THE YELLOW BABY

Dr. Elías Jiménez F.

The color of the newborn is extremely important in order to determine his health condition.

Usually, at the time of birth, the baby's color is purple (cyanotic), and after a few seconds of breathing room temperature air, his color changes to pink. His hand and feet will remain purple, since the blood circulation in those places is slower.

The baby will have the pink appearance during his first days, it will become less intense as time goes by, since his hemoglobin, which is very high at birth, begins to go down until it reaches the level that the child needs. As the hemoglobin destroys itself or degrades it converts into bilirubin, and this pigment is transformed and eliminated by the liver, most of it through the digestive tube. When excess bilirubin is accumulated, the skin turns yellow, and this is known as Jaundice or Icterus.

High levels of bilirubin can injure the child's nervous system and cause serious and permanent injuries. The principal causes for increase levels are:

1. More hemoglobin than the necessary is destroyed, this happens when the mother and the baby have different blood types.
2. The liver is not functioning well, this might happen to premature children due to this organ immaturity, or as an effect of the maternal milk.
3. Because the bilirubin can't be eliminated through the digestive tube.

A baby who turns yellow should be considered as an emergency, and the pediatrician must determine each case. There are some signs that may alert parents and have to be watched for; these are:

1. Presence of Jaundice in the first 72 hours of life. Usually this is caused by the excessive destruction of red blood cells and with them the hemoglobin, due to blood incompatibility between mother and son.
2. Jaundice accompanied of lethargy, lack of activity and of appetite.
3. Presence of fever or very low temperature.
4. Low birth weight, because premature children are more prone to the toxic effects or the bilirubin.
5. The skin coloration is very yellow or orange.

The treatment can be very simple, as increasing the amount of fluid intake and eliminating the intake of maternal milk; or putting the child under phototherapy, special lamps that facilitate the bilirubin found in the skin to transform and eliminate easily. The sun has a similar effect, but with the inconvenience that it can only be received a few hours a day. In the worst cases, when the levels of bilirubin in the blood are higher than 20 mg/dL, a blood exchange has to be carried the child's blood is changed through the umbilical vein.

Like in many other cases, the most important thing is to prevent this situation by giving an on time diagnosis and applying treatment in the right moment. In this way we prevent a simple problem becoming a complicated one.