Jaundice in newborns is typically a benign and self-limiting condition; however, timely and appropriate treatment is essential to prevent complications such as acute bilirubin encephalopathy or kernicterus.
The main goal of treatment is to lower high bilirubin levels before they become harmful to the brain. Most babies with jaundice in newborns only need close monitoring and general care. But in more serious cases, doctors need to take medical action.
This section explains the treatment options for jaundice in newborns. It covers when to start therapy, which methods are used, and how plans may differ based on the cause and severity. A clear and organised approach helps protect newborns, especially those who have other health problems.
Determining the Need for Treatment
Before starting any treatment, doctors check if it’s needed by doing the following:
- Measuring bilirubin in the blood (TSB) or through the skin (TcB)
- Looking at the baby’s age in hours using special bilirubin charts
- Considering risks like early birth, infection, G6PD deficiency, or birth injury
Doctors start treatment if bilirubin levels go near or above the limits. These limits are lower for babies who are sick or born early because their bodies are more sensitive to bilirubin.
Phototherapy in Jaundice in Newborns
Phototherapy is the most common and effective way to treat jaundice in newborns. This treatment shines blue light on the baby’s skin. The light changes bilirubin into a form that leaves the body in urine and stool, even without help from the liver.
Types of Phototherapy
- Regular phototherapy: Uses overhead blue lights or LED lamps.
- Fibre-optic (biliblanket): A glowing blanket or pad placed on the baby’s skin.
- Intensive phototherapy: Uses stronger lights close to the skin for serious cases.
Phototherapy is safe and does not hurt. But babies under phototherapy must be checked often:
- Bilirubin levels tested every 4 to 12 hours
- Body temperature watched to avoid overheating
- Good feeding to keep the baby hydrated
- Eyes covered to protect them from the light
Exchange Transfusion for Severe Jaundice
In very rare and serious cases of jaundice in newborns, if phototherapy fails or bilirubin is dangerously high, doctors may perform an exchange transfusion. This involves slowly removing the baby’s blood and replacing it with donated blood to:
- Quickly lower bilirubin levels
- Remove harmful antibodies (in cases like Rh problems)
- Help with oxygen delivery if the baby has anaemia
Exchange transfusion is risky and needs skilled care in an intensive unit. Doctors choose this only when:
- Bilirubin stays too high despite strong phototherapy
- The baby shows signs of brain trouble from bilirubin
- Serious blood issues like Rh or ABO mismatch are present
Even though the procedure has risks (such as infection or bleeding), it can save lives when used correctly.
Using IVIG in Jaundice in Newborns
If a baby has jaundice from immune problems like Rh or ABO mismatch, IVIG may be given through a vein. IVIG works by:
- Slowing down the destruction of red blood cells
- Cutting down bilirubin made from broken blood cells
When given early, IVIG helps lower bilirubin well. Doctors often use it along with phototherapy.
Feeding Support for Jaundice in Newborns
Good feeding plays a key role in treating jaundice in newborns, especially in less severe cases. Hydration helps bilirubin leave the body in pee and poop. Feeding also triggers more bowel movements, which clears bilirubin from the gut.
Tips for Breastfed Babies
- Feed every 2–3 hours
- Check how well the baby latches and drinks
- Add formula for a short time if baby isn’t drinking enough
Tips for Formula-fed Babies
- Keep a regular feeding routine
- Make sure the baby is gaining weight and staying hydrated
If breastfeeding is the cause, better milk flow and feeding techniques usually fix the problem. In breast milk jaundice (caused by things in the milk that slow bilirubin breakdown), the issue may last longer but rarely needs stopping breastfeeding.
Treating the Cause of Jaundice in Newborns
If a specific illness causes jaundice in newborns, treating that illness is key:
- Infections like sepsis or UTIs need antibiotics
- Metabolic issues like galactosaemia require special diets
- Thyroid problems need thyroid hormone treatment
- Biliary atresia needs surgery, often before 8 weeks of age, to help drain bile and protect the liver
Detailed testing helps find the cause and shape treatment beyond just managing symptoms, especially when a type called conjugated jaundice is suspected.
Monitoring After Treatment
After going home, babies treated for jaundice in newborns need regular checks to make sure:
- Bilirubin stays at safe levels
- Feeding is going well
- Weight gain is on track
If jaundice lasts longer than two weeks in full-term babies, doctors will check for more serious problems. Follow-ups include:
- Testing bilirubin again
- Checking growth
- Giving parents advice
Parental Support and Home Care
Teaching parents is a big part of care for jaundice. Parents should:
- Check skin and eye colour in natural light
- Count wet nappies and stools
- Feed often
- Go to follow-up appointments
Parents also need to know when to seek help. Signs like deep sleepiness, high-pitched crying, poor feeding, or stiff/floppy limbs may mean the baby is in danger from bilirubin.
In some places, babies can get phototherapy at home with doctor supervision. This option helps in mild cases and avoids hospital stays.
Conclusion: Jaundice in Newborns
The treatment of jaundice in newborns ranges from simple blue-light therapy to more serious steps like blood exchange or IVIG. The key to good care is spotting the problem early, acting quickly, and keeping track of the baby’s progress.
When health workers follow proper treatment plans and parents understand how to help, most babies recover well from jaundice in newborns. A complete and careful approach gives every baby the best chance at a healthy start.
