How is jaundice in newborns diagnosed?

How is Jaundice in Newborns Diagnosed?

Jaundice is a common condition in newborns, characterised by a yellowing of the skin and the whites of the eyes. It occurs due to an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells. While mild jaundice is common and usually harmless, it is essential to diagnose and monitor it to prevent complications. Here's how jaundice in newborns is diagnosed, particularly for a UK audience.

In the UK, midwives and healthcare professionals routinely check for signs of jaundice in newborns within the first 72 hours of birth. The diagnosis primarily involves a combination of visual assessments and various tests. During the visual examination, the midwife or doctor will look for yellow discoloration in the baby's skin and eyes, typically starting at the head and spreading to the chest, stomach, and finally the legs.

If jaundice is suspected, further quantitative measurements will be taken to confirm the diagnosis and assess bilirubin levels. One of the most common non-invasive methods is transcutaneous bilirubinometry. Using a device called a bilirubinometer, placed gently on the baby’s skin, it measures the level of bilirubin transcutaneously, based on the skin's absorption of a particular light wavelength. This method is painless and quick, providing immediate results that help in initial assessments.

If the transcutaneous bilirubin level is high or if the healthcare professional deems it necessary, a blood test may be performed to measure the serum bilirubin level, giving a more accurate reading of the bilirubin concentration in the baby's blood. This involves a small blood sample often taken from the baby’s heel, a procedure known as a heel-prick test. The blood sample is analysed to measure total serum bilirubin and to help determine the need for treatment.

It's crucial to monitor the bilirubin levels because they help decide the course of treatment. In the UK, guidelines provided by the National Institute for Health and Care Excellence (NICE) help health professionals interpret these bilirubin levels in the context of the baby’s age in hours and other risk factors, such as prematurity or underlying health conditions. These guidelines ensure that any treatment, such as phototherapy, is started promptly to reduce the risk of complications.

While most cases of newborn jaundice resolve without intervention, some require treatment to prevent conditions like kernicterus, a rare but serious type of brain damage. Therefore, timely diagnosis and appropriate monitoring are critical components of newborn care in the UK to ensure the health and wellbeing of the infant.