In utero, bilirubin crosses the placenta and is excreted by the mother. After birth, the infant must activate its own excretory mechanism. In 2-3 days following birth, the bilirubin level rises resulting in physiological jaundice. This jaundice usually clears at the end of the first week of life. The bilirubin Is largely uncongugated and the baby remains well.
Jaundice may be more severe and prolonged in preterm infants, especially if complicated by hypoxia and hypoglycemia, bowel obstruction and ilius. Uncongugated bilirubin is lipid soluble. It is bound to albumin in blood but may cross the blood-brain barrier and causes neurological deficit.
Jaundice in the 24 hours of life may be related to congenital transplacental infections which includes toxoplasmosis, rubella, cytomegalovirus, herpes simplex and syphilis.
Hemolytic disease of the new born results from an incompatibility with maternal antibodies, the mother being sensitized mismatched transfusion or from previous pregnancy.
Jaundice beginning between the second and fifth day may be pathological because of infection, galactosemia or hemolysis cased by birth trauma.
Delayed jaundice may be secondary to breastfeeding, hypothyroidism, neonatal hepatitis, galactosemia and bilary Atrasia, and it may occur in infants of diabetic mothers.
Neonatal jaundice can be subdivided into uncongugated and conjugated types though it is more convenient to classify it by medical and surgical causes from the management point of view
Causes of neonatal jaundice
- Hepatic infection
- Metabolic disease
- Bile plug syndrome
- Adrenal hemorrhage
- Drug related
- Neonatal hepatitis
- Bilary Atrasia
- Choledochal cyst
- Alagile syndrome
- Spontaneous perforation of the common bile duct major causes of obstructive jaundice in infancy are:
- Bilary Atrasia
- Congenital bile duct anamolies (Choledochal cyst)
- Infectious cholangitis
- Primary sclerosis
- Langerhans “cell histiocytosis
Neonatal jaundice symptoms
- There may be following symptoms of jaundice
- Extreme weakness
- Appetite loss
- Yellow discoloration of conjunctiva, tongue, skin, and urine.
Diagnosis of neonatal jaundice
Observe for jaundice in babies with cephalihematoma, signs of bruising, polycythemia, or an intracranial bleed.
Healthy term newborn: blood type and Coombs test (compare with mother), serum bilirubin level.
Any other infant: total and direct serum bilirubin levels, complete blood count with differential, mother’s blood type and Rh status, infant’s blood type and Rh status, direct and indirect Coombs, and reticulocyte count and peripheral smear (if patient is anemic or there is suspicion of hemolytic disease).
If elevated direct bilirubin levels: in addition to the above, consider liver function test 9bilary obstruction), blood and urine cultures, TORCH screen, serum alpha 1 antitrypsin levels, urine for reducing substances, abdominal ultrasound, radionuclide scan (evaluate biliary anatomy).
Homeopathic treatment for neonatal jaundice
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat neonatal jaundice but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat neonatal jaundice that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of neonatal jaundice:
Aconite, Bovista, Cheledonium, China, Bryonia, Chamomilla, Chionanthus, Collinsonia, Elaterium, Mercurius, Merc Dul, Myrica, Natrum Sulph, Nux Vomica, Phosphorous, Podophyllum, Sepia, Sulphur, and many other medicines.