Materiały źródłowe

• #1 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. […] Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice. […] Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of „used” red blood cells. […] Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. […] An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of 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 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. It happens because their livers arent developed enough to get rid of the bilirubin. […] Jaundice occurs when bilirubin (pronounced bil-ih-ROO-bin) builds up in your babys blood. Hyperbilirubinemia is the medical term for this condition. […] Bilirubin is a yellow substance your body creates when red blood cells break down. […] 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. Your liver normally filters bilirubin from your blood. […] 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.

• #3

  https://www.ijcmph.com/index.php/ijcmph/article/view/3952

  80% of healthy neonates present with some degree of hyperbilirubinemia after birth, however, only 5-10% would require therapy to prevent damage or treat the cause of jaundice. […] Neonatal jaundice can be classified as physiological and pathological and can have several causes such as breast milk feeding, blood group incompatibility, hemolysis, or genetic defects of enzymes in the bilirubin metabolism pathway. […] Most cases of neonatal hyperbilirubinemia and jaundice are physiological and benign. However, some severe cases may progress to develop severe and permanent long-term complications. […] Neonatal jaundice can be treated using phototherapy, pharmacological agents, intravenous immunoglobulins and exchange transfusion in severe cases.

• #4 Newborn Jaundice: Causes, Symptoms, Treatment, and Prevention

  https://www.healthline.com/health/newborn-jaundice

  Newborn jaundice is when a babys skin and eyes turn yellow from too much bilirubin. […] There are two types of newborn jaundice: physiological and pathological. […] Physiological jaundice is the most common, accounting for 75% of cases. […] On the other hand, pathological jaundice means that there is another underlying condition thats causing a problem with filtering out bilirubin. […] Possible causes include: blood type incompatibilities such as rhesus factor (Rh) or ABO, breakdown of red blood cells (hemolysis), conditions that affect how the body processes bilirubin like Gilberts syndrome and Crigler-Najjar syndrome, diabetes in the birthing parent, congenital hypothyroidism, intestinal obstruction, pyloric stenosis, breastmilk jaundice, which is a reaction to substances in the milk, breastfeeding jaundice, which can happen if the baby isnt feeding well. […] Pathological jaundice can also be caused by certain medications, such as certain antibiotics.

• #5 Newborn jaundice: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001559.htm

  Newborn jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can be removed from the body in the stool. […] It is normal for a baby’s bilirubin level to be a bit high after birth. […] Most newborns have some jaundice. This is called physiological jaundice. It is usually noticeable when the baby is 2 to 4 days old. Most of the time, it does not cause problems and goes away within 2 weeks. […] Severe newborn jaundice may occur if the baby has a condition that increases the number of red blood cells that need to be replaced in the body, such as: […] Things that make it harder for the baby’s body to remove bilirubin may also lead to more severe jaundice, including: […] Babies who are born too early (premature) are more likely to develop jaundice than full-term babies.

• #6 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.

• #7 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. […] Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice. […] Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of „used” red blood cells. […] Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. […] An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of 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.

• #8 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: congenital (eg, toxoplasmosis, rubella, cytomegalovirus (CMV), herpes simplex, syphilis) or postnatal infection. […] Increased haemolysis due to haematoma. […] Maternal autoimmune haemolytic anaemia: eg, systemic lupus erythematosus.

• #9 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is caused by the buildup of bilirubin in the blood, which can lead to its buildup in the body’s tissues (such as skin). Bilirubin is a yellow pigment that the body produces when red blood cells are broken down. It is naturally removed by the liver and then excreted in stool and urine. Bilirubin levels become high when it is made faster than it can be removed. […] One reason that bilirubin levels are higher in babies is that more red blood cells are broken down, which causes more bilirubin to be made. Newborn babies make two to three times more bilirubin than adults. This can be due to: […] Bruising and mild injuries during delivery (especially following difficult births, use of forceps, or vacuum assistance). […] When a pregnant person’s and their baby’s blood type is different (or „incompatible”); the person’s immune system may cause more of the baby’s red blood cells to break down. Therefore, it is important for pregnant people to know their blood group (A, B, AB, or O) and Rh factor status (negative or positive). People whose blood group is O or Rh factor is negative should talk with their doctor to see if their baby’s blood type has also been checked.

• #10 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. It happens because their livers arent developed enough to get rid of the bilirubin. […] Jaundice occurs when bilirubin (pronounced bil-ih-ROO-bin) builds up in your babys blood. Hyperbilirubinemia is the medical term for this condition. […] Bilirubin is a yellow substance your body creates when red blood cells break down. […] 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. Your liver normally filters bilirubin from your blood. […] 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.

• #11

  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).

• #12 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.

• #13 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.

• #14 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.

• #15

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

  Jaundice is caused by too much bilirubin in the blood. This is known as hyperbilirubinaemia. […] A newborn baby’s liver is not fully developed, so it’s less effective at processing the bilirubin and removing it from the blood. […] Breastfeeding your baby can increase their chances of developing jaundice. […] It’s unclear why breastfed babies are more likely to develop jaundice, but a number of theories have been suggested. […] 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), blood group incompatibility, rhesus disease, a urinary tract infection (UTI), Crigler-Najjar syndrome, a blockage or problem in the bile ducts and gallbladder. […] An inherited enzyme deficiency known as glucose 6 phosphate dehydrogenase (G6PD) could also lead to jaundice or kernicterus.

• #16 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.

• #17 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. […] 1. Inadequate feeding jaundice: If your baby isnt taking in enough breast milk or formula, they cant create enough stool to excrete the extra bilirubin. […] 2. Breast milk jaundice: We dont fully understand what causes this type of jaundice; its persistent and lasts several days. However, we suspect it occurs when a substance within breast milk prevents the breakdown of bilirubin. […] 3. Rh incompatibility: 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. […] 4. ABO incompatibility: 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.

• #18 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is normally seen in breastfed babies for two key reasons: […] First, some babies do not get enough breast milk because they have difficulty feeding or the mother is not producing enough breast milk. If this happens, the baby may lose a large amount of weight, which increases bilirubin levels. Increasing the mother’s milk supply, breastfeeding frequently, and making sure that the baby has a good „latch” can help ensure that the baby gets enough milk. […] Second, „breast milk jaundice” can also occur in breastfed babies. This begins the first week after birth, continues to peak during the two weeks after birth, and declines slowly over the next few weeks. It is thought to be due to how a baby’s immature liver and intestines process breast milk, which results in a slower removal of bilirubin from the body. It is not caused by a problem with the breast milk itself.

• #19 Jaundice in Newborns: Types, Causes & Treatment | Inspira Health

  https://www.inspirahealthnetwork.org/news/healthy-living/jaundice-newborns-types-causes-treatment

  Breastfeeding jaundice happens when the baby doesnt receive enough breast milk due to nursing difficulties or issues with milk supply. Suboptimal milk intake can cause the reabsorption of bilirubin in the babys intestines. […] Breast milk jaundice is different from breastfeeding jaundice. Its exact cause is unknown, but its thought to occur when substances in the mothers breast milk prevent the babys liver from processing bilirubin. Breast milk jaundice can take several weeks to resolve and requires the support of a medical care team.

• #20 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is normally seen in breastfed babies for two key reasons: […] First, some babies do not get enough breast milk because they have difficulty feeding or the mother is not producing enough breast milk. If this happens, the baby may lose a large amount of weight, which increases bilirubin levels. Increasing the mother’s milk supply, breastfeeding frequently, and making sure that the baby has a good „latch” can help ensure that the baby gets enough milk. […] Second, „breast milk jaundice” can also occur in breastfed babies. This begins the first week after birth, continues to peak during the two weeks after birth, and declines slowly over the next few weeks. It is thought to be due to how a baby’s immature liver and intestines process breast milk, which results in a slower removal of bilirubin from the body. It is not caused by a problem with the breast milk itself.

• #21 Jaundice in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/jaundice

  Children with jaundice often have a yellowish tint of the eyes and skin that usually begins on the face and moves down the body. Jaundice is a sign of a condition called hyperbilirubinemia. Babies and children develop hyperbilirubinemia when a waste product called bilirubin builds up in their blood. In newborns, hyperbilirubinemia is often a temporary condition, though it can be a symptom of a more serious illness. Early recognition and treatment are important to keep bilirubin from rising to dangerous levels. […] Jaundice is common in newborns whose livers are still developing. More than half of full-term babies have jaundice in their first week. Up to 80 percent of infants born premature have jaundice. […] There are several reasons a newborn can develop jaundice, including: Physiologic jaundice is a normal response to a baby’s limited ability to excrete bilirubin in the first days of life. Breastfeeding jaundice occurs in some babies in the first week due to low milk intake or dehydration. Breast-milk jaundice occurs in some babies in the second week of life or later for unknown reasons. It may be related to a substance in the breast milk that makes it easier for the intestine to reabsorb the bilirubin or due to the immature liver processing of bilirubin. Jaundice from hemolysis is a condition that results from excess breakdown of red blood cells due to hemolytic disease of the newborn (HDN), polycythemia, or hemorrhage. Inadequate liver function due to infection or other factors.

• #22 Jaundice in Newborns: Types, Causes & Treatment | Inspira Health

  https://www.inspirahealthnetwork.org/news/healthy-living/jaundice-newborns-types-causes-treatment

  Breastfeeding jaundice happens when the baby doesnt receive enough breast milk due to nursing difficulties or issues with milk supply. Suboptimal milk intake can cause the reabsorption of bilirubin in the babys intestines. […] Breast milk jaundice is different from breastfeeding jaundice. Its exact cause is unknown, but its thought to occur when substances in the mothers breast milk prevent the babys liver from processing bilirubin. Breast milk jaundice can take several weeks to resolve and requires the support of a medical care team.

• #23 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.

• #24 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. It is a multifactorial disorder with many symptoms. […] The main causes of increased bilirubin mostly are: race, genetic polymorphisms; inherited and acquired defects e.g. spherocytosis, Gilberts syndrome, Najjar 1 and 2. […] 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. […] Jaundice attributable to physiological immaturity which usually appears between 24-72 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 10-14 days of life.

• #25 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. […] 1. Inadequate feeding jaundice: If your baby isnt taking in enough breast milk or formula, they cant create enough stool to excrete the extra bilirubin. […] 2. Breast milk jaundice: We dont fully understand what causes this type of jaundice; its persistent and lasts several days. However, we suspect it occurs when a substance within breast milk prevents the breakdown of bilirubin. […] 3. Rh incompatibility: 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. […] 4. ABO incompatibility: 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.

• #26 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is caused by the buildup of bilirubin in the blood, which can lead to its buildup in the body’s tissues (such as skin). Bilirubin is a yellow pigment that the body produces when red blood cells are broken down. It is naturally removed by the liver and then excreted in stool and urine. Bilirubin levels become high when it is made faster than it can be removed. […] One reason that bilirubin levels are higher in babies is that more red blood cells are broken down, which causes more bilirubin to be made. Newborn babies make two to three times more bilirubin than adults. This can be due to: […] Bruising and mild injuries during delivery (especially following difficult births, use of forceps, or vacuum assistance). […] When a pregnant person’s and their baby’s blood type is different (or „incompatible”); the person’s immune system may cause more of the baby’s red blood cells to break down. Therefore, it is important for pregnant people to know their blood group (A, B, AB, or O) and Rh factor status (negative or positive). People whose blood group is O or Rh factor is negative should talk with their doctor to see if their baby’s blood type has also been checked.

• #27 Jaundice in Babies: Causes, Symptoms and TreatmentCircleBumpCheckedFilledMedicalBookmarkBookmarkTickBookmarkAddCheckBoxCheckBoxFilled

  https://www.thebump.com/a/jaundice-baby

  Baby’s early inability to get rid of excess bilirubin is what causes jaundice, but there are a few factors that can affect how likely baby is to develop the condition: […] Rh incompatibility. According to Lori Christ, MD, attending neonatologist in the division of neonatology at Children’s Hospital of Philadelphia, infant jaundice can occur when there’s an Rh incompatibility between a pregnant mom and her baby. That means if mom’s blood type is Rh-negative and baby’s is Rh-positive, mom’s blood will treat baby’s as a foreign body and develop antibodies against it. As these antibodies cross the placenta, they can damage baby’s red blood cells and cause a buildup of bilirubin, which leads to jaundice in newborns. This complication isn’t very common, however, since pregnant women are typically given a RhoGAM shot (a solution collected from plasma donors) to prevent these antibodies if an Rh incompatibility is determined.

• #28 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. […] 1. Inadequate feeding jaundice: If your baby isnt taking in enough breast milk or formula, they cant create enough stool to excrete the extra bilirubin. […] 2. Breast milk jaundice: We dont fully understand what causes this type of jaundice; its persistent and lasts several days. However, we suspect it occurs when a substance within breast milk prevents the breakdown of bilirubin. […] 3. Rh incompatibility: 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. […] 4. ABO incompatibility: 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.

• #29 Jaundice Causes and Prevention – Breastfeeding Perspectives

  https://www.breastfeedingperspectives.com/7-jaundice-causes-in-neonatal-infants/

  Jaundice is a common condition in newborns, characterized by yellowing of the skin and eyes. […] Infant jaundice, also known as neonatal jaundice, occurs when there is an excess of bilirubin in a babys blood. Bilirubin is the yellow pigment that is formed during the breakdown of red blood cells. […] The most common cause of infant jaundice is physiological jaundice. This type of jaundice occurs because a newborns liver is not yet fully matured. […] Some breastfed babies may develop a type of jaundice called breast milk jaundice. This condition occurs when substances in a mothers breast milk interfere with the babys ability to eliminate bilirubin. […] Hemolytic jaundice results from an increased breakdown of red blood cells, leading to higher bilirubin levels. […] Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic condition that can lead to hemolysis and jaundice in newborns when triggered by specific medications, infections, or dietary factors. […] When a babys blood type is incompatible with that of the mother, it can lead to both hemolysis and jaundice.

• #30 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Inherited causes of red blood cell breakdown, such as deficiency of a red blood cell enzyme called glucose-6-phosphate dehydrogenase (G6PD). G6PD deficiency traits are more common in males and in people of African American, Asian, Latin American, Mediterranean, Middle Eastern, and Native American ancestries compared with those of Northern and Western European ancestries. […] Illness, such as infection. […] Another reason that bilirubin levels are higher in babies is that not enough bilirubin is being eliminated in the urine and stools. This is because newborn babies’ bodies eliminate bilirubin more slowly than adults, particularly for babies who are born before 38 weeks or have certain rare genetic conditions. Additionally, if a baby does not get enough breast milk in the days after birth, they can become dehydrated, which can then lead to severe hyperbilirubinemia as well as other problems.

• #31 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.

• #32 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.

• #33 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.

• #34 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.

• #35 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.

• #36 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

• #37 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 is a genetic condition with an X-linked recessive inheritance. […] 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. […] The disease is characterised by inflammatory sclerosing cholangiopathy affecting the entire biliary tract.

• #38 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #39 Neonatal Jaundice | ACG

  https://gi.org/topics/neonatal-jaundice/

  Problems with bilirubin metabolism: In very rare cases the baby’s liver is not able to change the bilirubin into a form that can easily be removed from the body. This occurs in a condition called Crigler-Najjar syndrome. This is a very rare disease; the level of bilirubin increases very rapidly within hours. Immediate attention by a newborn specialist is then needed.

• #40 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.

• #41 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.

• #42 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #43 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.

• #44 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.

• #45 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. […] Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice. […] Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of „used” red blood cells. […] Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. […] An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of 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.

• #46 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: congenital (eg, toxoplasmosis, rubella, cytomegalovirus (CMV), herpes simplex, syphilis) or postnatal infection. […] Increased haemolysis due to haematoma. […] Maternal autoimmune haemolytic anaemia: eg, systemic lupus erythematosus.

• #47 Jaundice: Causes, Symptoms, and Treatment Options

  https://www.verywellhealth.com/jaundice-8640349

  Jaundice occurs when there is too much bilirubin in the body, referred to as hyperbilirubinemia. There are three main reasons why this might occur, which are: […] Prehepatic jaundice is caused when hemolysis is increased, overwhelming the liver with more bilirubin than it can handle. […] Hepatic jaundice is caused when liver cells involved in this process, called hepatocytes, are damaged. […] Posthepatic jaundice occurs when there is an obstruction in the pathway from the liver to the small intestine. […] Neonatal jaundice is caused when fetal hemoglobin (the protein in red blood cells that carries oxygen) is broken down and replaced with the post-birth form of hemoglobin. This breakdown causes the release of more bilirubin than a newborn’s liver can clear. […] Other serious causes in newborns include: biliary atresia (blocked bile ducts), Alagille syndrome (a genetic condition affecting bile flow), Rh factor hemolytic disease (a blood type mismatch between the pregnant person and the fetus), familial cholestasis (a genetic condition in which bile builds up in liver cells).

• #48 Jaundice in newborns

  https://www.aboutkidshealth.ca/jaundice

  Jaundice is a condition that causes the skin and the whites of the eyes to turn yellow. Learn about causes and treatments of jaundice in newborns. […] Jaundice occurs when there is a build-up of bilirubin in the blood. It is common in newborns. […] The most common cause of jaundice in newborns is physiological, or benign. This can happen because newborn babies: produce more bilirubin than older children and adults since their red blood cells break down more quickly […] may have a build-up of bilirubin in the blood because their young livers cannot yet remove it quickly enough. […] Jaundice is more common and can be more severe in babies with: a history of prematurity […] difficulty feeding or inadequate intake of milk […] an older sibling who had severe jaundice […] mothers who had diabetes mellitus during pregnancy […] a mismatch between the blood types of mother and baby […] bruising or scalp swelling from birth […] an inherited condition such as G6PD deficiency […] congenital hypothyroidism […] an infection in the blood or urinary tract […] problems of the liver, intestine or gut (rare).

• #49

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

  Jaundice is caused by too much bilirubin in the blood. This is known as hyperbilirubinaemia. […] A newborn baby’s liver is not fully developed, so it’s less effective at processing the bilirubin and removing it from the blood. […] Breastfeeding your baby can increase their chances of developing jaundice. […] It’s unclear why breastfed babies are more likely to develop jaundice, but a number of theories have been suggested. […] 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), blood group incompatibility, rhesus disease, a urinary tract infection (UTI), Crigler-Najjar syndrome, a blockage or problem in the bile ducts and gallbladder. […] An inherited enzyme deficiency known as glucose 6 phosphate dehydrogenase (G6PD) could also lead to jaundice or kernicterus.

• #50 Newborn Jaundice: Pathological, Prevention, Signs of Recovery

  https://www.medicinenet.com/newborn_jaundice_neonatal_jaundice/article.htm

  Neonatal jaundice most commonly occurs because their livers are not mature enough to remove bilirubin from the blood. […] Jaundice may also be caused by several other medical conditions, such as: Physiologic jaundice, Hemolysis, Polycythemia, Cephalohematoma, Infant swallowing during birth, Mothers who have diabetes, Crigler-Najjar syndrome, Lucey-Driscoll syndrome, Maternal-fetal blood group incompatibility (Rh, ABO), Breast milk and breastfeeding, Red blood cell enzyme and membrane defects. […] Jaundice is caused by the accumulation of bilirubin in the blood, typically from an increased production of bilirubin or a decreased ability to metabolize and excrete it. […] The causes of jaundice in newborns include the following: Physiologic jaundice, Maternal-fetal blood group incompatibility (Rh, ABO), Breast milk jaundice, Breastfeeding jaundice, Cephalohematoma, Red blood cell enzyme defects, Red blood cell membrane defects, Other causes. […] Other causes of neonatal jaundice include: Prematurity, Maternal diabetes, Polycythemia, Infection/sepsis, Hypothyroidism, Biliary atresia, Cystic fibrosis, Crigler-Najjar syndrome, Gilbert syndrome, Hepatitis, Thalassemia, Galactosemia.

• #51 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.

• #52 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. […] Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice. […] Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of „used” red blood cells. […] Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. […] An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of 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.

• #53 Jaundice in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/jaundice

  In a small number of cases, jaundice in a newborn can be a sign of: Cholestasis, a rare condition caused by a problem with the production or flow of bile; Biliary atresia, a rare condition in which the duct that carries bile from the liver to the small intestine is blocked or damaged. […] Jaundice in older children can be the sign of an obstruction in the biliary ducts. Or it may be due to a liver condition that is preventing the liver from processing the bilirubin appropriately. The following conditions can also cause jaundice in older children: Gallstones (cholelithiasis), crystals that build up in the gallbladder and obstruct the biliary duct; Infection with the viruses that cause liver cell damage such as hepatitis B or hepatitis C virus; Autoimmune hepatitis, a disorder of the immune system that causes immune cells to attack the liver cells as if they were an infection; Wilson disease, a genetic condition in which copper from food builds up in the liver; Cirrhosis, a late stage of chronic liver disease in which scar tissue replaces soft, healthy liver tissue.

• #54 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

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

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

  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. […] The diagnosis of BA should be confirmed by direct visualisation of the fibrotic biliary tract. […] The first description in the English language of a condition similar to BA appeared in a textbook written by Dr John Burns from the University of Glasgow in 1817. […] 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). […] The diagnosis is usually made in the first few years of life when the patient presents with jaundice or abdominal pain. […] Choledochal cyst is a congenital disorder characterised by cystic dilatation of the intrahepatic and/or extrahepatic bile duct.

• #56 Jaundice in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/jaundice

  In a small number of cases, jaundice in a newborn can be a sign of: Cholestasis, a rare condition caused by a problem with the production or flow of bile; Biliary atresia, a rare condition in which the duct that carries bile from the liver to the small intestine is blocked or damaged. […] Jaundice in older children can be the sign of an obstruction in the biliary ducts. Or it may be due to a liver condition that is preventing the liver from processing the bilirubin appropriately. The following conditions can also cause jaundice in older children: Gallstones (cholelithiasis), crystals that build up in the gallbladder and obstruct the biliary duct; Infection with the viruses that cause liver cell damage such as hepatitis B or hepatitis C virus; Autoimmune hepatitis, a disorder of the immune system that causes immune cells to attack the liver cells as if they were an infection; Wilson disease, a genetic condition in which copper from food builds up in the liver; Cirrhosis, a late stage of chronic liver disease in which scar tissue replaces soft, healthy liver tissue.

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

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

  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. […] The diagnosis of BA should be confirmed by direct visualisation of the fibrotic biliary tract. […] The first description in the English language of a condition similar to BA appeared in a textbook written by Dr John Burns from the University of Glasgow in 1817. […] 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). […] The diagnosis is usually made in the first few years of life when the patient presents with jaundice or abdominal pain. […] Choledochal cyst is a congenital disorder characterised by cystic dilatation of the intrahepatic and/or extrahepatic bile duct.

• #58 Neonatal jaundice – Wikipedia

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

  Neonatal jaundice is a yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. […] 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. […] In newborns, 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.

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

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

  Some of the health problems that can cause persistent jaundice include: Blood type mismatch between mother and baby, which makes babys red blood cells break down faster than normal and raises bilirubin levels; 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.

• #60

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

  Jaundice is caused by too much bilirubin in the blood. This is known as hyperbilirubinaemia. […] A newborn baby’s liver is not fully developed, so it’s less effective at processing the bilirubin and removing it from the blood. […] Breastfeeding your baby can increase their chances of developing jaundice. […] It’s unclear why breastfed babies are more likely to develop jaundice, but a number of theories have been suggested. […] 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), blood group incompatibility, rhesus disease, a urinary tract infection (UTI), Crigler-Najjar syndrome, a blockage or problem in the bile ducts and gallbladder. […] An inherited enzyme deficiency known as glucose 6 phosphate dehydrogenase (G6PD) could also lead to jaundice or kernicterus.

• #61 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.

• #62 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #63 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.

• #64 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.

• #65 Neonatal Jaundice Causes

  https://mobile.fpnotebook.com/NICU/GI/NntlJndcCs.htm

  Neonatal Jaundice Causes, Hyperbilirubinemia Causes in Newborns, Jaundice Causes in Newborns […] Jaundice onset within first 24 hours […] Neonatal Sepsis […] Jaundice onset after 2 weeks of life […] Persistent Late-Onset Breast Milk Jaundice […] Increased Hemolysis Causes (Anemia and Reticulocytosis) […] Coombs positive (common) […] Fetal hydrops from Rh Sensitization […] ABO Incompatibility […] Non-hemolytic causes (No Reticulocytosis) […] Breast Milk Jaundice or Physiologic Jaundice […] Maternal Diabetes Mellitus […] Decreased Conjugation (Indirect Hyperbilirubinemia, no Hemolysis) […] Common […] Breast Milk Jaundice […] Decreased Excretion of Conjugated Bilirubin (Direct Hyperbilirubinemia) […] Infection (Common) […] Sepsis […] Maternal Diabetes Mellitus (common) […] Genetic disorders […] Turner’s Syndrome […] Trisomy 21 […] Intestinal Obstruction (Direct Bilirubin 5 mg/dl, lower in other causes of direct Hyperbilirubinemia) […] Biliary atresia.

• #66 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.

• #67 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.

• #68 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.

• #69 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.

• #70 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is caused by the buildup of bilirubin in the blood, which can lead to its buildup in the body’s tissues (such as skin). Bilirubin is a yellow pigment that the body produces when red blood cells are broken down. It is naturally removed by the liver and then excreted in stool and urine. Bilirubin levels become high when it is made faster than it can be removed. […] One reason that bilirubin levels are higher in babies is that more red blood cells are broken down, which causes more bilirubin to be made. Newborn babies make two to three times more bilirubin than adults. This can be due to: […] Bruising and mild injuries during delivery (especially following difficult births, use of forceps, or vacuum assistance). […] When a pregnant person’s and their baby’s blood type is different (or „incompatible”); the person’s immune system may cause more of the baby’s red blood cells to break down. Therefore, it is important for pregnant people to know their blood group (A, B, AB, or O) and Rh factor status (negative or positive). People whose blood group is O or Rh factor is negative should talk with their doctor to see if their baby’s blood type has also been checked.

• #71 Jaundice in Newborns: Causes & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/jaundice-in-newborns

  Jaundice in infants, also called hyperbilirubinemia, is common and can be remedied quickly in most cases. […] Jaundice in newborns usually occurs within the first couple of days after birth when an excess of bilirubin, the yellow pigment in red blood cells, builds up in the newborns bloodstream giving a yellow appearance to the skin and eyes. […] The liver is responsible for filtering out bilirubin, and newborns make more bilirubin in the first days after birth due to more production and faster breakdown of red blood cells in infants. That excessive production of red blood cells coupled with an immature liver leads to the higher levels of bilirubin in a newborn, giving them the yellow color that is referred to as jaundice. […] Occasionally jaundice is caused by a condition or disease. Some of the most common disorders that cause jaundice include: Internal bleeding, Infection of the newborns blood, Liver issues, Enzyme deficiency, Prematurity, Incompatibility between mother and baby blood types, Abnormality in the breakdown of red blood cells.

• #72 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.

• #73 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.

• #74 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.

• #75 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. […] Jaundice in newborns is normal and usually goes away on its own. If it persists, more testing should be done.

• #76 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.

• #77 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.

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

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

  Bilirubin levels with a deviation from the normal range and requiring intervention would be described as pathological jaundice. […] 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. […] Hyperbilirubinemia is also associated with breast milk of mother in neonates. […] 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.

• #79 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.

• #80 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. […] Jaundice in newborns is normal and usually goes away on its own. If it persists, more testing should be done.

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

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

  Some of the health problems that can cause persistent jaundice include: Blood type mismatch between mother and baby, which makes babys red blood cells break down faster than normal and raises bilirubin levels; 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.

• #82 Newborn Jaundice: Pathological, Prevention, Signs of Recovery

  https://www.medicinenet.com/newborn_jaundice_neonatal_jaundice/article.htm

  Neonatal jaundice most commonly occurs because their livers are not mature enough to remove bilirubin from the blood. […] Jaundice may also be caused by several other medical conditions, such as: Physiologic jaundice, Hemolysis, Polycythemia, Cephalohematoma, Infant swallowing during birth, Mothers who have diabetes, Crigler-Najjar syndrome, Lucey-Driscoll syndrome, Maternal-fetal blood group incompatibility (Rh, ABO), Breast milk and breastfeeding, Red blood cell enzyme and membrane defects. […] Jaundice is caused by the accumulation of bilirubin in the blood, typically from an increased production of bilirubin or a decreased ability to metabolize and excrete it. […] The causes of jaundice in newborns include the following: Physiologic jaundice, Maternal-fetal blood group incompatibility (Rh, ABO), Breast milk jaundice, Breastfeeding jaundice, Cephalohematoma, Red blood cell enzyme defects, Red blood cell membrane defects, Other causes. […] Other causes of neonatal jaundice include: Prematurity, Maternal diabetes, Polycythemia, Infection/sepsis, Hypothyroidism, Biliary atresia, Cystic fibrosis, Crigler-Najjar syndrome, Gilbert syndrome, Hepatitis, Thalassemia, Galactosemia.

• #83 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #84 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #85 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.

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

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

  Some of the health problems that can cause persistent jaundice include: Blood type mismatch between mother and baby, which makes babys red blood cells break down faster than normal and raises bilirubin levels; 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.

• #87 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

• #88 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

• #89 Newborn Jaundice: Causes, Symptoms, Treatment, and Prevention

  https://www.healthline.com/health/newborn-jaundice

  Newborn jaundice is when a babys skin and eyes turn yellow from too much bilirubin. […] There are two types of newborn jaundice: physiological and pathological. […] Physiological jaundice is the most common, accounting for 75% of cases. […] On the other hand, pathological jaundice means that there is another underlying condition thats causing a problem with filtering out bilirubin. […] Possible causes include: blood type incompatibilities such as rhesus factor (Rh) or ABO, breakdown of red blood cells (hemolysis), conditions that affect how the body processes bilirubin like Gilberts syndrome and Crigler-Najjar syndrome, diabetes in the birthing parent, congenital hypothyroidism, intestinal obstruction, pyloric stenosis, breastmilk jaundice, which is a reaction to substances in the milk, breastfeeding jaundice, which can happen if the baby isnt feeding well. […] Pathological jaundice can also be caused by certain medications, such as certain antibiotics.

• #90 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.

• #91 Newborn Jaundice | Duke Health

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

  Newborn jaundice is caused by a pigment that we all have in our blood called bilirubin. […] Newborns typically develop higher bilirubin levels than adults over the first few days of life because they have higher levels and faster turnover of red blood cells — and produce more bilirubin. […] Pathologic jaundice, however, involves a higher level of bilirubin and requires treatment to hasten the removal of bilirubin. […] One risk factor is prematurity — babies born more than two weeks before their due date are more likely to develop higher levels of bilirubin. […] A blood type incompatibility between the mother and baby is also a reason to track the newborns jaundice more closely. […] A blood type incompatibility also exists if the mother has a Rh (Rhesus) factor negative blood type and the newborn is Rh factor positive.

• #92 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. […] Jaundice in newborns is normal and usually goes away on its own. If it persists, more testing should be done.

• #93 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 born before 37 weeks, or 8.5 months, of pregnancy might have jaundice because their liver is not fully developed. […] A baby born to an East Asian or Mediterranean family is at a higher risk of becoming jaundiced. […] Women with an O blood type or Rh negative blood factor might have babies with higher bilirubin levels.

• #94 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. […] Jaundice in newborns is normal and usually goes away on its own. If it persists, more testing should be done.

• #95 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.

• #96 Jaundice in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/jaundice-in-neonates

  Jaundice occurs in approximately 60 per cent of newborns, but is unimportant in most neonates. A few babies will become deeply jaundiced and require investigation and treatment. […] Major risk factors for severe hyperbilirubinaemia include jaundice within the first 24 hours and blood group incompatibility. […] Physiological jaundice develops due to increased production, decreased uptake and binding by liver cells, decreased conjugation (most important), decreased excretion, and increased enterohepatic circulation of bilirubin. […] Pathological jaundice is best considered in relation to time of birth. […] It is always pathological and is usually due to haemolysis, with excessive production of bilirubin. […] Causes of severe haemolysis include ABO incompatibility, Rh iso-immunisation, and sepsis.

• #97 Newborn jaundice | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/newborn-jaundice

  A problem with your babys red blood cells. […] A genetic condition, like G6PD deficiency. […] An infection, like sepsis. […] Bruising at birth. […] Untreated urinary or other infections in the mom. […] Use of Sulfa drugs. […] Some babies are more likely than others to have jaundice. […] Preterm babies. […] Breastfed babies, especially babies who arent breastfeeding well. […] Babies with East Asian or Mediterranean ethnic backgrounds. […] Babies who have sibling who had jaundice.

• #98 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.

• #99 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Jaundice (or hyperbilirubinaemia) occurs in approximately 60% of full term and 80% of pre-term babies within the first week of life. […] Hyperbilirubinaemia occurs when there is an imbalance between bilirubin production, conjugation and elimination. […] Kernicterus is a rare complication of neonatal unconjugated hyperbilirubinaemia that can lead to major long-term neurological sequelae. […] Features suggestive of pathological jaundice include: onset 24 hours old, unwell baby, elevated conjugated bilirubin component, prolonged jaundice, pale stool. These require prompt investigation and management. […] Early Onset: (24 hours) PATHOLOGICAL. […] Sepsis. […] Haemolysis: Isoimmunisation ABO or Rhesus D alloantibodies. […] RBC enzyme defects G6PD, hereditary spherocytosis, alpha thalassemia.

• #100 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.

• #101 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. […] You had gestational diabetes during your pregnancy.

• #102 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. […] Jaundice in newborns is normal and usually goes away on its own. If it persists, more testing should be done.

• #103 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

  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.

• #104 Jaundice Causes and Prevention – Breastfeeding Perspectives

  https://www.breastfeedingperspectives.com/7-jaundice-causes-in-neonatal-infants/

  Jaundice is a common condition in newborns, characterized by yellowing of the skin and eyes. […] Infant jaundice, also known as neonatal jaundice, occurs when there is an excess of bilirubin in a babys blood. Bilirubin is the yellow pigment that is formed during the breakdown of red blood cells. […] The most common cause of infant jaundice is physiological jaundice. This type of jaundice occurs because a newborns liver is not yet fully matured. […] Some breastfed babies may develop a type of jaundice called breast milk jaundice. This condition occurs when substances in a mothers breast milk interfere with the babys ability to eliminate bilirubin. […] Hemolytic jaundice results from an increased breakdown of red blood cells, leading to higher bilirubin levels. […] Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic condition that can lead to hemolysis and jaundice in newborns when triggered by specific medications, infections, or dietary factors. […] When a babys blood type is incompatible with that of the mother, it can lead to both hemolysis and jaundice.

• #105 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 baby’s red blood cells, blocked bile duct or bowel, rhesus or ABO incompatibility when the mother and baby have different blood types, the mother’s antibodies attack the baby’s 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.

• #106 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.

• #107 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.

• #108 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. It happens because their livers arent developed enough to get rid of the bilirubin. […] Jaundice occurs when bilirubin (pronounced bil-ih-ROO-bin) builds up in your babys blood. Hyperbilirubinemia is the medical term for this condition. […] Bilirubin is a yellow substance your body creates when red blood cells break down. […] 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. Your liver normally filters bilirubin from your blood. […] 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.

• #109 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.

• #110 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: congenital (eg, toxoplasmosis, rubella, cytomegalovirus (CMV), herpes simplex, syphilis) or postnatal infection. […] Increased haemolysis due to haematoma. […] Maternal autoimmune haemolytic anaemia: eg, systemic lupus erythematosus.

• #111 Jaundice Symptoms, Causes, Treatments and More – Dr. Axe

  https://draxe.com/health/jaundice/

  Neonatal jaundice is one of the most common conditions requiring medical attention in newborn babies. Approximately 60 percent of term and 80 percent of preterm babies develop this condition in the first week of life, which is why the American Academy of Pediatrics recommends that every newborn be examined for jaundice during routine medical checks after birth. […] Jaundice is common among newborns because the metabolism, circulation and excretion of bilirubin are slower than in adults. Newborn babies red blood cells have shorter life spans than those of adults, and the concentration of red blood cells in newborns is also higher. […] Usually, hyperbilirubinemia is harmless in newborn babies, and it only develops because a babys liver isnt mature enough to get rid of all the bilirubin in the bloodstream.

• #112 Neonatal jaundice – Wikipedia

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

  Neonatal jaundice is a yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. […] 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. […] In newborns, 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.

• #113 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.

• #114 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

• #115 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.

• #116 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.

• #117 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.

• #118 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.

• #119 Newborn Jaundice – Causes, Symptoms and Treatment | Apollo Hospitals

  https://www.apollohospitals.com/diseases-and-conditions/newborn-jaundice-causes-symptoms-and-treatment/

  The immature liver of a baby is typically unable to eliminate bilirubin quickly enough, resulting in an excess of bilirubin. […] Breast-feeding can also cause infant jaundice. […] Breastfeeding jaundice develops in the first week of life if the infant does not feed adequately or if the mothers milk takes a long time to arrive. […] Breast milk jaundice is caused by chemicals in the breast milk interfering with the bilirubin breakdown process. […] If untreated, high levels of bilirubin that produce acute jaundice can lead to catastrophic problems. […] A disorder known as acute bilirubin encephalopathy occurs when a neonate has severe jaundice and bilirubin passes into the brain. […] Kernicterus is a syndrome that develops when acute bilirubin encephalopathy results in permanent brain damage.

• #120 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.

• #121 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Haemorrhage cerebral, intra-abdominal. […] Blood extravasation (bruising/birth trauma). […] Prolonged/ conjugated (2 weeks) All should have: SBR (unconjugated/ conjugated), FBE, film and reticulocytes, TFTs, group and DAT, LFTs if conjugated bilirubin 10%. […] Extra-hepatic obstruction: Biliary atresia, choledochal cyst, bile plug. […] Neonatal hepatitis. […] If conjugated fraction 10% of total bilirubin. […] Refer to a specialty unit. […] Diagnosis of exclusion after considering above causes.

• #122 Hyperbilirubinemia in the Term Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0215/p599.html/1000

  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.

• #123 Jaundice: Causes, Symptoms, and Treatment Options

  https://www.verywellhealth.com/jaundice-8640349

  Jaundice occurs when there is too much bilirubin in the body, referred to as hyperbilirubinemia. There are three main reasons why this might occur, which are: […] Prehepatic jaundice is caused when hemolysis is increased, overwhelming the liver with more bilirubin than it can handle. […] Hepatic jaundice is caused when liver cells involved in this process, called hepatocytes, are damaged. […] Posthepatic jaundice occurs when there is an obstruction in the pathway from the liver to the small intestine. […] Neonatal jaundice is caused when fetal hemoglobin (the protein in red blood cells that carries oxygen) is broken down and replaced with the post-birth form of hemoglobin. This breakdown causes the release of more bilirubin than a newborn’s liver can clear. […] Other serious causes in newborns include: biliary atresia (blocked bile ducts), Alagille syndrome (a genetic condition affecting bile flow), Rh factor hemolytic disease (a blood type mismatch between the pregnant person and the fetus), familial cholestasis (a genetic condition in which bile builds up in liver cells).

• #124 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.

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

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

  Bilirubin levels with a deviation from the normal range and requiring intervention would be described as pathological jaundice. […] 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. […] Hyperbilirubinemia is also associated with breast milk of mother in neonates. […] 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.

• #126 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.

• #127 Jaundice in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/jaundice

  In a small number of cases, jaundice in a newborn can be a sign of: Cholestasis, a rare condition caused by a problem with the production or flow of bile; Biliary atresia, a rare condition in which the duct that carries bile from the liver to the small intestine is blocked or damaged. […] Jaundice in older children can be the sign of an obstruction in the biliary ducts. Or it may be due to a liver condition that is preventing the liver from processing the bilirubin appropriately. The following conditions can also cause jaundice in older children: Gallstones (cholelithiasis), crystals that build up in the gallbladder and obstruct the biliary duct; Infection with the viruses that cause liver cell damage such as hepatitis B or hepatitis C virus; Autoimmune hepatitis, a disorder of the immune system that causes immune cells to attack the liver cells as if they were an infection; Wilson disease, a genetic condition in which copper from food builds up in the liver; Cirrhosis, a late stage of chronic liver disease in which scar tissue replaces soft, healthy liver tissue.

• #128 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

• #129 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. There are several genetically determined enzyme deficiencies that interfere with bilirubin synthesis, metabolism and excretion. […] 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.

• #130 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.

• #131 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Jaundice (or hyperbilirubinaemia) occurs in approximately 60% of full term and 80% of pre-term babies within the first week of life. […] Hyperbilirubinaemia occurs when there is an imbalance between bilirubin production, conjugation and elimination. […] Kernicterus is a rare complication of neonatal unconjugated hyperbilirubinaemia that can lead to major long-term neurological sequelae. […] Features suggestive of pathological jaundice include: onset 24 hours old, unwell baby, elevated conjugated bilirubin component, prolonged jaundice, pale stool. These require prompt investigation and management. […] Early Onset: (24 hours) PATHOLOGICAL. […] Sepsis. […] Haemolysis: Isoimmunisation ABO or Rhesus D alloantibodies. […] RBC enzyme defects G6PD, hereditary spherocytosis, alpha thalassemia.

• #132 Jaundice in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/jaundice-in-neonates

  Jaundice occurs in approximately 60 per cent of newborns, but is unimportant in most neonates. A few babies will become deeply jaundiced and require investigation and treatment. […] Major risk factors for severe hyperbilirubinaemia include jaundice within the first 24 hours and blood group incompatibility. […] Physiological jaundice develops due to increased production, decreased uptake and binding by liver cells, decreased conjugation (most important), decreased excretion, and increased enterohepatic circulation of bilirubin. […] Pathological jaundice is best considered in relation to time of birth. […] It is always pathological and is usually due to haemolysis, with excessive production of bilirubin. […] Causes of severe haemolysis include ABO incompatibility, Rh iso-immunisation, and sepsis.

• #133 Newborn Jaundice: Causes, Symptoms, and Treatment Explained | Thomson Medical

  https://www.thomsonmedical.com/blog/childrens-health/newborn-jaundice-causes-symptoms-treatment-explained

  Newborn jaundice is a common condition that often affects pre-term babies (born before 38 weeks) and some breastfed infants. It generally appears on the second or third day after birth. Jaundice occurs when there’s an excess of bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells break down. While the liver normally processes and eliminates bilirubin, a newborn’s liver might not be fully developed, leading to a temporary buildup. […] Severe jaundice can result from: Blood infections (sepsis) […] Blood group incompatibilities (ABO or Rhesus factor). […] Blood Group Incompatibility Jaundice: Happens when the mother’s antibodies attack the baby’s red blood cells due to incompatible blood types. This typically appears within the first 24 hours after birth.

• #134 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: congenital (eg, toxoplasmosis, rubella, cytomegalovirus (CMV), herpes simplex, syphilis) or postnatal infection. […] Increased haemolysis due to haematoma. […] Maternal autoimmune haemolytic anaemia: eg, systemic lupus erythematosus.

• #135 Neonatal Jaundice Causes

  https://mobile.fpnotebook.com/NICU/GI/NntlJndcCs.htm

  Neonatal Jaundice Causes, Hyperbilirubinemia Causes in Newborns, Jaundice Causes in Newborns […] Jaundice onset within first 24 hours […] Neonatal Sepsis […] Jaundice onset after 2 weeks of life […] Persistent Late-Onset Breast Milk Jaundice […] Increased Hemolysis Causes (Anemia and Reticulocytosis) […] Coombs positive (common) […] Fetal hydrops from Rh Sensitization […] ABO Incompatibility […] Non-hemolytic causes (No Reticulocytosis) […] Breast Milk Jaundice or Physiologic Jaundice […] Maternal Diabetes Mellitus […] Decreased Conjugation (Indirect Hyperbilirubinemia, no Hemolysis) […] Common […] Breast Milk Jaundice […] Decreased Excretion of Conjugated Bilirubin (Direct Hyperbilirubinemia) […] Infection (Common) […] Sepsis […] Maternal Diabetes Mellitus (common) […] Genetic disorders […] Turner’s Syndrome […] Trisomy 21 […] Intestinal Obstruction (Direct Bilirubin 5 mg/dl, lower in other causes of direct Hyperbilirubinemia) […] Biliary atresia.

• #136 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Jaundice (or hyperbilirubinaemia) occurs in approximately 60% of full term and 80% of pre-term babies within the first week of life. […] Hyperbilirubinaemia occurs when there is an imbalance between bilirubin production, conjugation and elimination. […] Kernicterus is a rare complication of neonatal unconjugated hyperbilirubinaemia that can lead to major long-term neurological sequelae. […] Features suggestive of pathological jaundice include: onset 24 hours old, unwell baby, elevated conjugated bilirubin component, prolonged jaundice, pale stool. These require prompt investigation and management. […] Early Onset: (24 hours) PATHOLOGICAL. […] Sepsis. […] Haemolysis: Isoimmunisation ABO or Rhesus D alloantibodies. […] RBC enzyme defects G6PD, hereditary spherocytosis, alpha thalassemia.

• #137 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.

• #138 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. It is a multifactorial disorder with many symptoms. […] The main causes of increased bilirubin mostly are: race, genetic polymorphisms; inherited and acquired defects e.g. spherocytosis, Gilberts syndrome, Najjar 1 and 2. […] 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. […] Jaundice attributable to physiological immaturity which usually appears between 24-72 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 10-14 days of life.

• #139 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.

• #140 Jaundice in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/jaundice

  Children with jaundice often have a yellowish tint of the eyes and skin that usually begins on the face and moves down the body. Jaundice is a sign of a condition called hyperbilirubinemia. Babies and children develop hyperbilirubinemia when a waste product called bilirubin builds up in their blood. In newborns, hyperbilirubinemia is often a temporary condition, though it can be a symptom of a more serious illness. Early recognition and treatment are important to keep bilirubin from rising to dangerous levels. […] Jaundice is common in newborns whose livers are still developing. More than half of full-term babies have jaundice in their first week. Up to 80 percent of infants born premature have jaundice. […] There are several reasons a newborn can develop jaundice, including: Physiologic jaundice is a normal response to a baby’s limited ability to excrete bilirubin in the first days of life. Breastfeeding jaundice occurs in some babies in the first week due to low milk intake or dehydration. Breast-milk jaundice occurs in some babies in the second week of life or later for unknown reasons. It may be related to a substance in the breast milk that makes it easier for the intestine to reabsorb the bilirubin or due to the immature liver processing of bilirubin. Jaundice from hemolysis is a condition that results from excess breakdown of red blood cells due to hemolytic disease of the newborn (HDN), polycythemia, or hemorrhage. Inadequate liver function due to infection or other factors.

• #141 Patient education: Jaundice in newborn infants (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/jaundice-in-newborn-infants-beyond-the-basics/print

  Jaundice is caused by the buildup of bilirubin in the blood, which can lead to its buildup in the body’s tissues (such as skin). Bilirubin is a yellow pigment that the body produces when red blood cells are broken down. It is naturally removed by the liver and then excreted in stool and urine. Bilirubin levels become high when it is made faster than it can be removed. […] One reason that bilirubin levels are higher in babies is that more red blood cells are broken down, which causes more bilirubin to be made. Newborn babies make two to three times more bilirubin than adults. This can be due to: […] Bruising and mild injuries during delivery (especially following difficult births, use of forceps, or vacuum assistance). […] When a pregnant person’s and their baby’s blood type is different (or „incompatible”); the person’s immune system may cause more of the baby’s red blood cells to break down. Therefore, it is important for pregnant people to know their blood group (A, B, AB, or O) and Rh factor status (negative or positive). People whose blood group is O or Rh factor is negative should talk with their doctor to see if their baby’s blood type has also been checked.

• #142 Hyperbilirubinemia and Jaundice | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hyperbilirubinemia-and-jaundice

  Although low levels of bilirubin are not usually a concern, large amounts can circulate to tissues in the brain and may cause seizures and brain damage. […] The timing of the appearance of jaundice helps with the diagnosis. […] When jaundice appears on the second or third day, it is usually „physiologic” or related to dehydration. […] Later appearance of jaundice in the second week, is often related to breast milk feedings, but may have other causes. […] Treatment depends on many factors, including the cause of the hyperbilirubinemia and the level of bilirubin. […] Treating any underlying cause of hyperbilirubinemia, such as infection.

• #143 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.

• #144 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #145 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.

• #146 Newborn Jaundice: Pathological, Prevention, Signs of Recovery

  https://www.medicinenet.com/newborn_jaundice_neonatal_jaundice/article.htm

  Neonatal jaundice most commonly occurs because their livers are not mature enough to remove bilirubin from the blood. […] Jaundice may also be caused by several other medical conditions, such as: Physiologic jaundice, Hemolysis, Polycythemia, Cephalohematoma, Infant swallowing during birth, Mothers who have diabetes, Crigler-Najjar syndrome, Lucey-Driscoll syndrome, Maternal-fetal blood group incompatibility (Rh, ABO), Breast milk and breastfeeding, Red blood cell enzyme and membrane defects. […] Jaundice is caused by the accumulation of bilirubin in the blood, typically from an increased production of bilirubin or a decreased ability to metabolize and excrete it. […] The causes of jaundice in newborns include the following: Physiologic jaundice, Maternal-fetal blood group incompatibility (Rh, ABO), Breast milk jaundice, Breastfeeding jaundice, Cephalohematoma, Red blood cell enzyme defects, Red blood cell membrane defects, Other causes. […] Other causes of neonatal jaundice include: Prematurity, Maternal diabetes, Polycythemia, Infection/sepsis, Hypothyroidism, Biliary atresia, Cystic fibrosis, Crigler-Najjar syndrome, Gilbert syndrome, Hepatitis, Thalassemia, Galactosemia.

• #147 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Haemorrhage cerebral, intra-abdominal. […] Blood extravasation (bruising/birth trauma). […] Prolonged/ conjugated (2 weeks) All should have: SBR (unconjugated/ conjugated), FBE, film and reticulocytes, TFTs, group and DAT, LFTs if conjugated bilirubin 10%. […] Extra-hepatic obstruction: Biliary atresia, choledochal cyst, bile plug. […] Neonatal hepatitis. […] If conjugated fraction 10% of total bilirubin. […] Refer to a specialty unit. […] Diagnosis of exclusion after considering above causes.

• #148 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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 most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis.

• #149 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Haemorrhage cerebral, intra-abdominal. […] Blood extravasation (bruising/birth trauma). […] Prolonged/ conjugated (2 weeks) All should have: SBR (unconjugated/ conjugated), FBE, film and reticulocytes, TFTs, group and DAT, LFTs if conjugated bilirubin 10%. […] Extra-hepatic obstruction: Biliary atresia, choledochal cyst, bile plug. […] Neonatal hepatitis. […] If conjugated fraction 10% of total bilirubin. […] Refer to a specialty unit. […] Diagnosis of exclusion after considering above causes.

• #150 Jaundice in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/jaundice

  In a small number of cases, jaundice in a newborn can be a sign of: Cholestasis, a rare condition caused by a problem with the production or flow of bile; Biliary atresia, a rare condition in which the duct that carries bile from the liver to the small intestine is blocked or damaged. […] Jaundice in older children can be the sign of an obstruction in the biliary ducts. Or it may be due to a liver condition that is preventing the liver from processing the bilirubin appropriately. The following conditions can also cause jaundice in older children: Gallstones (cholelithiasis), crystals that build up in the gallbladder and obstruct the biliary duct; Infection with the viruses that cause liver cell damage such as hepatitis B or hepatitis C virus; Autoimmune hepatitis, a disorder of the immune system that causes immune cells to attack the liver cells as if they were an infection; Wilson disease, a genetic condition in which copper from food builds up in the liver; Cirrhosis, a late stage of chronic liver disease in which scar tissue replaces soft, healthy liver tissue.

• #151 Jaundice in early infancy

  https://www.rch.org.au/clinicalguide/guideline_index/jaundice_in_early_infancy/

  Haemorrhage cerebral, intra-abdominal. […] Blood extravasation (bruising/birth trauma). […] Prolonged/ conjugated (2 weeks) All should have: SBR (unconjugated/ conjugated), FBE, film and reticulocytes, TFTs, group and DAT, LFTs if conjugated bilirubin 10%. […] Extra-hepatic obstruction: Biliary atresia, choledochal cyst, bile plug. […] Neonatal hepatitis. […] If conjugated fraction 10% of total bilirubin. […] Refer to a specialty unit. […] Diagnosis of exclusion after considering above causes.

• #152 Neonatal Jaundice

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

  Crigler-Najjar syndrome or Dubin-Johnson syndrome. […] Gilbert’s syndrome. […] Infection – eg, urinary tract infection. […] Hypothyroidism, hypopituitarism. […] Galactosaemia. […] Breast milk jaundice: the baby is well and the jaundice usually resolves by six weeks but occasionally continues for up to four months. […] Gastrointestinal (GI): biliary atresia, choledochal cyst, neonatal hepatitis. […] Infection. […] Parenteral nutrition. […] Cystic fibrosis. […] Metabolic: alpha-1-antitrypsin deficiency, galactosaemia, aminoacidurias, organoacidaemias. […] GI: biliary atresia, choledochal cyst, neonatal hepatitis. […] Endocrine: hypothyroidism, hypopituitarism.

• #153 Infant Jaundice: Causes, Risks and Treatment

  https://www.birthinjuryhelpcenter.org/birth-injuries/infant-brain-damage/infant-jaundice/

  The risk of jaundice has increased since the 2017 AGOG guidelines suggested delayed umbilical cord clamping for both term and preterm infants for at least 30-60 seconds after birth. […] If newborn jaundice is ignored and not treated, more serious cases occasionally develop into a very serious and even life-threatening situation. […] In the worst-case scenario, untreated infant jaundice can progress into a deadly condition called kernicterus resulting in permanent injury to the brain. […] The medical condition known as jaundice occurs when levels of unprocessed bilirubin circulating in the bloodstream become too high. […] Jaundice in infants occurs so frequently because their liver is often underdeveloped or as efficient when they are firstborn. […] Jaundice occurs when the liver is not able to process bilirubin fast enough to keep pace with hemolysis.

• #154 Jaundice in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/jaundice-in-neonates

  If there is substantial elevation of conjugated bilirubin (> 15 per cent of the total), consider hepatitis. […] Breast-milk jaundice occurs from as early as the third day of life, and the SBR concentration of breastfed infants is higher than those who are formula-fed. […] Persistent jaundice may be the earliest sign of hypothyroidism in an infant. […] Hepatitis can be caused by infection or metabolic disorders. […] Biliary atresia is a very rare disorder in which the bile ducts are absent, causing an obstructive jaundice which is fatal in most cases.

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