Jaundice is a common condition in newborns that causes yellowing of the skin and eyes due to high bilirubin levels. It is usually harmless and resolves on its own within 2 weeks as the liver matures. During the newborn physical examination, healthcare providers check for jaundice and examine the eyes, heart, hips, and testes for any abnormalities. Jaundice occurs because newborn livers are immature and less able to break down bilirubin from broken down red blood cells. It is treated only if bilirubin levels are very high to prevent potential brain damage, using phototherapy or blood exchange transfusions.

1. Jaundice
Pranav Patel

2. Introduction.
Jaundice is a common and usually harmless condition in
newborn babies that causes yellowing of the skin and the
whites of the eyes.
The medical term for jaundice in babies is neonatal
jaundice.

3. Symptoms.
Yellowing if the palms of the hands or soles of the feet.
Dark, yellow urine(a new born baby’s urine should be colorless)
Pale-colored poo(it should be yellow or orange)
The symptoms of newborn jaundice usually develop 2-3 days
after the birth and tend to get better without treatment by the
time the baby is about 2 weeks old

4. When to get medical advice?
If baby will be examined for signs of jaundice within 72
hours of being born as part of the newborn physical
examination, which includes screening tests to find out if
baby has any problems with their eyes,heart,hips and in
boys testes.

5. How is the newborn physical examination
done?
During the examination, the health professional will also:
ØLook into baby’s eyes with a special torch to check how their eyes look and
move.
ØListen to baby’s heart to check their heart sounds.
ØExamine their hips to check the joint.
ØExamine baby boys to see if their testes have descended into the scrotum.

6. What does newborn physical examination
check for?
Eyes:
The health professional will check the appearance and movement of baby’s eyes.
They are looking for cataracts, which is a clouding of the transparent lens inside the eye
and other conditions.
About 2 or 3 in 10,000 babies are born with problems with their eyes that need treatment.
Cataracts occurs when changes in the lens of the eye cause it to become less
transparent.

7. Heart:
The health professional will check baby’s heart. This is done by observing baby,
feeling baby’s pulses and listening of their heart with a stethoscope.
Sometimes heart murmurs are picked up. A heart murmur is where the heartbeat
has an extra or unusual sound caused by a disturbed blood flow through the heart.
Heart murmurs are common in babies. The heart is normal in almost all cases
where a murmur is heard,but about 1 in 200 babies has a heart problem that needs
treatment.

8. Hips:
Some newborns have hip joints that are not formed properly.
This is known as development dysplasia of the hip(DDH)
Left untreated,it can cause a limp or joint problems, about 1 or 2
in 1000 babies have DDH that needs to be treated.

9. Testicles:
Baby boys are checked to make sure their testicles are in the right place.
During pregnancy, the testicels form inside the baby’s body. They may not
drop down into the scrotum until a few months after birth.
In about 1 in 100 baby boys, the testicles only descend partially or not at
all.
This needs to be treated to prevent possible problems later in life, such as
reduced fertility.

10. Why does baby have jaundice?
Jaundice is caused by the buildup of bilirubin in the blood.
Bilirubin is a yellow substance produced when RBC,which carry
oxygen around the body are broken down.
Jaundice is common in newborn babies because babies have a
high number of RBC in their blood, which are broken down and
replaced frequently.

11. Also, a newborn baby’s liver is not fully developed, so it’s less
effective at removing the bilirubin from the blood.
By the baby is about 2 weeks old, the liver is more effective at
processing bilirubin, so jaundice often corrects bilirubin itself by
this age without causing any harm

12. Treating newborn jaundice.
Treatment for newborn jaundice is not usually needed because
the symptoms normally pass within 10-14 days, although they
can occasionally last longer.
Treatment is usually only recommended if tests show very high
levels of bilirubin in baby’s blood.

13. There are main two treatments that can be carried out in
hospitals to quickly reduce baby’s bilirubin level:
1. Phototherapy: a special type of light shines on the skin, which
alters the bilirubin into a form that can be more easily broken down
by the liver.
2. An exchange transfusion-where baby’s blood is removed using a
thin tube placed in their blood vessels and replaced with blood
from a matching donor; most babies respond well to treatment and
can leave hospital after a few days.

14. Complications.
If a baby with very high levels of bilirubin is not treated, there's a
risk they could develop permanent brain damage. This is known
as “kernicterus”
Kernicterus is very rare in the UK,affecting less than 1 in every
1,00,000 babies born.

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