Jaundice is not a disease but a symptom that indicates an underlying condition. The yellow skin and eyes indicate the presence of excessive amounts of bilirubin in the blood.
Jaundice can happen in adults, children, and newborns. It is very common in newborns, but the cause for newborn jaundice is different. In older children, the condition is rare. Here, MomJunction talks about jaundice in children other than newborns. Read on to know about the types of jaundice, the reasons for the condition, and how it can be treated.
What is Jaundice?
Jaundice is a condition that results in yellowing of the skin and the white part of the eye, called the Sclerae. It occurs when there is excess bilirubin in the body. Bilirubin or bile is a yellowish fluid that the liver produces. The fluid aids in digestion and comes out of the body through the stool. When it does not go out, its content increases in the body, leading to a condition called hyperbilirubinemia, which causes yellow skin or jaundice (1).
Types of Jaundice
Typically, jaundice in children, as it is in adults, can be of three types (2).
- Obstructive jaundice is a condition that occurs when the normal or natural elimination of bile from the body is obstructed. This leads to excess bile in the liver.
- Hemolytic or pre-hepatic jaundice occurs when the breakdown of the red blood cells is accelerated (hemolysis), resulting in excess production of bile in the body.
- Jaundice caused due to liver injury, or liver-related illness is Hepatocellular or Intra-hepatic jaundice.
Symptoms Of Jaundice In Children
The early symptom of jaundice is a yellowing of the skin and whites of the eyes. The other symptoms of jaundice include (1):
- Itchy skin (3).
- Flu-like symptoms such as fever, joint pains, etc.
- Pale or yellow-colored stool and dark colored urine.
- Chills and abdominal discomfort – your child could complain of stomach pain.
- Sudden dwindling of appetite, nausea, and vomiting.
- Weight loss, tiredness, and lethargy.
- Bitter taste in the mouth.
The yellowness of the skin is first evident on the face and then spreads to other parts of the body. You will also find that the lining of organs like the mouth and the mucous membrane (nose) also turns yellow before the eyes or the nails change color.
What Causes Jaundice In Children?
Jaundice is a common occurrence in preterm babies. The liver is still in the developing stage, and the bilirubin does not get flushed out of the body regularly. The level of bilirubin usually goes down by around two weeks after birth.
However, jaundice in toddlers and older children can occur due to several reasons. Finding out the exact cause of the condition is important to be able to treat it. Here is a list of possible underlying conditions that cause jaundice in children (3). Each of these conditions directly or indirectly affects the levels of bilirubin in the body, causing yellow skin.
- Weak liver, liver inflammation, or any liver infection.
- Inflammation or obstruction of the bile duct prevents the removal of bilirubin.
- Hemolytic anemia accelerates the breakdown of red blood cells, causing jaundice.
- Gilbert’s Syndrome, a condition that impacts the normal functioning of enzymes, prevents the disposal of bile from the body.
- Cholestasis is a condition in which the passage of bile is prevented, resulting in excess bilirubin accumulation in the liver.
- Medical conditions such as malaria, sickle cell anemia, thalassemia, hereditary spherocytosis, and a genetic syndrome called Crigler-Najjar syndrome can cause pre-hepatic jaundice.
- Viral hepatic infections like hepatitis A, hepatitis B, and hepatitis C can cause hemolytic jaundice.
- Hepatitis A virus spreads through food and water, inadequate sanitation, and personal hygiene.
- Leptospirosis (a bacterial infection spreading from animals), glandular fever, and primary biliary cirrhosis can also cause jaundice.
- Rare liver conditions like autoimmune hepatitis, Dubin-Johnson syndrome, and primary sclerosing cholangitis can also cause intra-hepatic jaundice.
- Pancreatic cancer, bile duct cancer, or gallstones can also cause post-hepatic jaundice.
- Drinking unhealthy or unclean water and consuming unhealthy food.
- Prolonged usage of drugs such as acetaminophen, anticonvulsants, anesthetics, antituberculosis agents, and antibiotics can cause hepatotoxicity and could lead to jaundice.
Often, yellow skin and sclerae in a child can indicate jaundice. However, doctors can take a systematic approach to diagnose jaundice in children, to pinpoint the underlying cause and recommend effective treatment quickly. They prescribe several pathological tests to diagnose jaundice.
- Physical examination to check the eyes and skin.
- The doctor would look for unusual bruises, also known as spider angiomas, which are lesions on the skin with a central red dot and reddish extensions around it. This could indicate liver damage (4).
- The swelling of feet, legs, and ankle might indicate cirrhosis of the liver.
- Urine tests to measure the level of urobilinogen.
- Bilirubin tests to check the levels of fluid in the body.
- Blood tests, including full blood count and complete blood count.
- Liver tests to diagnose hepatitis and liver cirrhosis.
- Imaging tests like ultrasound, CT scan, and an MRI can be recommended in case intra-hepatic or post-hepatic jaundice is suspected.
- If the doctor suspects that your child’s antibodies are attacking their red blood cells (autoimmune conditions), then a test known as Coombs’ test might also help in diagnosing the problem (5).
- In severe conditions, where the liver has been damaged due to liver cirrhosis or cancer, a biopsy may be recommended (3).
Treating Jaundice In Children
The treatment for jaundice depends on the severity of the case. Any treatment that the doctor recommends would not be for jaundice, but the illness causing it. Treatment options and procedures usually include:
- Taking excess water and close monitoring of renal function (3).
- Increase in intake of iron supplements and iron-rich foods to improve the amount of iron in the blood to treat jaundice caused due to hepatic anemia (6).
- Anti-viral medications or steroids may be prescribed to treat jaundice-causing hepatitis.
- If jaundice is due to obstruction of bile ducts, surgery may be performed to remove the blockage.
- Treatment is not necessary for jaundice caused due to Gilbert’s Syndrome, as it is a mild disorder that does not pose any significant threat to your health (7).
- In the case of genetic blood disorders like thalassemia and sickle cell anemia, a complete blood cell replacement may be required.
- If it is a case of liver damage, little can be done in the way of treatment. In such a case, doctors would recommend a diet and lifestyle change to prevent further deterioration of the organ.
Home Remedies For Jaundice In Children
In addition to the prescribed medications and treatment course, children should get adequate care and rest at home. We have compiled a few home remedies that can aid jaundice treatment in children. Note that these home remedies do not cure the condition. They support medical care, which is essential to eliminate the condition that causes jaundice.
- Tomatoes have an enzyme called lycopene, which can help in repairing the damage to the liver (8).
How to: A glass of fresh tomato juice, with salt and pepper, consumed during breakfast could help.
- Turmeric might help the enzymes that are responsible for flushing out liver-damaging carcinogens. A study on mice revealed that curcumin found in turmeric led to reduced liver damage, bile duct blockage, and fibrosis (9).
How to: A glass of warm water with a quarter spoon of turmeric, twice every day, might help.
- According to ancient medical practices (Unani system), sugarcane juice is considered beneficial for the liver. When given to people with jaundice, sugarcane juice might quicken the recovery from jaundice (10).
How to: You could consider giving one glass of sugarcane juice, mixed with juice from half a lemon, twice a day.
- According to the Greek–Arab and Indian folk medicine, radish is used as a household remedy for treating jaundice, gallstones, and liver diseases (11).
How to: You could give the child a cup of radish juice once every day. This might also help in improving the appetite.
- Chemical investigations found that pigeon pea plant contains globulins known as cajanin and concajanin, which have been widely used to treat hepatitis, jaundice, and expelling bladder stones (12).
How to: A cup of pigeon pea leaves juice every day might aid in fighting jaundice in children.
- A study conducted on rats found that barley bran has improved liver enzymes and nearly restored the damaged liver tissues (13).
How to: Boil a cup of barley in three liters of water and simmer it for two hours. Let it cool and give it to the child frequently during the day.
- Ridged gourd leaves were found effective in fighting jaundice (14).
How to: Boil 15 grams of dried ridge gourd leaves in a quarter liter of water. Boil 50 grams of coriander seeds in half a liter of water and make a decoction. Give 30ml to 60ml of the gourd leaf infusion, mixed with coriander seed decoction, thrice a day.
- Almonds, cardamom, and dried dates are considered to be effective in treating jaundice.
How to: Soak almonds and dried dates in water overnight. De-seed the dates and peel the skin of almonds before making a fine paste of them. Make your child take half a spoon of this paste once or twice a day, which might help reduce jaundice.
- According to the Unani system of medicine, taking a sufficient quantity of buttermilk with roasted alum and black pepper thrice a day might help in reducing the effect of jaundice (15).
- In India, oregano was found helpful in relieving jaundice (16).
How to: Boil one spoon of oregano in a cup of water and simmer it for around ten minutes. Strain the liquid and give it to the child for relief from symptoms.
- Studies found that the consumption of citrus fruits might influence the genotype, which is associated with lowering serum bilirubin (17).
How to: You can give lemon juice diluted with water or mix it with equal quantities of beetroot juice.
- It is believed that chamomile tea if taken frequently, might help alleviate the symptoms of jaundice.
How to: If your child has jaundice, give them one cup of chamomile tea every day to aid in recovery. However, make sure your child is not allergic to the tea.
- Studies found that extracts of the bael leaves possess hepatoprotective property and might help in relieving the symptoms of jaundice (18).
How to: Make a powder out of bael leaves and mix it in one glass of water. Give this once a day to the child, to cure jaundice sooner.
- In India and South Africa, chicory flowers, seeds, and leaves have therapeutic properties that can help in fighting jaundice (19).
How to: Make a juice of the herbs (fruits, leaves, flowers, seeds, and roots) and consider giving a teaspoon of this juice to your child.
These remedies should be considered only for aiding the treatment process. They are not a replacement for the medications prescribed by doctors.
Diet For Jaundice
One of the best ways to fight jaundice in toddlers and children is to follow a diet that enables the effective elimination of bile from the body. A good diet is a key to faster recovery from the symptoms, which include constant fatigue and weakness (20). Here are a few tips on preparing the ideal diet for alleviating jaundice symptoms in children and helping them recover sooner.
- When your child has jaundice, they may not be able to digest heavy foods.
- Replace any solid foods with juices made from fresh oranges, grapefruit, pears, lemon, carrots, beetroots, and sugarcane.
- A light solid meal without oil and fat should be served. Stick to healthy vegetable soups, while continuing to give fresh fruit juices during the day.
- Feed your child frequently, between short intervals, instead of restricting meals to fixed times during the day.
- Limiting the intake of protein can be a good idea for patients showing symptoms of jaundice.
- You may even give a hot water enema to ease bowel movements and facilitate the removal of bile naturally. Talk to your doctor about it before trying.
- Avoid canned foods, food prepared outside the house, or ready-to-eat foods. The diet should only contain healthy, home-cooked meals that are easy to digest.
- Include buttermilk in the diet every day.
- Give coconut water, fruit juices, and vegetable juices during snack time.
Follow a strict diet until your child has completely recovered from the condition. Make sure you check with your doctor about the diet. Do not switch to a normal or regular solid diet until the doctor approves of it.
5 Tips For Preventing Jaundice In Children
Here are a few things to remember to prevent jaundice in children.
- Maintain hygiene at home and around. Teach your children to maintain personal hygiene at all times to prevent microbial infections.
- Always eat fresh and healthy food. Avoid eating or drinking in places with unhygienic surroundings. Potentially contaminated food and water can result in jaundice.
- Drink clean, purified water to prevent liver-related diseases that cause jaundice.
- If you are traveling to places where diseases like malaria are prevalent, make sure you get the vaccine before you go.
- Talk to your doctor and get the children a hepatitis B vaccine shot to prevent the illness.
Remember that jaundice is not an illness, but a symptom that indicates an underlying medical condition. It affects the liver, one of the most important organs of the body. So, do not delay in taking your child to a doctor at the first hint of jaundice. Proper treatment, with medication, diet restrictions, and rest, is the only way to make recovering from jaundice easy for your child.
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