Jaundice is a common condition affecting newborn babies that is usually mild and disappears without treatment within one or two weeks, in which case it is physiological and not considered a problem. Pathological jaundice, on the other hand, is a problem either because it is too severe, the timing is wrong or it is a symptom of a more serious condition.
Pathological jaundice is mostly defined in terms of time. At times, it may be too early which means it occurs before the baby is 48 hours old; too high which means the jaundice is too severe between 24 hours and 10 days of age or too long when it presents from between 10 days and two weeks. Physiological jaundice, considered normal and usually harmless, appears between 24 to 72 hours of the babies life and has disappeared by the 10th to the 14th day. A further important difference between physiological and pathological jaundice is that physiological jaundice is not a health risk as it has developed in a healthy baby while pathological jaundice is a health risk due to its cause or the degree it is present.
Physiological jaundice occurs when a newborn is unable to process the bilirubin in their system. Bilirubin is a yellowish pigment found in bile, which is a fluid made by the liver. It is a by-product of the breakdown of hemoglobin, or red blood cells, and under normal circumstances, it is released as bile through the intestines after passing through the liver. When the newborn baby's liver is unable to process bilirubin quickly enough, the build-up results in the skin and the whites of the eyes taking on a yellow tinge. Physiological jaundice occurs in the majority of newborns and is due to the immaturity of the liver. It disappears by 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, there should be a check-up to test for the condition within days of discharge. If jaundice is noticed within 24 hours of birth, however, this is a symptom of pathological jaundice and the baby will not be discharged as normal. Similarly, in babies already discharged, if the yellow tinge characteristic of jaundice deepens or spreads, or if the baby develops a fever and begins to show signs of being unwell, then a doctor should be consulted.
Other symptoms of pathological jaundice include vomiting, lethargy, weight loss and dark urine. Blood or liver diseases, genetic issues and infections are some of the causes of pathological jaundice. Should levels of bilirubin exceed 25 mg, then very serious conditions such as deafness, cerebral palsy and other forms of brain damage may result. For this reason, jaundice, regardless of timing and severity, should always be checked by a health care professional.