One of the most common and earliest appearing conditions is jaundice. Jaundice is evidenced by a yellow-orange discoloration of the skin and is caused by the buildup of a substance called bilirubin in the bloodstream. Bilirubin is a by-product of the breakdown of worn-out red blood cells, and during pregnancy this process is managed for the baby by the mother’s liver and circulatory system. After birth, the newborn’s liver takes a few days to gear up for the job, and during this time the level of bilirubin will increase by a modest amount. If a significant backlog of bilirubin develops, the baby’s skin will take on a yellow-orange hue, beginning with the head and gradually spreading downward.
Whether or not jaundice is significant will depend upon several factors, including the level of bilirubin, how soon and how fast it has risen, the suspected cause and whether the baby was full-term or premature. In some instances, extremely high bilirubin levels can damage the central nervous system, especially in the premature infant. If you notice that your new baby’s skin is turning orange and the whites of the eyes yellow, and if your infant is feeding poorly, see your doctor immediately. He or she will order blood tests to check the bilirubin level and other studies may be done to look for underlying causes.
Normally the jaundice will resolve on its own, although some healthy babies will carry a slightly yellow tint for several weeks. Occasionally some extra help is needed, in which case your pediatrician may adopt one of the following approaches:
- Treatment for underlying causes (such as an infection).
- Increasing the baby’s fluid intake.
- Exposure to indirect sunlight. This involves undressing the child down to his diaper in a room bright with sunlight that does not shine directly on his sensitive skin. Since indirect sunlight has only a modest effect, don’t use this approach unless you are sure that your baby won’t become too hot or cold.
- Occasionally, an enzyme found in mother’s milk may interfere slightly with the clearing of bilirubin. In such cases, your health-care provider may ask you to stop nursing briefly and use formula until the problem improves. It’s important to express milk in the meantime so your breasts will still be producing it when your baby is able to resume breastfeeding.
- A treatment called phototherapy may be utilized if the bilirubin level needs to be treated more actively. Under a physician’s direction, the baby, wearing protective eyewear, lies under a special intense blue light like a sunbather at the beach. A baby can also lie on a thin plastic light source called BiliBlanket.
Other health issues to watch out for during the first three months of life include colds and other respiratory infections, which are relatively uncommon in this age group. When they occur, the irregular breathing patterns they produce may cause you some concern. A doctor’s exam is in order when watery or thick drainage appears from one or both nostrils. Excess nasal discharge can be suctioned out with a rubber-bulb syringe. Do not give any decongestant or cold preparations to a baby this young unless directed by your baby’s physician.
Infections of the middle ear (otitis media) may complicate a cold in any baby, including a newborn. Unfortunately, they’re difficult to detect. If an infant is acting ill, irritable, running a fever or all of these, he will need to have his ears checked by a doctor.
A narrowing of the tear duct in one eye or the other can cause the eye to overflow with tears. This can lead to a local infection manifested in goopy, discolored drainage, crusting and, if more widespread, a generalized redness of the eye known as conjunctivitis. The crusting and drainage will have to be removed gently using moist cotton balls, which should be promptly thrown away. Your pediatrician may also prescribe antibiotic eye drops or ointment for a few days.
Finally, you will want to be on the lookout for any intestinal and digestive abnormalities. Spitting up breast milk or formula is not uncommon during the first weeks of life, especially if the baby is not adequately burped. If an infant in this age group begins vomiting more forcefully, you should seek prompt medical attention. Projectile vomiting may be a symptom of pyloric stenosis, a thickening of a muscle in the portion of the small intestine known as the pylorus. If there is a noticeable increase in the amount of stool (usually indicating that an infection has developed in the intestinal tract), the baby will need to be taken to the doctor and observed carefully for signs of dehydration.
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