What is pathological jaundice?

Jaundice is a common condition affecting newborns that is usually mild and goes away without treatment in a week or two, in which case it is physiologic and not considered a problem. Pathologic jaundice, on the other hand, is a problem because it's too severe, the timing is wrong, or it's a symptom of a more serious condition.

Pathologic jaundice is primarily defined in terms of time. Sometimes it can be too early, meaning it happens before the baby is 48 hours old; too high, meaning the jaundice is too severe between 24 hours and 10 days of age or too long when it occurs between 10 days and two weeks. Physiological jaundice, considered normal and generally harmless, appears between 24 and 72 hours of the babies life and has disappeared between day 10 and 14. Another important difference between physiological and pathological jaundice is that physiological jaundice is not a health risk because it has developed in a healthy baby, whereas pathological jaundice is a health risk because of its cause or the degree to which it is present.

Physiologic jaundice occurs when a newborn is unable to process bilirubin in their system. Bilirubin is a yellowish pigment found in bile, which is a fluid produced by the liver. It is a byproduct of the breakdown of hemoglobin, or red blood cells, and under normal circumstances, is released as bile through the intestines after passing through the liver. When a newborn baby's liver can't process bilirubin fast enough, the buildup causes the skin and whites of the eyes to take on a yellow tint. Physiologic jaundice occurs in most newborns and is due to immaturity of the liver. It disappears in the second week of life when the liver matures enough to cope with the amount of bilirubin produced.

As physiological jaundice usually develops after the baby has left the hospital, a check-up to assess the condition should be done within days of discharge. However, if jaundice is observed within 24 hours after birth, this is a symptom of pathological jaundice and the baby will not be discharged normally. Similarly, in babies who are already discharged, if the characteristic yellow tinge of jaundice deepens or spreads, or if the baby develops a fever and begins to show signs of discomfort, a doctor should be consulted.

Other symptoms of pathologic jaundice include vomiting, lethargy, weight loss, and dark urine. Blood or liver diseases, genetic problems and infections are some of the causes of pathological jaundice. If bilirubin levels exceed 25 mg, very serious conditions can occur, including deafness, cerebral palsy, and other forms of brain damage. For this reason, jaundice, regardless of timing and severity, should always be checked out by a healthcare professional.

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