Jaundice in newborns is the most common symptom observed during the first hours and days of life. Early jaundice, is associated with elevated levels of bilirubin in the blood - the highest during life. Late jaundice is associated with a component in breast milk that affects the reuptake of bilirubin in the intestines, leading to elevated levels in the blood. This condition usually persists for up to 10 days after birth and passes as lactation normalises. If the symptoms of jaundice persist for more than 14 days, further diagnosis is necessary.
Jaundice occurring in the neonatal period is the most frequently observed clinical sign in the first days of life, related to the level of unbound bilirubin in the blood, which is then the highest in the context of the entire life of the human being. Breastfeeding is very important from the point of view of both the newborn and the mother, but this leaves an increased risk of jaundice and a greater severity of jaundice. In the context of the early form of jaundice in breastfed babies, inadequate caloric supply is crucial, and as lactation normalises, jaundice resolves. The late form of jaundice - when we refer to maternal food jaundice - is observed between days 4 and 7 of a newborn's life and is related to the presence of an unknown factor in the mother's milk, which is the reason for the increased reabsorption of enterohepatic bilirubin. Late jaundice is a major factor in prolonged jaundice in the baby. An elevated level of bilirubin in the child's blood is always a worrying condition and it is imperative that it be checked and the diagnosis expanded.
Current knowledge
Until recently, jaundice, which was associated with breastfeeding, was not perceived as a risk and was spoken of as a mild, temporary condition that did not cause damage to the nervous system. However, currently available research and analysis results challenge this certainty, while suggesting increased monitoring of the baby - checking the bilirubin level in the newborn's blood is crucial. In order to make the diagnosis - breastfeeding jaundice - a differential diagnosis is necessary, i.e. ruling out other causes of jaundice. However, if the diagnosis is made, it is presumed that the bilirubin level in the baby's blood will have evened out by 12 - 14 weeks of age and, if the baby is developing normally and is gradually gaining weight, it is only advisable to promote breastfeeding and regular paediatric monitoring of the baby. It is also not a contraindication to the application of preventive vaccinations.
Jaundice in the first days of life
During the first few days of a newborn's life, a very high level of unbound bilirubin is observed, the highest in a lifetime. The pathomechanism involved relates to the increased production of bilirubin, which is the result of the breakdown of haem and the insufficient capacity of the liver to absorb it, followed by its excessive reabsorption in the intestines. It is therefore possible to speak of jaundice, or rather of two types - early jaundice (related to breastfeeding) and late jaundice (related to breast milk). It is also possible that one form of jaundice may develop into another. Furthermore, an increase in blood levels of unbound bilirubin is also observed in adults, in exceptional situations such as a 24-hour break in food intake.
