Neonatal jaundice is a very common condition in newborns, with about 50% of full-term babies having jaundice in the first week and up to 80% of premature babies having jaundice. A small percentage of newborns have “pathological jaundice”, so parents need to be vigilant and pay attention to whether it is caused by biliary retention, biliary occlusion or other problems, and send their babies to the hospital in a timely manner. What is the normal value of neonatal jaundice for newborns? And newborn jaundice high how to do? And how to care for newborn jaundice and other issues.
Neonatal jaundice is due to abnormal bilirubin metabolism, causing an increase in the level of bilirubin in the blood, and appears in the skin, mucous membranes and sclera jaundice as a characteristic condition. The main manifestation is yellowing. There are pathological and physiological jaundice in newborns, and most physiological jaundice can subside on its own within 10 days, but pathological jaundice may be caused by disease and requires examination and treatment.
Normal value of jaundice in newborns
The normal value of jaundice in full-term babies is different from that in preterm babies. Usually, the normal value for jaundice in full-term newborns is 12.9 mg/100 ml, which means that the bilirubin level in 100 ml of blood is less than 12.9 mg. The normal value for jaundice in preterm infants is 15 mg/100 ml of blood, which means that the bilirubin level in 100 ml of blood is less than 15 mg.
When the baby’s jaundice value exceeds 12.9 mg/dl or when the neonatal jaundice index rises too quickly (more than 5 mh/dl per day), or when the jaundice lasts longer than the time it takes for a full-term baby to subside in 14 days and a premature baby to subside in 4 weeks, or when the jaundice recedes and returns. It means that the newborn may have pathological jaundice.
Neonatal jaundice index criteria
Jaundice is generally divided into physiological jaundice and pathological jaundice, as long as the range beyond the physiological jaundice is called pathological jaundice.
1, physiological jaundice
Usually after 2 days of life, newborns can see with the naked eye that the skin is a little yellow, reaching a peak in 3-5 days and disappearing in 7-10 days, when the jaundice index (serum bilirubin value) generally does not exceed 15 mg/dl is the normal range.
2.Pathological jaundice
There are many causes of pathological jaundice, and the criteria are not the same for full-term and preterm babies.
(1) Newborns found within 24 hours of birth are “early-onset jaundice”.
(2) The jaundice index rises too high at once, increasing by more than 5 mg/dl a day, which is more common in hemolytic jaundice (in which the mother and baby do not have the same blood type).
(3) The jaundice index rises too high, with 15mg/dl.
(4) It lasts too long, generally the duration of physiological jaundice is 7-10 days, if more than 2 weeks should be noted.
What are the dangers of high neonatal jaundice?
The jaundice that occurs due to excessive bilirubin production in newborns, immature liver function and intestinal and hepatic circulation resulting in increased bilirubin concentration is clinically known as physiological jaundice. Physiological jaundice in full-term infants appears on the second to third day, when the skin is light yellow, the sclera (white eyes) is mainly blue with a slight yellow tinge, the urine is slightly yellow, and the general condition is good, reaching a peak on the fourth to fifth day and disappearing in the first to second week, with normal liver function and increased serum unconjugated bilirubin on examination. Physiologic jaundice in preterm infants appears earlier, is higher, and lasts longer, but mostly subsides four weeks after birth.
Pathological jaundice can be caused by hemolysis, severe infections, neonatal hepatitis, biliary atresia, and metabolic diseases. Jaundice, regardless of the cause, can cause “nuclear jaundice” when severe, and its prognosis is poor, in addition to neurological damage, can cause death in severe cases.
Etiological analysis of pathological jaundice, early examination and clinical observation of neonatal jaundice, strengthening neonatal bilirubin monitoring, early detection of the cause and treatment of the cause can effectively reduce the damage to the central nervous system of bilirubin encephalopathy, which is the key to reduce the death and disability rate of neonatal bilirubin encephalopathy.
Mild jaundice in early neonates does not have serious consequences, but severe jaundice in early neonates can cause bilirubin encephalopathy (nuclear jaundice), and nuclear jaundice is not only life-threatening, but survivors can be disabled for life due to neurological damage. Recent multicenter studies have shown that moderate to severe neonatal hyperbilirubinemia can cause auditory damage and abnormal brainstem auditory evoked potentials. Therefore, dynamic monitoring of bilirubin levels and brainstem auditory evoked potential testing should be performed early in children with jaundice.
What should I do if my newborn has high jaundice?
1, physiological jaundice is also known as breast milk jaundice, usually 3-4 days after birth slowly appear, to the 10-16 days jaundice will reach its peak, but will not cause bilirubin encephalopathy, if you have been breastfeeding, jaundice will last about a week will slowly under the birth, about 3-12 weeks to return to normal. In fact, the identification of breast milk jaundice is very simple, stop feeding breast milk for 2 to 4 days, the skin jaundice recede half, if again feeding, skin jaundice and reappear.
2, if once identified as breast milk jaundice, the mother does not need to panic, usually without special treatment, and do not discontinue breastfeeding. To prevent minor brain damage from breast milk jaundice, reduce the number of feedings at the peak of jaundice, suspend feeding mother’s milk for 2 to 3 days if necessary, give formula feedings, and resume feeding mother’s milk when the serum bilirubin value drops to a safe range.
3, at the same time hold the baby more out in the sun, sunshine process, let the baby’s skin to enjoy contact with the sun, more sunshine every day can also be back to yellow. However, you can’t sunbathe through the glass, and you should cover your baby’s eyes to avoid burning them with the hot sun.
4, once the newborn found pathological jaundice should be handled early. The most effective method is to let the child sleep naked in a warm box, with light exposure to change the structure of the bilirubin in the blood, to promote its change into substances harmless to neural tissue and excretion, and can be combined with drug therapy, such as static glucose, albumin, oral or intramuscular injection of phenobarbital to accelerate the metabolism and excretion of bilirubin. Children with very severe cases need to be treated with blood exchange therapy.
Precautions.
Also to be reminded that many parents currently believe that giving sugar water to a jaundiced baby can treat the baby’s jaundice symptoms, in fact, this is a misconception, because feeding too much sugar water to the baby, then his digestive tract is full of glucose, which will make the baby have no appetite for milk, the number and amount of milk will be reduced, which will affect the excretion of bilirubin, resulting in the aggravation of jaundice symptoms.
Care of neonatal jaundice.
1, so that the baby’s fetal stool is excreted as soon as possible: in the early days we should feed the newborn as soon as possible, so that the fetal stool is excreted as soon as possible, because the fetal stool contains a lot of bilirubin, because if the fetal stool is not excreted, the bilirubin will be reabsorbed into the blood through the newborn’s special liver and intestinal circulation, making the jaundice increase. How can we see if the fetal stool is clean? The main thing is to see the fetal stool change from black to yellow fetal stool is clean.
2, give the newborn adequate water: to determine whether the newborn fluid intake is adequate is to look at the newborn urine, generally normal newborns 6-8 times a day urine, if the number is not enough, it is possible that his fluid intake is not enough, too little urine is not conducive to the excretion of bilirubin. We should ensure the fluid intake of newborns, generally the newborn’s fetal stool should be excreted in 2-3 days, so as to reduce the degree of jaundice.
3, pay attention to the observation of: fetal yellow infant’s general symptoms, whether there is mental depression, drowsiness, difficulty sucking milk, alarm and restlessness, two eyes straight, limbs straight or convulsions, in order to early detection of serious children, timely treatment. Closely observe heart rate, heart sounds, degree of anemia and changes in liver size for early prevention and treatment of heart failure.
4. Pay attention to cleanliness: keep the infant’s skin, umbilicus and buttocks clean to prevent breakage and infection. When blood exchange therapy is needed, the air in the ward should be disinfected in a timely manner, with all the blood and various drugs and items available, and strict operating procedures.
Home care for jaundiced children
If there are no abnormalities in physiological jaundice, the baby should be observed and cared for in the same way as normal care, without special treatment. The recommended methods are as follows.
1.Giving adequate feedings.
2. It is not recommended to give glucose water, boiled water or fetal-reducing water, because not only will it not improve the jaundice, but it will aggravate the symptoms and even affect the appetite, causing serious consequences such as ionic imbalance. Drugs such as octopamine should not be taken either.
3, sunlight or general sunlight exposure may help a little, but the effect is still inconclusive, and must be careful not to be sunburned.
4, some conditions that can cause jaundice or aggravate jaundice need to be avoided, such as sericea infants need to avoid contact with nebulizer, purple potion and other substances that can cause hemolysis.
5, the use of medication must be prescribed by a physician, because certain creams or drugs can also cause hemolysis in infants with sericea.
6. Avoid infection, inadequate diet, high or low ambient temperature, etc.