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Newborn Has Physiological Jaundice And Treatment Isn’t Helping!

how treat physiological jaundice
Baby with physiological jaundice – not the one in the question.
2 weeks ago our doctor said that our newborn son was a little bit yellow, so he has physiological jaundice and needed some treatment. He was then 26 days old.

The doctor suggested glucose water mixed with charcoal (carbon tablet) of 200ml per day. My son is refusing to drink, hardly takes 100ml.

When I checked his bilirubin level 1 week ago it was 5.8, I again started to give glucose and after 5 days checked bilirubin – it was 6.3.

I am worried. Why is the level increasing? The local doctor said it is because of not enough glucose.

Can you suggest me what I have to do?

by Aisha (Ashgabat,Turkmenistan)

Baby Helpline:

How To Treat Physiological Jaundice In Newborn

I have a feeling that there is a slight confusion here. What babies in most cases need when they have jaundice is liquid and sun light. So if you breastfeed, do that as much as you can and keep your baby in daylight as much as possible. Not in direct sun light, but as much day light a possible with as little clothes as possible. Put the crib by the window. Take long stroller walks. Nurse in a chair by the window.

The glucose, I believe, is only to make your baby drink more water – or possibly to increase your baby’s energy intake.

Is your baby increasing in weight? Does he wet several diapers every day? Is his urine clear? If so, then you can usually safely nurse him more often instead of offering water to help him get rid of jaundice. A common recommendation for babies with jaundice is to nurse as often as every second hour around the clock until bilirubin levels start to come down to levels that are not dangerous.

The charcoal might help, but it is not a common treatment. Phototherapy is much more common, actually the norm. And home treatment is generally what I just told you; breastfeeding and daylight.

Breast Milk Jaundice

There is one type of jaundice that is called breast milk jaundice, because it occurs in healthy, breastfed babies. This type of jaundice usually peaks at around 3 weeks of age, but it can take up to three months to disappear completely. It is not dangerous at all and no treatment is needed unless bilirubin levels become dangerously high.

Science isn’t clear on why some babies get breast milk jaundice. It tends to run in some families. One theory is that there is some substance in the breast milk that prevents certain proteins in the liver from breaking down the bilirubin. This affects some 0.5-2.4% of all newborn babies.

Since in this case it is substances in the actual breast milk that causes jaundice, more frequent breastfeeding obviously isn’t going to help. Sometimes, if the bilirubin levels climb very high, the mom will be asked to stop breastfeeding for 24 hours (and pump during this day) to see if the bilirubin levels fall.

But really, breast milk has huge health benefits for the baby, so to stop breastfeeding for a while, is usually only recommended as a treatment after all other options have been tried (like daylight and more frequent breastfeeding).

The bilirubin level that your baby has; around 6 isn’t very high. Bilirubin levels lower than 12 are typically not dangerous to the baby.

All this said, I still think you should take your son to see another doctor if possible. Since you are worried, and the treatment your doctor is recommending doesn’t help, a second opinion is always good.

In rare cases, some other illness is the reason to why the jaundice doesn’t disappear, and this can only be evaluated by a doctor.

Find more information about breastfeeding and jaundice here. (Opens in new window.)

I hope this helps. Please let me know about your son’s progress. He is lucky to have such an engaged mom!

Paula
(Answer approved by our Medical Reference Team)

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Comments

May 11, 2013

Update and thank you

by: Aisha


Dear Paula,
Thank you very much for your advice, this is what I am doing now:

I have stopped giving glucose, can’t see my child crying all the time, I just give him 20-30 ml a day.

Also doctor has prescribed viferon suppositories (its antiviral and boost his immune system, every 12 hours). His nose wasn’t clear, so the doctor said it might be cold.

Now he is fine, only on my milk +20ml of glucose.

Regarding sunligh, its winter time and very little sun over here. In 2 days time I have to visit doctor and check his bilirubin again.

One more thing Paula, not sure whether it’s related, but I am unable to get an answer, hope someone can help me. Every year I do tumor marker, and this time, my CA15-3 is risen to 400, when normal value from 0-25. I don’t have any symptoms of breast cancer, only urine infection almost every month, but during pregnancy, it didn’t disturb me. Doctor here doesn’t know why its so high, they suspect that it might be bcs of breastfeeding, as that can be a course of high numbers. I can’t do any further test as for that I have to stop breastfeeding.

What should I do? Does my child’s case with jaundice anyhow related to my problem?

thank you


May 11, 2013

Daylight vs Sunlight when jaundice

by: Paula (Baby Help Line)


Hi again Aisha,
I am happy to hear about things improving with your son.
One thing; you mention that the winter means very little sun light where you live. However, your baby doesn’t really need sun light, he needs day light to fight off jaundice. If you can’t go outside because it is too cold, then make sure to keep his crib next to the lightest window you have. Never pull the curtains when he is asleep and go outside with him as often as possible.

Regarding your own tumor tests – I am sorry, but this is really beyond me. I wish I could help you, but all I can do is to urge you to seek medical advice from some other doctor close to where you live if your first doctor doesn’t have any answers. Really – don’t wait with that!

All the best,
Paula


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