As a Houston, Texas medical malpractice lawyer, I handle a lot of cases related to labor and delivery and newborn care.
One of the most common conditions in newborns is jaundice, also called hyperbilirubinemia, which causes the skin to turn yellow. About 60% of newborns and 80% of premature babies develop jaundice. Bilirubin, a pigment or chemical naturally found in our bodies, is the culprit or cause of jaundice in babies.
When our bodies break down old the protein in red blood cells, it produces bilirubin. When a baby is still in the womb, the mother’s liver filters out bilirubin. After birth, the liver in some newborns is not developed enough to be able to get rid of the bilirubin quickly enough. In those situations, the bilirubin builds up in the blood and causes jaundice.
What to look out for in jaundice
Doctor look out for mild jaundice in newborns because it can either be a normal, harmless process or the first sign of a serious medical problem.
In most situations, jaundice is first noticed by a yellowish tint that usually appears first on the baby’s face before spreading to the chest, stomach, arms, and legs. It can also cause the whites of the eyes to look yellow. Jaundice is sometimes harder to spot in babies with darker skin colors. Jaundice babies are often poor feeders and lethargic.
Once jaundice is suspected, the standard of care requires blood work to determine bilirubin levels. A comprehensive bilirubin test measures all three bilirubin levels in the blood, including direct, indirect, and total.
Many newborns have a high bilirubin level simply because of the stress of the birthing process. A normal expected value for an indirect bilirubin level in a newborn is less than 5.2 mg/dL within the first 24 hours of birth. A newborn is considered to have jaundice if bilirubin levels are above 5 mg/dL within the first few days after birth.
Causes of newborn jaundice
Pediatricians and neonatologists have found three main causes of easily-treatable newborn jaundice. First is physiological jaundice, which develops at two to four days after birth caused by temporary delay in the functioning of the liver. Second is breast-feeding jaundice, which develops during the first week of life when the baby is not getting enough milk. Third is breastmilk jaundice, which shows up around the second or third week of life, when the baby encounters difficulty processing breastmilk.
There are other causes of jaundice that are more serious, including abnormal blood cell shapes, a blood type mismatch between the baby and mother, genetic defects, complications of delivery, premature delivery, and infections.
Treating jaundice in babies
Quite often, mild newborn jaundice will resolve on its own within two or three weeks. For moderate or severe jaundice, though, additional treatment may be necessary.
The most common treatment is phototherapy, which is also called light therapy. Special lighting causes bilirubin to change in shape and structure, such that it can be eliminated through urine and stool. Our pediatrician prescribed a phototherapy fibe-roptic blanket for one of our children for about a week after birth. It involved keeping the baby wrapped in a glowing blanket. We called her our little glow-worm. It took care of the jaundice quickly and that was the end of it.
If the jaundice is related to a blood type difference between the baby and mother, then the doctor may order a medical therapy called IV immunoglobulin.
When jaundice does not resolve in response to other treatments, the baby may require an exchange transfusion of blood to dilute the bilirubin levels.
Serious danger of untreated jaundice
Although low levels of bilirubin do not cause a large concern in most pediatricians and neonatologists, large amounts can cause seizures and brain damage. This permanent brain condition is called kernicterus. Kernicterus is a very rare type of brain damage that may be prevented by treating jaundice early before it gets severe.
Experts consider jaundice appearing in the first 24 hours after birth to be serious and requiring immediate treatment. Jaundice appearing a day or two after birth is usually not serious, but still warrants attention. If it appears toward the end of the first week after birth, it is usually caused by an infection. If jaundice shows up even later, it is often related to breast-feeding’s, but could have many other causes.
We are here to help
If you or a loved one has a child who was severely injured because a doctor, hospital, or other healthcare provider failed to properly and timely treat jaundice, then call Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who focuses his law practice on representing patients and family members in medical negligence and wrongful death cases. He has handled a variety of labor, delivery, newborn, infant, pediatric, and adult cases where medical mistakes or malpractice caused serious injury or death.