In clinical practice, we find that half of all newborns are yellow (60% of full-term babies and 80% of preterm babies). Such children are usually diagnosed with neonatal jaundice, which is due to an increased concentration of bilirubin in the baby’s blood, so we also call it neonatal hyperbilirubinemia.
With such a high incidence, do they all need to be treated aggressively?
In fact, most neonatal jaundice is physiological, which means that it is a specific physiological phenomenon that occurs during the neonatal period, commonly known as “lunar nest yellow”, and does not require special treatment.
Parents may ask, “What does it mean that no special treatment is needed? How can I tell if my child is physiological or pathological? If it is pathological, how can I treat it?
In the case of physiological jaundice, newborns are generally in good condition, with jaundice appearing 2-3 days after birth in full-term infants, peaking at 4-5 days and subsiding in 5-7 days, with a maximum delay of no more than two weeks; in preterm infants, jaundice mostly appears 3-5 days after birth, peaking at 5-7 days and subsiding in 7-9 days, with a maximum delay of 3-4 weeks, while bilirubin levels in the blood of newborns do not rise very rapidly each day, with total bilirubin levels During this period, parents must pay more attention to their child’s jaundice, and if they feel that the jaundice is developing very rapidly or does not fade for a long time, they should see a doctor in a timely manner.
Some parents may ask, “What you say is too theoretical, we can’t draw blood and test our children at home, it’s not practical. How can we monitor our child’s jaundice? What if it gets worse? Here I will introduce some simple and practical methods for parents to refer to.
1, early opening of milk
The mother in the puerperium should be fully aware of the importance of the three early (early contact, early sucking, early opening of the milk): open the milk within 30 minutes of birth, open the milk can make the newborn get colostrum, thus reducing the physiological jaundice of the newborn. In daily feeding, attention should be paid to giving milk on demand. In the stage of neonatal physiological jaundice, ensuring early and sufficient intake of energy for the newborn will enable early discharge of meconium and establish normal intestinal flora, thus reducing the absorption of bilirubin from the intestine and facilitating the regression of neonatal jaundice. At the same time, we must ensure an adequate supply of water to prevent the concentration of blood, resulting in an increase in bilirubin levels.
2, more observation, diligent measurement
If the child is found to be jaundiced after three days, naked eye observation, parents can observe the degree of newborn skin yellowing under natural light, if only the face yellowing, for mild jaundice, you can continue to observe at home; if found trunk skin yellowing, for moderate jaundice; if the extremities and hands and feet heart also appear yellowing, for severe jaundice. At this time, it is necessary to go to the hospital for laboratory tests.
3, not necessarily draw blood to test jaundice
When you go to the hospital, many parents are most afraid to draw blood for their children. In fact, many times, if the doctor does not feel that the child is heavy, usually can use a transdermal lateral bile
The doctor can usually use a transcutaneous lateral bile instrument (which is generally available in large hospitals) to take a rough test (the instrument can be touched to the skin). If it is very serious, you need to promptly draw blood for laboratory tests
4.Eating and drinking should be noted
In addition to the above-mentioned early opening of milk, we usually advise parents of children with physiological jaundice to
Feed some glucose water (as in the case of white sugar, no strict quantification, diuretic effect): give the newborn sufficient water, because too little urine is not conducive to the excretion of bilirubin.
Feed some lactobacillus preparations (such as mommy’s love, gold double, etc.): with the help of these drugs, the fetal stool can be excreted as early as possible. Because fetal stool contains a lot of bilirubin, if the stool is not excreted, the bilirubin will be reabsorbed into the blood through the special liver and intestinal circulation of the newborn, causing jaundice to increase.
Feed some Chinese medicine (Yin Gardenia Huang granules), that is, Yin Chen extract 12g Gardenia extract 6.4g Baicalin 40g Gold Yin Hua extract 8g, that is, you can use Chinese medicine to play the role of clearing heat and detoxifying, and dampness and reducing yellow.
These methods, all very safe, can be early intervention treatment for children with physiological jaundice.
5. Observation of diarrhea and bowel movements
Children jaundice, in addition to eating and drinking, but also more observation of the color of urine and stool; if the stool becomes clay-colored, pathological jaundice should be considered, mostly due to congenital biliary malformations; if you find that the diaper is dyed by urine into a particularly yellow color, to seize the time to go to the hospital.
6.Care should be active
After the birth of a child, especially premature babies, many new mothers will not feed and care. These children in addition to eating well, to touch the child’s skin, the conditions can also allow the child to swim, research shows that: the use of infants with a larger body surface area than adults, the skin is delicate, rich in subcutaneous capillaries, through swimming・Spa and other exercises can achieve to promote the jaundice to subside, shorten the duration of jaundice, to reduce the adverse effects of jaundice on the body’s role.
7, jaundice prolonged without panic
Physiological jaundice stage, usually about half a month to a month, due to various reasons, many children with physiological jaundice prolonged, this time, you need to actively go to the hospital to let the doctor check. It is important for parents to know that jaundice appears on the face and gradually spreads to the whole body, but when it fades, it fades in reverse order, that is, the child’s facial yellow color fades last, so many parents only pay attention to the child’s exposed face does not fade, and they are very nervous. In fact, as long as the body is basically faded, the problem is not big, some children’s face will take more than a month to fade away. But if you find that your child’s whole body is yellow, you must hurry to the hospital.
8, pathological jaundice to recognize.
In what cases is jaundice pathological in children and should be promptly hospitalized?
Pathological jaundice has the following characteristics.
① Jaundice appears too early, within 24 hours after birth.
②The jaundice subsides too late, lasts too long, exceeds the normal time of remission, or the jaundice has subsided and reappears, or the jaundice gradually recedes after the peak time and then progressively worsens.
③The degree of jaundice is too severe, often spreading to the whole body, and the skin mucosa is obviously yellow.
④Bilirubin exceeds 12mg/dl when serum bilirubin is checked, or rises too rapidly, more than 5mg/dl per day.
⑤ In addition to jaundice, it is accompanied by other abnormalities, such as mental fatigue, less crying, less movement, less eating or unstable body temperature. Pathological jaundice can be complicated by bilirubin encephalopathy, often called “nuclear jaundice”, which can cause neurological damage and lead to serious sequelae such as mental retardation in children, or even death.
Therefore, when a child has jaundice, any of the above five aspects should be taken seriously by parents so that pathological jaundice can be detected early for timely treatment.
In short, in the face of jaundice, parents should pay attention to it and not take it lightly. Under the guidance of a doctor, most newborns can pass through the jaundice period smoothly with proper feeding and reasonable care.