Jaundice is a term used to describe the yellowing of skin tone and jaundice in babies is referred to as neonatal jaundice.
This yellowing is caused by a naturally occurring substance in the body called bilirubin and elevated levels of bilirubin in the blood stream is known as hyperbilirubinemia.
Why might a baby have neonatal jaundice?
Jaundice itself is not painful and isn’t a disease. Bilirubin is produced when red blood cells are broken down in the liver, after which they are excreted from the body in our faeces. However, not only do newborn babies have a higher number of red blood cells which are being produced and replaced at a more frequent rate than adults, their livers are also not as fully developed and so are not as effective at removing the bilirubin from the blood. This leads to a backlog of excess bilirubin, which causes jaundice.
Also, in the early days of a newborn’s life, if breastfeeding is not properly monitored to ensure it has been established there is a risk the newborn may not be getting sufficient calories or nutrients and is then at an increased risk of developing jaundice.
In certain cases though, neonatal jaundice can be caused by other health problems, such as urinary tract infections, a problem with gallbladder function or hypothyroidism, for example. These causes of neonatal jaundice are known as pathological jaundice.
What are the signs of neonatal jaundice?
As with adults, jaundice in newborn babies initially causes yellowing of the skin, whites of the eyes and gums. A newborn baby with jaundice may also be sleepy, have very dark yellow wee (a newborn’s urine should be light in colour or colourless) and may not be feeding well.
Usually newborn babies are examined within 72 hours for jaundice as part of their newborn examination. In most instances, jaundice is seen as harmless and will resolve on its own without treatment after a couple of weeks.
It may be however, that a baby develops jaundice after 72 hours, or that the jaundice does not resolve on its own and symptoms worsen. For example, the baby may develop a fever, start arching their neck or back backwards, the whites of their eyes may yellow and they may become very irritable and difficult to console. In such circumstances, the baby should be taken to their GP or to see a nurse for a check-up and to have tests performed to check their bilirubin levels.
Such tests would include a visual examination for signs of jaundice in natural light and if necessary a bilirubin test to check the levels in the blood. If the bilirubin level in the newborns blood is high then the reading will be used to determine the treatment needed.
What is the treatment for neonatal jaundice?
If it is decided that treatment is needed as the bilirubin levels are high then the baby may be treated with phototherapy or exchange transfusion.
- Phototherapy uses exposure to a special light source and a process called photo-oxidation to help the liver break down the bilirubin.
- Exchange transfusion is often attempted if the bilirubin levels are very high and phototherapy has not worked. Exchange transfusion involves a complete blood transfusion.
Whilst both of these treatments are intensive and intrusive, if the jaundice is untreated it can lead to serious conditions as the bilirubin can be toxic to the baby’s nervous system and can in some instances lead to brain damage.
What if neonatal jaundice is left untreated?
Where the bilirubin levels are severely high and have been left untreated, bilirubin can cross in to the brain from the blood and cause damage to a newborn’s brain and spinal cord.
Where excess bilirubin damages the brain this can lead to a very serious condition called Kernicterus. Symptoms of Kernicterus include seizures, lethargy, apnoea and irritability.
In some instances, even if treatment is successful in lowering bilirubin levels in the blood, it may be that the neonatal jaundice was not picked up until significant brain damage had been sustained, or treatment was started too late to effectively treat the jaundice. A baby may therefore still develop lifelong problems as a result of the toxic bilirubin levels such as hearing loss, learning disabilities and cerebral palsy.
Claims arising out of neonatal jaundice
If you or a loved one has suffered an injury as a result of hyperbilirubinemia due to negligent medical treatment you may be able to make a claim for compensation.
Whilst jaundice is relatively common among newborn babies, if it is not monitored or treated properly it can lead to potentially life changing and life threatening conditions which will have a significant impact upon the child and their family.
How can Nelsons help?
If you have been affected by the points raised in this article or would like information in relation to neonatal jaundice negligence claims, please contact Kate or another member of the team in Derby, Leicester or Nottingham on 0800 024 1976 or via our online form.
At Nelsons, our team prides itself on our friendly and professional service and we are always happy to discuss queries over the phone, via email or where appropriate at a meeting.