TIMBREZA, Mercel Jaine Q.

BSN2-A

Jaundice in newborns is the yellow coloring in an infant’s skin. Jaundice occurs when bilirubin builds up
in your baby’s blood. Hyperbilirubinemia is the medical term for this condition.

- Bilirubin is a yellow substance your body creates when red blood cells break down. While you’re
pregnant, your liver removes bilirubin for your baby. But after birth, your baby’s liver must begin
removing bilirubin. If your baby’s liver isn’t developed enough, it may not be able to get rid of
bilirubin. When excess bilirubin builds up, your baby’s skin may appear yellow.
Jaundice in infants is common. It’s usually not serious and goes away within a couple of weeks. But it’s
important for your baby’s healthcare provider to check them for jaundice. Severe jaundice can lead to
brain damage if it goes untreated.

TYPES:
1. Physiological jaundice
- The most common type of jaundice in newborns is physiological jaundice. This type of jaundice
is normal. Physiological jaundice develops in most newborns by their second or third day of life.
After your baby’s liver develops, it will start to get rid of excess bilirubin. Physiological jaundice
usually isn’t serious and goes away on its own within two weeks.
2. Breastfeeding jaundice
- Jaundice is more common in breastfed babies than formula-fed babies. Breastfeeding jaundice
frequently occurs during your baby’s first week of life. It happens when your baby doesn’t get
enough breast milk. It can occur due to nursing difficulties or because your milk hasn’t come in
yet. Breastfeeding jaundice may take longer to go away.
3. Breast milk jaundice
- Breast milk jaundice is different than breastfeeding jaundice. Substances in your breastmilk your
breast milk can affect how your baby’s liver breaks down bilirubin. This can cause a bilirubin
buildup. Breast milk jaundice may appear after your baby’s first week of life and may take a
month or more to disappear.
Other types of jaundice can occur if your baby has an unrelated medication condition.
CAUSES:
It is normal for a baby's bilirubin level to be a bit high after birth.
When the baby is growing in the mother's womb, the placenta removes bilirubin from the baby's body.
The placenta is the organ that grows during pregnancy to feed the baby. After birth, the baby's liver
starts doing this job. It may take some time for the baby's liver to be able to do this efficiently.
Most newborns have some yellowing of the skin, or jaundice. This is called physiological jaundice. It is
usually noticeable when the baby is 2 to 4 days old. Most of the time, it does not cause problems and
goes away within 2 weeks.

Severe newborn jaundice may occur if the baby has a condition that increases the number of red blood
cells that need to be replaced in the body, such as:

Abnormal blood cell shapes (such as sickle cell anemia)

Blood type mismatch between the mother and baby (Rh incompatibility or ABO incompatibility)
Bleeding underneath the scalp (cephalohematoma) caused by a difficult delivery
Higher levels of red blood cells, which is more common in small-for-gestational age (SGA) babies and
some twins
Infection
Lack of certain important proteins, called enzymes
SYMPTOMS:
Jaundice causes a yellow color of the skin. It usually begins on the face and then moves down to the
chest, belly area, legs, and soles of the feet.
Sometimes, infants with severe jaundice may be very tired and feed poorly.

TESTS that will likely be done include:

- Complete blood count
- Coombs test
- Reticulocyte count
TREATMENT:
A baby with jaundice needs to take in plenty of fluids with breast milk or formula:

Feed the baby often (up to 12 times a day) to encourage frequent bowel movements. These help
remove bilirubin through the stools. Ask your provider before giving your newborn extra formula.
In rare cases, a baby may receive extra fluids by IV.
Some newborns need to be treated before they leave the hospital. Others may need to go back to the
hospital when they are a few days old. Treatment in the hospital usually lasts 1 to 2 days.

Sometimes, special blue lights are used on infants whose levels are very high. These lights work by
helping to break down bilirubin in the skin. This is called phototherapy.

The infant is placed under these lights in a warm, enclosed bed to maintain a constant temperature.
The baby will wear only a diaper and special eye shades to protect the eyes.
Breastfeeding should be continued during phototherapy, if possible.
In rare cases, the baby may need an intravenous (IV) line to deliver fluids.
TIMBREZA, Mercel Jaine Q.
BSN2-A

NEWBORN SCREENING TEST

Newborn screening tests look for developmental, genetic, and metabolic disorders in the newborn baby.
This allows steps to be taken before symptoms develop. Most of these illnesses are very rare, but can be
treated if caught early.
The types of newborn screening tests that are done vary from state to state. By April 2011, all states
reported screening for at least 26 disorders on an expanded and standardized uniform panel. The most
thorough screening panel checks for about 40 disorders. However, because phenylketonuria (PKU) was
the first disorder for which a screening test developed, some people still call the newborn screen "the
PKU test".
In addition to blood tests, screening for hearing loss and critical congenital heart disease (CCHD) is
recommended for all newborns. Many states require this screening by law as well.

How the Test is Performed

Screenings are done using the following methods:
- Blood tests. A few drops of blood are taken from the baby's heel. The blood is sent to a lab for
analysis.
- Hearing test. A health care provider will place a tiny earpiece or microphone in the infant's ear.
Another method uses electrodes that are put on the baby's head while the baby is quiet or
asleep.
- CCHD screen. A provider will place a small soft sensor on the baby's skin and attach it to a
machine called an oximeter for a few minutes. The oximeter will measure the baby's oxygen
levels in the hand and foot.
The baby will most likely cry when the heel is pricked to get the blood sample. Studies have shown that
babies whose mothers hold them skin-to-skin or breastfeed them during the procedure show less
distress. Wrapping the baby tightly in a blanket, or offering a pacifier dipped in sugar water, may also
help ease pain and calm the baby. The hearing test and the CCHD screen should not cause the baby to
feel pain, cry, or respond.
Screening tests do not diagnose illnesses. They show which babies need more testing to confirm or rule
out illnesses.
If follow-up testing confirms that the child has a disease, treatment can be started, before symptoms
appear.

 Blood screening tests are used to detect a number of disorders. Some of these may include:
- Amino acid metabolism disorders
- Biotinidase deficiency
- Congenital adrenal hyperplasia
- Congenital hypothyroidism
- Cystic fibrosis
- Fatty acid metabolism disorders
- Galactosemia
- Glucose-6-phosphate dehydrogenase deficiency (G6PD)
- Human immunodeficiency disease (HIV)
- Organic acid metabolism disorders
- Phenylketonuria (PKU)
- Sickle cell disease and other hemoglobin disorders and traits