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What Causes Jaundice In Newborns - Causes | Symptoms | Treatments - Wit Biology

                                        INFANT JAUNDICE 

        Neonatal jaundice (Infant Jaundice)... So just to run through what we're discuss go through Definitions, the causes of neonatal jaundice, clinical features, investigations and management. 

        So why do we need to learn about neonatal jaundice well over 60% of newborns become Dauntless this may be physiological or it may be due to underlying disease and this may have serious consequences as high unconjugated serum bilirubin is neurotoxic and can cause deafness connectors and athetoid cerebral palsy. Just to run through some definitions a neonate is defined as between birth and until 28 days postnatally and jaundice is when the serum bilirubin is over 30 millimoles per liter. 

        So what are the causes of neonatal jaundice well it's best to divide these into causes according to the age of onset of jaundice as this is a useful guide to the likely cause. So if the baby develops darkness within 24 hours it's usually a hematological condition such as recess hemolytic disease ABO incompatibility g6pd deficiency or even it could be a congenital infection between 24 hours and 2 weeks could be physiological jaundice which we'll discuss in more detail later or breast milk. 

        Jundice are also infection again hemolytic disorders or breathing if the baby develops jaundice when they're over two weeks old it's important to divide these inter unconjugated bilirubin and conjugated bilirubin. The unconjugated causes are again physiological and breast milk jaundice again infection. But also hypothyroidism and the hemolytic disorders. If the bilirubin is conjugated then the causes could be sepsis, TPN, Neonatal hepatitis,  Cystic fibrosis or bile duct obstruction. So just to discuss in a bit more detail physiological jaundice is very common so often starts when the baby is 24 hours old it peaks at a few days but always resolves by day 14 the mechanism is due to the immaturity of hepatic bilirubin conjugation an action is required. 

        If the serum bilirubin is over 260 millimoles per liter breast milk .Jaundice is when jaundice is exacerbated just due to the contents of what's in the breast milk the cause for this is unknown infection is also an important cause of jaundice and this is due to a number of mechanisms. Firstly poor fluid intake by the infant hemolysis reduced hepatic function or an increase in entero hepatic circulation conjugated jaundice is suggested by dark urine and pale stools. Billary atresia is an important cause to remember so the clinical features of neonatal jaundice are firstly that the jaundice progresses in a cough alack caudal direction. It's observed most easily by directly blanching the skin and in direct sunlight the manifestations of connectors are lethargy poor feeding irritability and increased tone.

         So to run through the investigations that you do for a neonate that was doing this firstly you could just do a urine dip to rule out a urinary tract infection and send this off the culture if necessary the investigations done within the Bloods would be that you had checked the level of the serum bilirubin. There are now a lot of transcutaneous bilirubin meters in hospitals. But these are often inaccurate so best to take a venous sample you can check the hemolytic disorders by doing an FBC in film checking the blood group and doing a direct Coombs test to check for infection a capillary blood gas is always useful and you can consider a septic screen. Such as lfts a tort screen TFT is a beaker to rule out hypothyroidism. 

         You can also do hepatitis serology our red blood cell deflects and tests for cystic fibrosis imaging is required to rule out biliary atresia this could be a liver ultrasound scan or a liver biopsy or even nuclear medicine liver scans. 

So now to discuss the management of neonatal jaundice. 

        The management of neonatal jaundice depends totally on the level of the serum bilirubin and the age in days of the baby. This is an example of the guidelines from Norway but every hospital has their own guidelines and they all looked fairly similar to this in essence. 

        The basic management is to encourage regular feeding as dehydration exacerbates jaundice and phototherapy.
        If according to the guidelines it's required this is commonly used and light waves convert the unconjugated bilirubin into harmless water soluble pigment very rarely an exchange transfusion is required when the serum bilirubin is extremely high the prognosis for neonatal jaundice is generally good and luckily connector assess a rare complication nowadays. But it is serious and needs to be remembered. 

        So in summary we've gone through the basic definitions of jaundice,  the common causes, how to investigate it and the principles of management thanks for Reading ❤️✌️... 

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