What is Jaundice?
Jaundice means the yellow appearance of the skin and whites of the eyes that occurs when the blood contains an excess of the pigment called bilirubin.
Bilirubin is a natural product arising from the normal breakdown of red blood cells in the body and is excreted in the bile, through the actions of the liver.
Although jaundice is most often the result of a disorder affecting the liver it can be caused by a variety of other conditions affecting for example the blood or spleen. It should be thoroughly investigated so that the underlying cause can be identified and treated.
What Causes Jaundice?
Bilirubin comes from red blood cells. When red blood cells get old, they are destroyed. Hemoglobin, the iron-containing chemical in red blood cells that carries oxygen, is released from the destroyed red blood cells after the iron it contains is removed. The chemical that remains in the blood after the iron is removed becomes bilirubin.
The liver has many functions. One of the liver's functions is to produce and secrete bile into the intestines to help digest dietary fat. Another is to remove toxic chemicals or waste products from the blood, and bilirubin is a waste product. The liver removes bilirubin from the blood. After the bilirubin has entered the liver cells, the cells conjugate (attaching other chemicals, primarily glucuronic acid) to the bilirubin, and then secrete the bilirubin/glucuronic acid complex into bile. The complex that is secreted in bile is called conjugated bilirubin. The conjugated bilirubin is eliminated in the feces. (Bilirubin is what gives feces its brown color.) Conjugated bilirubin is distinguished from the bilirubin that is released from the red blood cells and not yet removed from the blood which is termed unconjugated bilirubin.
Jaundice occurs when there is 1) too much bilirubin being produced for the liver to remove from the blood. (For example, patients with hemolytic anemia have an abnormally rapid rate of destruction of their red blood cells that releases large amounts of bilirubin into the blood), 2) a defect in the liver that prevents bilirubin from being removed from the blood, converted to bilirubin/glucuronic acid (conjugated) or secreted in bile, or 3) blockage of the bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines. (For example, the bile ducts can be blocked by cancers, gallstones, or inflammation of the bile ducts). The decreased conjugation, secretion, or flow of bile that can result in jaundice is referred to as cholestasis: however, cholestasis does not always result in jaundice.
How is Jaundice Treated?
Most jaundice needs no treatment, but when it does, phototherapy (light therapy) is considered very safe and effective: Placing your baby under blue "bililights" lights — naked in a bassinet, with his eyes covered — will often do the trick because ultraviolet light changes the bilirubin to a form that your baby can more easily dispose of in his urine. Another option involves wrapping your baby in a fiber-optic blanket called a bili-blanket or bili-pad. With a prescription from your doctor, you may be able to rent one of these blankets to treat your baby at home.
Phototherapy is usually effective, but if a baby develops a severe case of jaundice, or his bilirubin levels continue to rise despite phototherapy treatment, he may need to be admitted to the intensive care unit for a blood transfusion called an "exchange transfusion."
Something else you can do on your own to help reduce jaundice is make sure that your baby is getting plenty of breast milk or formula — so he'll have frequent bowel movements. If you have any concerns about jaundice, check with his doctor to make sure you're taking the right steps to get your baby back in the pink.