Jaundice come from the French word "Jaune ",which means "yellow ".when a person has jaundice ,their skin looks yellow. the whites of their eyes can also turn yellow.
•What is a Physiological Neonatal Jaundice?
Most infants (60%) develop visible jaundice due to elevation of unconjugated bilirubin concentration during their first week. This common condition is called "Physiological Neonatal Jaundice".
•What is a non-physiological Neonatal Jaundice?
-jaundice detected within 24 hours
-if bilirubin rise at a rate of >0,5mg/dL per hour or 5mg/dL per day,
-if total bilirubin exceed 15mg/dL in a full-term infant or 10mg/dL in a preterm infant,
-if evidence of acute hemolysis or if hyperbilirubinemia persists beyond 10days in a full-term infants or 21 days in a preterm infant.
1) Physiological Neonatal Jaundice:
• Clinical signs
-Frequent in pre-term baby
-Starts on the second to fourth day of life (skin colour is usually normal by the end of first week).
-there in no anaemia and urine is clear
-clinical examination is normal
-there is no signs suggesting infections (no associated abnormalities with jaundice ).
• Treatment
-advice to sunbathe (natural phototherapy) with eye protection and good hydration 15 minute three times a day.
-the only danger is neurological complications if high level of bilirubin (Kernicterus).
-Phototherapy using UV light can be used if available (with eye protection and fluid balance monitoring).
2) Non Physiological Neonatal Jaundice:
• Clinical signs suggesting pathological Jaundice
-Early onset of Jaundice: premature<12 hours and full term baby <24 hours
-prolonged Jaundice:premature >2 weeks and full term baby>1week.
-associated signs
+/- signs of haemolysis (pallor,hepatomegaly,splenomegaly, haemoglobinuria or anasarca).
+/- signs of severe infections
-Stool discoloration
• Investigations
-check haematocrit or haemoglobin
-check malaria smear if endemic area
-if available,check for hepatitis,syphilis
-rule out forgo-maternal incompatibility
-do a cells blood count.
• Treatment
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-Treat as for severe infection if suspected
-Phototherapy if available
-Blood transfusion if needed
-Malaria treatment if smear positive (check also mother)