Q: How can I tell if my baby has jaundice?
A: Jaundice is a very common condition affecting up to 75% of newborn babies and presents itself as yellowness of the skin and eyes. It usually happens during the first week of life.
Yellowing of the skin typically starts at the forehead and face, before extending downwards to the lower body. The condition can be detected by blanching the skin with finger pressure under bright lighting.
Q: What tests are available to find out if my baby has jaundice, and how will I know if my baby needs treatment?
A: Jaundice is a clinical diagnosis whereby the skin colour is inspected under bright lighting by an experienced professional; e.g. a paediatrician or paediatric nurse. If a newborn baby is diagnosed with jaundice, their blood would need to be checked to determine the bilirubin level. There are several tests that can be done for this. The common ones are transcutaneous bilirubinometer (as a screening method) and capillary or venous blood sampling.
Newborn babies with jaundice will require treatment If their bilirubin level is higher than the phototherapy level. For example, a healthy newborn baby with low risk of jaundice will need phototherapy if their total bilirubin is more than 290 micromol/L at 96 hours of life. It is advisable that every baby with jaundice obtain a detailed assessment as well as a check of their bilirubin level done to determine whether treatment is needed.
Q: What will the treatment involve and long will it take to have an effect?
A: The mainstay of treatment for jaundice is phototherapy in the blue light range (wavelength of about 400–500 nm). It is easily available at any healthcare centre. However, if the jaundice is severe and the bilirubin is not reduced by phototherapy, a procedure called exchange transfusion may be indicated.
A baby treated with phototherapy would usually be shone overnight with their serum bilirubin checked again afterwards. If the bilirubin level is below the phototherapy level, the baby does not need phototherapy but would need follow-up assessments of their bilirubin level.
In cases of mild jaundice in which no phototherapy is indicated, the condition should gradually resolve. Sunlight exposure is not recommended as there is a risk of dehydration and sunburn.
Q: Will I able to feed and cuddle my baby during treatment?
A: During phototherapy, feeding can be continued as usual and the mother can stay by the baby’s side.
Q & A with Dr. Tay Chee Pin,
Consultant Paediatrician,
Pantai Hospital Klang
