during their first week of life. […] Normal physiological neonatal jaundice is due to immaturity of liver enzymes involved in bilirubin metabolism, immature gut microbiota, and increased breakdown of fetal hemoglobin (HbF).

• #2 Jaundice in babies | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/jaundice-in-babies

  Jaundice is caused by an excess of a chemical called bilirubin. […] Jaundice is caused by a build-up of a chemical called bilirubin in the babys blood and tissues. […] Other less common causes of jaundice include blood group differences between mother and baby, haemolytic anaemia, hepatitis and galactosaemia. […] Occasionally, underlying blood and liver conditions can also cause jaundice in babies. These conditions include blood group antibodies, haemolytic anaemia, hepatitis and galactosaemia. […] Jaundice can also be caused by a range of other things including: breastmilk, Rhesus (Rh) and ABO blood group incompatibilities, haemolytic anaemia. […] More rarely, jaundice may be caused by the following conditions: neonatal hepatitis, galactosaemia, biliary atresia.

• #2 Neonatal Jaundice

  https://patient.info/doctor/neonatal-jaundice-pro

  Bilirubin levels are higher in neonates than in adults because newborn babies have a higher concentration of red blood cells, which also have a shorter lifespan. Red blood cell breakdown creates unconjugated bilirubin which circulates mostly bound to albumin. Unconjugated bilirubin is metabolised by the liver to produce conjugated bilirubin which is excreted in the stool. […] This results from increased erythrocyte breakdown and immature liver function. […] Haemolytic disease: eg, haemolytic disease of the newborn (rhesus), ABO incompatibility, glucose-6-phosphate dehydrogenase deficiency, spherocytosis. […] Infection – eg, urinary tract infection. […] Jaundice lasting for longer than 14 days in term infants and 21 days in preterm infants: […] Infection – eg, urinary tract infection.

• #2 Jaundice in Newborns and Babies: Causes & Symptoms | Pampers

  https://www.pampers.com/en-us/baby/newborn/article/jaundice

  Your baby has certain genetic issues that make red blood cells fragile, which means they break down more easily and, therefore, increase bilirubin levels. […] Your baby develops sepsis, a severe response to an infection. […] Your baby has internal bleeding of any kind. […] You, the one who gave birth, have cytomegalovirus (CMV), which is a common virus occurring in 50 to 80 percent of women in the U. S. by the time they turn 40. […] Your Rh factor, which is a protein found on the surface of red blood cells, is negative, and your babys is positive. […] If jaundice occurs before the second day or after the fourth day of birth, it may be caused by something more serious than physiological or normal jaundice, such as a genetic disorder, an infection, or one of the other causes of jaundice listed above.

• #2 Infant jaundice: Causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/165358

  Infant jaundice is caused by an excess of bilirubin. Bilirubin is a waste product, produced when red blood cells are broken down. It is normally broken down in the liver and removed from the body in the stool. […] However, an underdeveloped liver cannot filter out the bilirubin as fast as it is being produced, resulting in hyperbilirubinemia (an excess of bilirubin). […] Some cases of severe infant jaundice are linked to an underlying disorder; these include: liver disease, sickle cell anemia, bleeding underneath the scalp (cephalohematoma) caused by a difficult delivery, sepsis a blood infection, an abnormality of the babys red blood cells, blocked bile duct or bowel, rhesus or ABO incompatibility when the mother and baby have different blood types, the mothers antibodies attack the babys red blood cells, higher numbers of red blood cells more common in smaller babies and twins, enzyme deficiency, bacterial or viral infections, hypothyroidism underactive thyroid gland, hepatitis an inflammation of the liver, hypoxia low oxygen levels, some infections including syphilis and rubella.

• #2 Jaundice in Newborns: Facts, Causes & Symptoms

  https://liverfoundation.org/liver-diseases/complications-of-liver-disease/jaundice-in-newborns/

  Certain risk factors increase a newborn’s chance of having jaundice: Premature birth, East Asian or Mediterranean ethnicity, Sibling who had jaundice, Feeding difficulties, Breast-feeding. […] If the newborn’s jaundice is very severe and is not treated, it can cause permanent damage to a baby’s brain. […] The severity of the newborn’s jaundice will determine if and what type of treatment is needed: Mild: If the baby has mild levels of jaundice, it usually goes away on its own. […] Moderate: If the baby has moderate levels of jaundice, a doctor may recommend phototherapy. […] Severe: If the baby has very severe jaundice and other treatments do not work, a doctor may recommend an exchange transfusion. […] In most cases, newborn jaundice normal and not preventable. However, adequate feeding and stimulating bowel movements can help avoid the condition. […] Jaundice in newborns is normal and usually goes away on its own. If it persists, more testing should be done.

• #2 Does My Baby Have Jaundice? What Are the Treatments?

  https://www.webmd.com/parenting/baby/digestive-diseases-jaundice

  It’s a common and usually harmless condition in which your new baby’s skin and eyes look yellow. […] It happens when too much bilirubin, a chemical that red blood cells release during their normal breakdown process, builds up in the blood. […] Sometimes, your newborn’s liver can’t break down bilirubin quickly enough, and it starts to build up. Because bilirubin is a yellow compound, it turns your baby’s skin and eyes yellow. […] Babies have a greater chance of getting jaundice if theyre: Born before 37 weeks, Of East Asian or Mediterranean descent, Are only breastfed or are having trouble feeding, A younger sibling of a child who had jaundice, Born to a mother with type O or Rh-negative blood. […] The most common kind of newborn jaundice, called physiologic jaundice, happens because babies naturally have a high turnover of red blood cells in their first few days, and their growing livers can’t keep up.

• #2 New guidelines on newborn jaundice: What parents need to know – Harvard Health

  https://www.health.harvard.edu/blog/newborn-jaundice-what-parents-need-to-know-2021020421886

  The systems that work to get rid of bilirubin may not be ready yet in babies who are born early. […] Liver diseases. A number of different liver problems can make it harder for the baby’s body to get rid of bilirubin. […] Diseases that affect an important enzyme. One common disease is glucose-6-phosphate dehydrogenase (G6PD) deficiency, which can cause red cells to break down. Other diseases, such as Gilbert syndrome or Crigler-Najjar syndrome, lead to a problem with an enzyme that is important for getting rid of bilirubin. […] Genetic factors. Not all of these factors are well understood. If one baby in a family has jaundice, future babies may have a higher risk too. Babies of East Asian descent, for example, are more likely to have higher bilirubin levels.

• #2 Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4935699/

  Variations of 388 GA (Asp130Asn, rs2306283), 521 TC (Val174Ala, rs4149056), 463 CA(Pro155Thr, rs11045819) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) gene which encodes the hepatic solute carrier organic anion transporter 1B1, a putative bilirubin transporter, may dispose subjects to newborns hyperbilirubinemia by the limitation of hepatic bilirubin uptake. […] Furthermore, in a genome wide association study, two polymorphisms of SLCO1B3 gene (rs17680137 CG and rs2117032 CT) were observed to have a strong association with serum bilirubin levels and to contribute to idiopathic mild unconjugated hyperbilirubinemia in healthy adults. […] Several types of Bilirubinemia have been reported in neonates including physiological jaundice, pathological jaundice, jaundice due to breastfeeding or breast milk and hemolytic jaundice including three subtypes due to Rh factor incompatibility, ABO blood group incompatibility and Jaundice associated with Glucose-6-phosphate dehydrogenase (G6PD) deficiency.

• #2 Jaundice – Wikipedia

  https://en.wikipedia.org/wiki/Jaundice

  While most cases of newborn jaundice are not harmful, when bilirubin levels are very high, brain damage kernicterus may occur leading to significant disability. […] Kernicterus is associated with increased unconjugated bilirubin (bilirubin which is not carried by albumin). […] Jaundice in newborns is usually transient and dissipates without medical intervention. […] In cases when serum bilirubin levels are greater than 421 mg/dl, infants may be treated with phototherapy or exchanged transfusion depending on the infant’s age and prematurity status.

• #2 Newborn Jaundice | Duke Health

  https://www.dukehealth.org/blog/newborn-jaundice

  Although breastfeeding is also considered a risk factor, it is actually lack of effective breastfeeding that is the risk factor. […] Other risk factors for pathologic jaundice include excessive bruising of the newborn, having a sibling that required treatment for jaundice, and being of East Asian race. […] Jaundice in the first 24 hours of life is never physiologic and always merits an evaluation. […] Extremely high levels of bilirubin can lead to the rare but serious condition of kernicterus, a form of brain damage. […] Treatment for jaundice starts at levels that are far lower that those that could cause kernicterus. […] The likelihood of developing pathologic jaundice, or jaundice that requires treatment, can be minimized by frequent feedings.

• #2 Neonatal Jaundice – Toronto Centre for Neonatal Health

  https://torontocentreforneonatalhealth.com/education-opportunities/elearning/neonatal-jaundice/

  The abnormal functioning of any of these biophysical processes may cause neonatal jaundice that progresses to severe hyperbilirubinaemia, acute bilirubin encephalopathy and kernicterus. […] Common causes of neonatal jaundice during the first week of life include those physiological mechanisms that are unique to the newborn infant, immaturity of hepatic enzymes, and breast feeding. […] Physiological jaundice is first observed in the face when the serum bilirubin (SBR) is at least 80-120 micromol/L. […] Atypical jaundice early onset jaundice, a rapidly rising bilirubin, prolonged jaundice, late onset jaundice or conjugated hyperbilirubinaemia is likely to reflect pathology. […] Conditions that cause early onset neonatal jaundice include: increased degradation of red blood cells as a direct consequence of either enzymatic or structural defects of the red blood cell, abnormality of hepatic membrane receptors and/or hepatic enzymes, impairment of hepatobiliary excretion, increased enterohepatic circulation of bilirubin, breast feeding jaundice. […] Conditions that cause prolonged jaundice, late onset jaundice, or conjugated hyperbilirubinaemia include: breast milk jaundice, congenital hypothyroidism, congenital infection, metabolic disorders, structural abnormalities of the liver and hepatobiliary tract.

• #3 Neonatal Jaundice

  https://patient.info/doctor/neonatal-jaundice-pro

  Bilirubin levels are higher in neonates than in adults because newborn babies have a higher concentration of red blood cells, which also have a shorter lifespan. Red blood cell breakdown creates unconjugated bilirubin which circulates mostly bound to albumin. Unconjugated bilirubin is metabolised by the liver to produce conjugated bilirubin which is excreted in the stool. […] This results from increased erythrocyte breakdown and immature liver function. […] Haemolytic disease: eg, haemolytic disease of the newborn (rhesus), ABO incompatibility, glucose-6-phosphate dehydrogenase deficiency, spherocytosis. […] Infection – eg, urinary tract infection. […] Jaundice lasting for longer than 14 days in term infants and 21 days in preterm infants: […] Infection – eg, urinary tract infection.

• #3 Neonatal Hyperbilirubinemia – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/metabolic-electrolyte-and-toxic-disorders-in-neonates/neonatal-hyperbilirubinemia

  Most cases involve unconjugated hyperbilirubinemia. […] Some of the most common causes of neonatal jaundice include Physiologic hyperbilirubinemia, Breastfeeding (chestfeeding) jaundice, Human milk jaundice, Pathologic hyperbilirubinemia due to hemolytic disease. […] Liver dysfunction (eg, caused by parenteral alimentation causing cholestasis, neonatal sepsis, or neonatal hepatitis) may cause a conjugated or mixed hyperbilirubinemia. […] Physiologic hyperbilirubinemia occurs in almost all neonates. […] Breastfeeding (chestfeeding) jaundice develops in one-sixth of breast-fed infants during the first week of life. […] Human milk jaundice is different from breastfeeding jaundice. […] Pathologic hyperbilirubinemia in term infants is diagnosed if Jaundice appears in the first 24 hours, after the first week of life, or lasts 2 weeks. […] Some of the most common pathologic causes are Immune and nonimmune hemolytic anemia, Hematoma resorption, Sepsis, Hypothyroidism.

• #3 New guidelines on newborn jaundice: What parents need to know – Harvard Health

  https://www.health.harvard.edu/blog/newborn-jaundice-what-parents-need-to-know-2021020421886

  The systems that work to get rid of bilirubin may not be ready yet in babies who are born early. […] Liver diseases. A number of different liver problems can make it harder for the baby’s body to get rid of bilirubin. […] Diseases that affect an important enzyme. One common disease is glucose-6-phosphate dehydrogenase (G6PD) deficiency, which can cause red cells to break down. Other diseases, such as Gilbert syndrome or Crigler-Najjar syndrome, lead to a problem with an enzyme that is important for getting rid of bilirubin. […] Genetic factors. Not all of these factors are well understood. If one baby in a family has jaundice, future babies may have a higher risk too. Babies of East Asian descent, for example, are more likely to have higher bilirubin levels.

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