How is neonatal jaundice treated?

Ensuring that the baby feeds early and regularly will stimulate the intestine so that the re-absorption of the bile is minimised.

Neonatal jaundice is treated by means of phototherapy. When unconjugated bilirubin is subjected to specific fluorescent light-waves, its structure is changed and it becomes water-soluble. This means that the excess can also be cleared in the urine. Whilst undergoing phototherapy, the baby’s eyes must be protected against light. The baby must be fed regularly to keep up a good urine output and to prevent dehydration. The baby may have loose stools whilst undergoing phototherapy and may also become “tanned”.

Charts have been devised (one for term and one for preterm babies) to assist health professionals as to how and when to intervene in the management. The course of action depends on the baby’s age and the bilirubin level.

In severe haemolytic disease, if the unconjugated levels rise to above 350 ìmol/l, it may be necessary to do an exchange transfusion. Here an attempt is made to remove the baby’s own blood, the bilirubin, and the antibodies causing the haemolysis, and to replace with donor blood. An exchange transfusion may be performed in other circumstances where the unconjugated bilirubin is excessively raised or there is severe anaemia. This is not a simple procedure. Not just the TSB level but many other factors have to be considered such as the cause of the jaundice, the age of the baby, whether the baby has other problems and so on before embarking on an exchange transfusion.