Physiological Jaundice in Newborns
Causes, Symptoms, and Bilirubin Levels
Jaundice is a common condition in newborns, affecting about 60% of full-term babies and 80% of preterm babies. Among the different types of jaundice, physiological jaundice is the most common and usually harmless. In this blog post, we’ll explore what physiological jaundice is, its causes, symptoms, and the role of bilirubin levels in diagnosis and treatment.
What is Physiological Jaundice?
Physiological jaundice is a normal response of a newborn’s body as it adjusts to life outside the womb. It occurs due to the breakdown of fetal red blood cells and the immaturity of the baby’s liver, which cannot process bilirubin efficiently.
Unlike pathological jaundice (which may indicate an underlying health issue), physiological jaundice:
Appears after 24 hours of birth
Peaks around 3-5 days of life
Resolves within 1-2 weeks in full-term babies and up to 3 weeks in preterm babies
What Causes Physiological Jaundice?
Increased Bilirubin Production – Newborns have a high red blood cell count, and these cells break down faster than in adults, releasing bilirubin.
Immature Liver Function – A newborn’s liver is still developing and may not process bilirubin efficiently.
Delayed Bowel Movements – Since bilirubin is excreted through stool, delayed meconium (first stool) passage can increase bilirubin levels.
Normal Bilirubin Levels in Newborns
Bilirubin levels are measured in milligrams per deciliter (mg/dL). The acceptable range varies based on the baby’s age in hours and whether they are full-term or preterm.
| Age of Baby | Normal Bilirubin Level (mg/dL) |
|---|---|
| 24 hours | < 6 mg/dL |
| 48 hours | < 10 mg/dL |
| 72 hours | < 12-15 mg/dL |
| 4-5 days (peak) | Up to 17 mg/dL (full-term), higher in preterm |
| After 1 week | Gradually decreases |
Note: If bilirubin levels exceed 20 mg/dL, it may require medical intervention to prevent complications like kernicterus (a rare but serious form of brain damage).
Symptoms of Physiological Jaundice
Yellowing of the face, chest, and whites of the eyes
Mild drowsiness or difficulty feeding (in some cases)
No fever or signs of illness
When to See a Doctor:
Jaundice appears within the first 24 hours
Yellowing spreads to arms and legs
Baby is not feeding well, is lethargic, or has a high-pitched cry
Bilirubin levels rise too quickly
Treatment for Physiological Jaundice
Most cases resolve on their own, but treatments may include:
✔ Frequent Feeding – Helps flush out bilirubin through stool.
✔ Phototherapy – Blue light breaks down bilirubin in the skin.
✔ Exchange Transfusion (in severe cases) – Replaces the baby’s blood to rapidly lower bilirubin.
Final Thoughts
Physiological jaundice is a normal and temporary condition in newborns. Monitoring bilirubin levels and ensuring proper feeding can help manage it effectively. However, if symptoms seem severe or persist, always consult a pediatrician.
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