Newborn Jaundice: Concerns and Follow-Up Care

Q: Newborn Jaundice: Concerns and Follow-Up Care

Hello： The baby's jaundice reached 31, and after an emergency exchange transfusion, it is now around 7. <br>Since there is a known case of G6PD deficiency, it is uncertain if there are other pathological causes, so I recommend consulting the physician who conducted the examinatio

Post-Jaundice Complications in Newborns

I would like to ask about my baby who was born on June 10th.
On June 13th (Saturday), the jaundice level at the clinic was 11.3.
Our baby has G6PD deficiency and was very pale at birth.
I noticed that while breastfeeding at the clinic, the baby's skin color seemed to darken, but I didn't realize it was jaundice since the color looked similar to when we got home.
It wasn't until Sunday when my sister visited and mentioned that the baby looked a bit yellow that I started to pay attention.
We were advised by friends and family that newborns often have jaundice and to just monitor it.
Additionally, the father was reluctant to take the baby to the hospital at such a young age for fear of infection, so we delayed until Wednesday for a check-up.
Initially, the hospital said the jaundice level was in the 20s, but they later called to say it was at 31, and we needed an urgent blood exchange.
After the exchange, the baby had a fever once, but the jaundice has since dropped to over 7 and is currently stable.
However, during the blood exchange, the baby experienced oxygen deficiency and often has a bluish tint to the face and lips at night.
I would like to know if this indicates any potential long-term effects.
Will our situation definitely lead to complications? The baby is only 16 days old and is starting to coo, which seems normal, right? The baby is also very active with kicking, but occasionally has leg twitching (the doctor mentioned that newborns can have delayed responses and advised us to wait and observe without worrying).
Is there anything else we can do to help? This is our first child, and I am really concerned! Do you have any recommendations for pediatric specialists? Thank you.

Zhuang Bao Ma, 20~29 year old female. Ask Date: 2015/06/26

Dr. He Shenglong reply Pediatrics

Hello: The baby's jaundice reached 31, and after an emergency exchange transfusion, it is now around 7.
Since there is a known case of G6PD deficiency, it is uncertain if there are other pathological causes, so I recommend consulting the physician who conducted the examinations and treatment.
Regarding the mentioned symptoms of cyanosis and convulsions, are they due to breath-holding or normal twitching? I suggest following up with a pediatric specialist.
As for potential long-term effects based on your correspondence, careful observation is indeed necessary.
If there are any concerns later on, a follow-up with a pediatric neurologist may also be warranted.
Both specialties are available at regional hospitals or medical centers.
I hope everything goes smoothly~~ Thank you for your message!

Reply Date: 2015/06/26

More Info

Understanding newborn jaundice is crucial for new parents, especially when there are additional health concerns such as G6PD deficiency (蠶豆症). Jaundice in newborns is a common condition characterized by a yellowing of the skin and eyes due to elevated bilirubin levels in the blood. This condition can arise from various factors, including the immaturity of the liver, which is responsible for processing bilirubin, or conditions like hemolytic disease, which can occur in infants with certain genetic predispositions.

In your case, your baby was born on June 10 and had a bilirubin level of 11.3 on June 13. This level indicates mild jaundice, which is not uncommon in newborns, especially those born slightly premature or with conditions like G6PD deficiency. The fact that you noticed a change in skin color and sought advice from family and friends is understandable, but it’s essential to rely on medical professionals for accurate assessments.

The delay in seeking medical attention until June 16, when the bilirubin level was significantly higher, led to the need for a blood exchange procedure. This is a critical intervention used to rapidly reduce bilirubin levels in cases of severe jaundice. After the exchange, it’s reassuring to hear that your baby’s bilirubin levels decreased to 7. However, the subsequent symptoms you mentioned, such as oxygen desaturation (indicated by the bluish discoloration of the face and lips), warrant careful monitoring.

Regarding your concerns about potential long-term effects, it’s important to understand that while severe jaundice can lead to complications like kernicterus (a form of brain damage), most infants recover well with appropriate treatment. The fact that your baby is showing normal developmental signs, such as vocalizing and moving limbs, is a positive indicator. The occasional leg twitching can be common in newborns and may not necessarily indicate a problem, but it’s wise to keep an eye on it and discuss any concerns with your pediatrician.

As for follow-up care, it’s crucial to maintain regular pediatric appointments to monitor your baby’s growth and development. Pediatricians can assess milestones and provide guidance on any concerns you may have. If you’re looking for a specialist, consider seeking a pediatrician with experience in managing newborns with jaundice and G6PD deficiency. They can provide tailored advice and reassurance as your baby grows.

In summary, while your baby’s jaundice and associated health concerns are understandably worrisome, with proper medical care and monitoring, many infants navigate these challenges successfully. Continue to observe your baby’s development and maintain open communication with your healthcare provider. If you have any lingering concerns or questions, don’t hesitate to reach out to a pediatric specialist who can provide the support you need during this critical time.

Similar Q&A

Understanding Newborn Jaundice: Causes, Risks, and Prevention Tips

Is it common for newborns to exhibit symptoms of jaundice? Recently, a relative and a friend of mine both gave birth, and their infants showed signs of jaundice, requiring them to stay in the hospital for phototherapy. Both mothers have healthy livers. I am currently seven months...

Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: Please consult with pediatrics, thank you! Hsinchu City Hospital, Department of Obstetrics and Gynecology.

Understanding Neonatal Jaundice: Causes, Treatment, and Recovery

Doctor: My child is 10 days old, and the hospital said the bilirubin level is relatively high, requiring phototherapy. However, there was no jaundice at birth, so I would like to ask you: Can jaundice appear so many days after birth? Also, the whites of the child's eyes are ...

Dr. Xiao Kaiwen reply Pediatrics
Neonatal jaundice may not appear immediately; it can also develop gradually. Jaundice is merely a symptom, and it is important to investigate the underlying cause to provide appropriate treatment, including determining whether the bilirubin levels are high enough to require photo...

Understanding Elevated Bilirubin Levels in Newborns: When to Seek Further Care

The baby is currently over one month old, but has a high bilirubin level. The first test showed T-BILIRUBIN 7.2, DIRECT-BILIRUBIN 3.8; the second test showed T-BILIRUBIN 7.1, BILIRUBIN 3.6; and the third test showed T-BILIRUBIN 5.6, BILIRUBIN 3.1. Is this decrease in bilirubin le...

Dr. Xie Kaisheng reply Rare Disease
Based on your description, your baby is experiencing pathological jaundice, indicating that there is an issue with the production and processing of bilirubin in their body, which requires further evaluation and treatment. Generally, neonatal jaundice should be closely monitored u...

Impact of Phototherapy on Newborns' Eyesight: What Parents Should Know

Dear Doctor, a 3-day-old newborn is placed in a phototherapy incubator due to high bilirubin levels. Although the eyes are covered, will this have any impact on the child's eyes or vision?

Dr. Pei Rensheng reply Pediatrics
Hello: (1) The history of phototherapy for neonatal jaundice has been 30 years, and to date, there have been no reports of visual impairment under the protection of eye coverings. (2) However, care must be taken to ensure that the eye coverings do not become loose or obstruct bre...