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Neonatal Jaundice
Identifying and Treating Jaundice
By Mary Weidler
What Gina Friars of Woodbury, N.J. remembers about her first son at birth was his suntan.
"Jason must have inherited my love for the sun," she told relatives and friends when they visited the hospital to see her baby. "He isn't pale or red like the rest of the babies. He looks almost bronzed."
Jason was the "golden boy" of the nursery, but his pediatricians didn't admire the "tan." Instead, they diagnosed Jason with jaundice, a usually harmless condition that affects 50 to 70 percent of all newborns. Fortunately, Jason's "golden glow" cleared up after a few phototherapy treatments, during which the baby had to spend time under special sunlamps (like mother, like son, indeed!).
"Most jaundice is actually hyperbilirubinemia," says Dr. Gary Edelstein, a Manhattan pediatrician. "That's just a technical way of saying the baby gets yellow. Generally, the appearance of jaundice indicates that the baby has an increased breakdown of red blood cells. It could mean that the pathway for the elimination of the bilirubin is immature, so the liver becomes overwhelmed."
Every day, one percent of a person's blood cells are replaced, and the old cells break down and are processed through the liver. Bilirubin – a bi-product of this normal breakdown of red blood cells – usually leaves the body through feces and other excretions. When the bilirubin builds up quicker than the liver can break it down, jaundice appears.
"An easy way to explain the process is to compare it to a bruise in the arm," says Dr. Alan Greene of ABC Pediatrics in San Mateo, Calif. "The color of the bruise changes as it is broken down and processed. The yellow pigment you see in the bruise is actually the red blood cells being broken down. Similarly, the yellow pigment of jaundice is actually the result of hemoglobin – the red pigment in blood cells – being broken down."
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