A few things you should know about neonatal jaundice.
Moms and dads are nervous and confused about their baby’s jaundice, and there are also many misconceptions about neonatal jaundice. We have summarized these common misconceptions and questions in the hope of eliminating moms and dads’ confusion so that they will no longer worry unnecessarily about being nervous.
1.Every baby will have jaundice more or less and does not need treatment. (Wrong)
Although jaundice can occur in people of different races and colors, the incidence of jaundice in newborns is higher in our East Asian population than in other races. The incidence of jaundice in our newborns is about 50% in full-term babies and 80% in preterm babies, and not all babies develop jaundice.
Mild jaundice is not harmful to most babies, it is a normal growth process and does not require treatment. However, severe jaundice and the presence of some high-risk factors can be harmful to the baby, the most frightening being neurological damage caused by bilirubin entering the brain. Because of this, some babies need to be hospitalized for medical treatment in order to prevent jaundice from damaging their brains.
Does my baby need to be hospitalized for jaundice? This must be determined by a trained pediatrician, taking into account a variety of factors, and parents should accept the doctor’s advice and not make their own judgments.
2, as a parent I am so afraid of my baby going to the hospital, worried that no one will hold him, no one will touch and comfort him, and he will not be able to drink breast milk. (I understand the mother’s feelings very well)
As doctors, we don’t want our babies to leave their mothers’ arms, but they do need professional help when they are sick, so it is advisable to hospitalize newborn babies as a last resort. Doctors usually do their best to treat them and try to get them better quickly and back to their parents sooner. During the baby’s hospitalization, there are nurses and doctors who take care of them together: milk when they are hungry, diapers are changed promptly when they are dirty, and they are bathed and cleaned every day …… Although not as tenderly cared for as mom and dad, but definitely not alone and unsupported. Compared to the terrible consequences of jaundice causing bilirubin encephalopathy resulting in mental retardation, motor impairment, hearing damage, etc., weighing the pros and cons, the impact of the baby leaving his mother’s arms to go to hospital for treatment is still acceptable.
3. My baby was also very yellow at that time, and it was normal afterwards without treatment. (Luckily your baby did not have brain damage due to jaundice, but some babies are not so lucky)
Jaundice is only a brief and transitory manifestation in the newborn period, and it will naturally subside when the baby grows up. However, if the jaundice is severe, it may produce some irreversible damage to the brain, and even if the jaundice subsides later, the damage cannot be undone. Although the incidence of brain damage caused by jaundice is not 100%, and some babies are not affected by the treatment, but once the neurological damage occurs, the consequences are quite serious and difficult to reverse; and the side effects of blue light treatment are quite small, so it is recommended that if the jaundice is severe or there are clear high-risk factors, you should listen to the doctor’s advice for hospital treatment.
4. Breastfeeding should be stopped when jaundice appears to prevent it from getting worse. (Wrong)
Some newborns who are breastfed may have more jaundice than those who are artificially fed. But this is mostly caused by improper feeding, not breast milk itself. In this case, the first thing to check is whether the feeding method is appropriate, rather than unilaterally stopping the breast milk. Good feeding practices can reduce jaundice by promoting increased intestinal motility and bilirubin excretion from the stool. Therefore, it is more important to adhere to breastfeeding at this time, increase the number of breastfeeding, 8-12 times / day (i.e. 2-3 hours once), and try to reach 30-60ml of milk each time.
5, blue light treatment is not good for the eyes. (You worry for nothing)
All babies will wear eye shields to protect their eyes when they receive blue light treatment, so don’t worry. The blue light used for neonatal jaundice treatment is blue visible light with a wavelength of 425-475nm, and sunlight contains these same wavelengths of light.
Common side effects of phototherapy include fever, diarrhea and rash, but they are not serious and can be recovered quickly after stopping phototherapy, leaving no after-effects. Now there is a new type of cold light source blue light invented, this blue light side effects are smaller.
6, the baby has no congenital malformation, so it is certainly not pathological jaundice. (Wrong)
Congenital malformations are not directly related to neonatal jaundice.
Because bilirubin affects newborns of different gestational ages, birth weights and ages, the risk of harm varies, and there is a high risk for physiological jaundice ranges and a low risk for pathological jaundice ranges. So we don’t think it makes much sense to key words to say whether jaundice is physiologic or pathologic.
One of the high-risk factors is a genetically related disease called “glucose-6-phosphate dehydrogenase deficiency”, commonly known as “jelly bean disease”, which is more common in southern China and the Yangtze River basin. If there is a family history of this disease, babies should be alerted at birth and closely monitored for changes in skin jaundice for timely detection and management.
There are also some rare congenital diseases associated with neonatal jaundice, such as Gilbert syndrome and Crigler-Najjar syndrome.
7. Feeding more water and glucose water and urinating more often can reduce yellowing. (The most common misconception)
Bilirubin is mainly excreted in the body through the stool, and very little is excreted through the urine. It is not correct to say that more urination can reduce yellowing. For a small baby with a limited belly, drinking plain water and glucose water will distend the stomach and lead to a reduction in milk consumption, which will reduce bilirubin excretion through the stool, which is not conducive to the elimination of jaundice.
8, the sun will be able to reduce the yellow. (Not exactly true)
Direct sunlight can help reduce yellowing, but the effect is not ideal because the amount of blue wavelength light in sunlight is limited, and it is difficult to expose a large area of skin to sunlight at home, and even if you can do it, it is easy to cause ultraviolet burns and colds. So we don’t recommend relying on sunlight to get rid of yellow.
9, probiotics and gardenia yellow to help reduce the yellow effect is good. (debatable, with reservations)
Probiotics on bilirubin in vivo metabolism of the current limited number of studies, so its efficacy on receding yellow is yet to be further studied, and probiotic preparations of side effects and other aspects of research are also still in the exploration stage, for the time being there is no authoritative guide to the literature recommending the use of probiotics to help recede yellow, so at present it is not recommended to use probiotic preparations to help recede yellow.
Gardenia jasminoides is a traditional Chinese medicine preparation, and we are inconvenienced to analyze it from the perspective of western medicine.
The taste of these two drugs is sweet, which can easily reduce the baby’s hunger and may affect the amount of milk, but cause the jaundice to subside slowly.
10.Why are newborns prone to jaundice? How is the excess bilirubin produced and metabolized? (The content is relatively specialized, so I hope you can understand it)
Jaundice is a yellowing of the skin, sclera and mucous membranes that we can observe with the naked eye. The cause is an increase in the level of bilirubin in the blood.
Bilirubin is a chemical product in the human body, mainly found in red blood cells.
After birth, newborns start to breathe on their own, pulmonary circulation is established, and there is sufficient oxygen supply, too many red blood cells in the body start to be destroyed, and hemoglobin is decomposed to produce a large amount of unconjugated bilirubin, because the liver enzymes of newborns are not mature, unconjugated bilirubin cannot be metabolized by the liver and excreted, and it accumulates more and more in the body, thus making the skin, mucous membranes and other tissues yellow. As the destruction of red blood cells decreases and liver enzymes mature, unconjugated bilirubin is gradually metabolized and excreted through the intestine and urinary tract, and jaundice is gradually reduced and disappears.