A critical review on neonatal hyperbilirubinemia-an Ayurvedic perspective

Neonatal hyperbilirubinemia is the elevation of the bilirubin level in the newborns blood, which results in yellowish staining of the skin and sclera of the newborn eyes by pigment of bile. It is due to the breakdown of RBC's (which release bilirubin into the blood) and the immaturity of newborns liver (which cannot effectively metabolize the bilirubin and prepare it for excretion into the urine). Increased bilirubin production, reduced hepatic clearance and enhanced enterohepatic circulation are the sole causes of increased prevalence of jaundice in newborn. The science of Ayurveda is supposed to add a step in order to understand the pathophysiology of neonatal jaundice that have resemblance with clinical entity of kamala (jaundice) mentioned in Kashyapa Samhita. The concept of neonatal hyperbilirubinemia in Ayurveda can be understood in the context of Pittaja stanya dushti along with the physiological variations in the newborns leading to the raised level of unconjugated bilirubin. Therefore, the patho-physiology should be known by a pediatrician in Ayurveda based on the involvement of dosha, dhatu, mala and srotas. Hence, an attempt is made in this review to discuss about the hidden concept of pathology of neonatal jaundice described in Ayurveda. These findings to understand the concept of neonatal jaundice in Ayurveda add up to the Ayurvedic science that has been developed through ages.