Neonatal Jaundice

INTRODUCTION

• Neonatal jaundice is a common condition in newborns characterized by yellow discoloration of skin and eyes due to increased bilirubin. It occurs in about 60% of term and 80% of preterm babies.

  
  

DEFINITION

Neonatal jaundice is yellow discoloration of skin, sclera, and mucous membranes due to serum bilirubin >5 mg/dL in newborns.

TYPE

CAUSES

Physiological

• Increased RBC breakdown

• Immature liver enzymes

• Increased enterohepatic circulation

Pathological

• Hemolysis (Rh/ABO incompatibility)

• Infection (sepsis)

• Birth trauma (cephalohematoma)

• Liver disorders

  
  

RISK FACTORS

• Prematurity

• Low birth weight

• Birth asphyxia

• Sepsis

• Blood group incompatibility

• Poor feeding

  
  

CLINICAL MANIFESTATIONS

Main Signs

• Yellow discoloration (starts from face → spreads downward)

Other Signs

• Poor feeding

• Lethargy

• High-pitched cry

• Hypotonia

⚠️ Severe Signs (Danger)

• Opisthotonus (arching)

• Seizures

• Kernicterus (brain damage)

  
  

DIAGNOSIS

Clinical Assessment

• Kramer’s rule (zone-wise jaundice)

Laboratory Tests

• Serum bilirubin (total & direct)

• Blood group & Rh typing

• Coombs test

• CBC

  
  

MANAGEMENT

1. Phototherapy (Main Treatment)

• Blue light converts bilirubin → excretable form

2. Exchange Transfusion

• For severe cases

• Removes bilirubin rapidly

3. Supportive Care

• Adequate feeding (breastfeeding)

• Maintain hydration

• Monitor bilirubin levels

4. Treat Underlying Cause

• Antibiotics (if infection)

• Treat hemolysis

  
  

COMPLICATIONS

• Kernicterus (bilirubin encephalopathy)

• Hearing loss

• Cerebral palsy

• Developmental delay

  
  

PREVENTION

• Early and frequent breastfeeding

• Monitor high-risk babies

• Blood group screening

• Early detection

  
  

NURSING MANAGEMENT

• Monitor jaundice progression

• Eye care during phototherapy

• Maintain temperature

• Record intake/output

• Parent education

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🚀Here’s a short “exam trick” version for Neonatal Jaundice — super quick points you can remember :

🧸 Introduction

👉 Common newborn condition with yellow discoloration due to high bilirubin.

📖 Definition

👉 Yellow staining of skin & sclera when bilirubin >5 mg/dL

🟡 Types

👉 Physiological, Pathological, Breastfeeding, Breast milk, Hemolytic

⚡ Causes

👉 Increased RBC breakdown + immature liver + hemolysis/infection

⚠️ Risk Factors

👉 Prematurity, low birth weight, sepsis, blood incompatibility

🧠 Clinical Features

👉 Yellow skin, poor feeding, lethargy, high-pitched cry

🚨 Severe Signs

👉 Seizures, opisthotonus, kernicterus

🔍 Diagnosis

👉 Serum bilirubin + blood group + Coombs test

💡 Assessment

👉 Kramer’s rule (face → whole body progression)

💊 Treatment

👉 Phototherapy is main treatment

🔴 Severe Treatment

👉 Exchange transfusion for very high bilirubin

🧴 Supportive Care

👉 Adequate feeding + hydration + monitoring

👩‍⚕️ Nursing Care

👉 Eye care, temp maintenance, monitor bilirubin

⚠️ Complications

👉 Kernicterus, hearing loss, cerebral palsy

🛡️ Prevention

👉 Early breastfeeding + screening + infection control

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🚀Here’s a set of 07 MCQs on Neonatal Jaundice for practice:

1. Neonatal jaundice becomes clinically visible at bilirubin level:

A. 2 mg/dL

B. 5 mg/dL

C. 10 mg/dL

D. 15 mg/dL

✅ Answer: B

2. Physiological jaundice usually appears:

A. Within 12 hours

B. Within 24 hours

C. After 24 hours

D. After 7 days

✅ Answer: C

3. Which is a sign of pathological jaundice?

A. Appears after 3 days

B. Resolves in 1 week

C. Appears within 24 hours

D. Mild jaundice

✅ Answer: C

4. Main treatment of neonatal jaundice:

A. Antibiotics

B. Phototherapy

C. Surgery

D. Oxygen therapy

✅ Answer: B

5. Breastfeeding jaundice is mainly due to:

A. Excess milk

B. Poor feeding

C. Infection

D. Liver disease

✅ Answer: B

6. Severe complication of neonatal jaundice:

A. Anemia

B. Kernicterus

C. Pneumonia

D. Diarrhea

✅ Answer: B

7. Which condition causes hemolytic jaundice?

A. Dehydration

B. Prematurity

C. Rh incompatibility

D. Poor feeding

✅ Answer: C