Bilirubin is the breakdown part of old and used red blood corpuscles in the body. And this bilirubin is responsible for the yellow color of jaundice. And when these bilirubins become excess, jaundice develops. The condition of excess bilirubin in blood is known as hyperbilirubinemia.
Etiology – normal bilirubin metabolism requires the following factors.
1 maturity in livers
2 normal load of bilirubin
3 adequate quality and quantity of glucuronic acid conjugate for conversion of the fat-soluble bilirubin (it is called as indirect bilirubin) in order to water soluble (direct) bilirubin for proper excretion.
4 normal biliary passages.
5 patency and motility for intestines.
The indirect bilirubin that crosses the immature blood-brain barrier causing kernicterus or brain damage, and if it occurs, it is a serious condition.
So it is in the ‘matured liver’ who takes up the bilirubin and after a series of a process, it is released into the intestine, since the liver of the new born is not matured enough to remove the bilirubin quickly, there is excess of bilirubin in blood, this condition is known as physiological jaundice.
In infants jaundice may be also due to-
Sepsis
Blood incompatibility between mother’s blood and infant’s blood.
Internal bleeding
Bacterial or viral infection
Malfunctioning of liver
Deficiency of certain enzymes.
In newborn, jaundice appear on about the 4th day and last for 5 days in full-term babies. But it may extend up to 7 days in preterm infants. And the increases in value began to decline by about 2 mg% which last for up to 14 days in the second phase. This may last for more than one month in preterm infants and with exclusive breast-feeding and usually requires no intervention.
Symptoms
In new-born, jaundice first appears in the skin and white of the eyes. It should be examined under the day light
How to check jaundice in new born?
Examination in natural light is a must to check the neonatal jaundice. Gently press on the tip of the nose or forehead of the baby. If there is paleness while pressing there is no jaundice.
Features of pathological jaundice
(i) Jaundice in first 24 hours
(ii) Increase in total bilirubin > 0.5mg/dl/hr
(iii) Total bilirubin >15mg/dl
(iv) Direct bilirubin>2mg/dl
Treatment
Frequent breast-feeding is good to remove the excess bilirubin. Feed the baby at least in every 2 to 3 hours in a day and whenever the child wakens at night.
Sun bath-expose the infant to sunlight daily for about 15 minutes for 3 times a day.
How to perform a sun bath?
Keep the baby exposed next to a closed window and let the sunlight rays shine on the body for about 15 minutes. The baby should be fully exposed.
Even after the above measures if the discoloration spread to other parts of the body, and the infant refuses to take breast milk, and if there are fever and excessive crying, then definitely it is time to consult the doctor.
Homeopathic treatment
Homeopathy is definitely effective in the treatment of neonatal jaundice.
Usual remedies are Chamomilla, Arnica, Nux vom, Merc sol etc.;
