What are the other Names for this Condition? (Also known as/Synonyms)

• Icterus Gravis Neonatorum (Physiologic Type)
• Neonatal Jaundice (Physiologic Type)
• Newborn Physiological Jaundice

What is Physiologic Jaundice? (Definition/Background Information)

• There are several types of Jaundice that affect a newborn child
• Physiologic Jaundice is a common disorder affecting infants shortly after birth. It is caused due to a decreased excretion of bilirubin from the baby’s body. As a result, yellowing of the eyes, mucus, and skin is noticed
• It is rarely severe or serious, and the condition is usually self-limiting. However, sometimes preterm or low-birth weight infants may have a risk of developing certain medical complications, due to higher severity of the condition

Who gets Physiologic Jaundice? (Age and Sex Distribution)

• The onset of Physiologic Jaundice is normally within the first few days (or in the first week) after birth, and continues for about 2 weeks. The incidence of this physiological disorder is high, with 50-70% of the babies being regularly affected
• Both male and female babies are equally affected

What are the Risk Factors for Physiologic Jaundice? (Predisposing Factors)

• Jaundice in newborns may run in the families. Children (even siblings) born in families with a medical history of the condition, may be at risk
• If the baby does not feed well, or there is reduced milk production causing decreased intake, it could worsen the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Physiologic Jaundice? (Etiology)

• Red blood cells that get continuously broken down (a normal process in the body) are processed by the liver, resulting in the formation of a yellowish pigment bilirubin. Under normal conditions, this bilirubin pigment is excreted out of the body system
• In the period immediately following birth, the baby’s liver functioning efficiency is limited, and all bilirubin is not excreted out of the body. This inherent inability of the body to dispose the yellowish substance, causes Physiologic Jaundice
• As the baby begins to feed, grow, and develop normally, the body’s physiological systems start functioning well, and the jaundice subsides within 1-2 weeks

What are the Signs and Symptoms of Physiologic Jaundice?

Signs and symptoms of Physiologic Jaundice are:

• Gradual yellowing of eyes and skin (face) initially, which then slowly spreads to the entire body, within the first week of birth. The jaundice does affect the skin tone or vitality
• Baby may be sleepy, lethargic, and may feed poorly. Otherwise the baby’s muscle and neuro-reflexes appear normal. Some weight loss may be observed
• In infants born preterm, the jaundice symptoms may be of a higher severity

How is Physiologic Jaundice Diagnosed?

There are several types of baby jaundice. Thus, an accurate evaluation and assessment is important. Diagnostic tests for detecting Physiologic Jaundice of the newborn child include:

• Physical exam with evaluation of medical history is important. It is also important to evaluate, both the child and mother
• Blood analysis: Total blood count, peripheral blood smear test, blood typing, evaluation of serum bilirubin amount, count of old RBCs (reticulocytes), check for certain protein levels, platelet count
• Urine test and culture
• A differential diagnosis should be considered to eliminate other jaundice types

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Physiologic Jaundice?

Physiologic Jaundice complications may develop, especially if the infant is born preterm, is severely malnourished, or does not get the correct treatment. These may include:

• Liver, other organs being affected
• Serious brain damage causing neurological abnormalities due to severe state of jaundice. This is  known as kernicterus
• Sepsis; due to underlying infections

How is Physiologic Jaundice Treated?

The treatment measures recommended for Physiologic Jaundice are based on certain parameters of the infant, which include serum bilirubin level (and its rate of increase), baby’s age (in days), condition at birth, and baby weight.

• In most cases, and for otherwise healthy babies, Physiologic Jaundice may not require any treatment. It is a self-limiting condition
• If bilirubin levels are low, then a healthy infant may be monitored closely, until the child’s condition improves. No specific treatment is necessary
• Increasing breastfeeding incidences may decrease bilirubin levels. Thus, regular and frequent feeding is advised. Education about proper breastfeeding techniques may help in ensuring that the baby suckles well. The latching technique should be corrected, if required
• Breast milk may be supplemented by formulaic preparations, or through intravenous fluid administration. However, both these are prescribed, only when it is really necessary
• Phototherapy (or light treatment) is used to help the body break-down bilirubin. The baby’s skin is exposed to a special blue light (light of a particular wavelength) for certain periods of time
• In case the breast milk production is delayed or is less, then the mother is also treated accordingly. This is done after determining the cause of decreased breast milk production

How can Physiologic Jaundice be Prevented?

• Physiologic Jaundice is a common disorder that manifests itself shortly after birth; it cannot be prevented
• It is not a serious condition, and an increased nursing (breastfeeding) of the infant can help the child speedily recover, from the illness

What is the Prognosis of Physiologic Jaundice? (Outcomes/Resolutions)

• Physiologic Jaundice is a transient condition with full recovery that is ensured when the baby starts to grow, mature, and body systems function to their full capacity. It has an excellent prognosis in a majority of the cases
• Some babies with underlying medical conditions may require additional treatment measures, if any complications develop

Additional and Relevant Useful Information for Physiologic Jaundice:

• There are basically 3 types of jaundice that affect the newborn babies: Physiologic Jaundice, Breast Milk Jaundice, and Breastfeeding Jaundice
• It has to be ensured that the condition of the baby is rightly assessed and diagnosed; in order to correlate it with the right treatment mode

A differentiation should be made between Physiologic Jaundice and Early (Non-Physiologic) Jaundice. Non-Physiologic Jaundice is the presence of jaundice-like symptoms observed in a newborn, on the first day of birth. This is of concern and may be due to congenital or other prenatal abnormalities, and needs thorough medical investigation.