I. What is neonatal jaundice?
Neonatal jaundice is one of the most common manifestations of neonatal period. It is caused by an increase in the level of bilirubin in the baby’s blood. The clinical manifestation is the appearance of yellowing symptoms about 3 days after birth, usually starting from the face and eyes and gradually spreading to the skin of the arms, legs and feet and the body. Normal adult serum bilirubin is less than 17 μmol/L (1 mg/dl), and jaundice occurs if it exceeds 34 μmol/L (2 mg/dl). In neonates, due to the abundance of capillaries, jaundice is visible to the naked eye when the serum bilirubin level reaches 85 μmol/L (5 mg/dl). Neonatal jaundice is classified as physiological or pathological. When jaundice is detected, parents must find a doctor to ask about the baby’s condition, because there are two types of neonatal jaundice, normal (physiological jaundice) and abnormal (pathological jaundice).
1. Normal (physiological jaundice).
(1) Good general condition not accompanied by other clinical symptoms, normal color of urine and stool.
(2) Jaundice appears 2~3 days after birth in full-term infants, peaks on the 4th~5th day and subsides on the 5th~7th day, with a maximum delay of 2 weeks; in preterm infants, jaundice mostly appears 3~5 days after birth, peaks on the 5th~7th day and subsides on the 7th~9th day, with a maximum delay of 3~4 weeks.
(3) Daily elevation of serum bilirubin <85μmol/L (5mg/dl) <0.85μmol/L (0.5mg/dl) per hour.
(4) Jaundice is first seen on the face and neck, then can spread to the trunk and extremities, generally slightly yellow, the sclera may have a mild yellow stain, but the palms and soles are not yellow.
Again, 60%-70% of neonatal jaundice is physiological and can subside on its own, so parents of babies need not worry too much.
2, abnormal (pathological jaundice).
(1) Jaundice appears within 24 hours after birth.
(2) The serum total bilirubin value has reached the corresponding age and the corresponding risk factors under phototherapy intervention criteria, or a daily rise of more than 85 μmol/L (5 mg/dl) or more than 0.85 μmol/L (0.5 mg/dl) per hour.
(3), long duration of jaundice, >2 weeks in term infants and >4 weeks in preterm infants.
(4), Jaundice receded and reappeared.
(5), Serum conjugated bilirubin exceeds 34 μmol/L (2mg/dl).
The diagnosis of pathological jaundice is made if any one of them is present.
Pathological jaundice usually appears much earlier, within 24 hours of birth, and can be head followed by feet throughout the body, and vomitus and cerebrospinal fluid can also be yellow, and it can take up to 2 to 3 weeks to improve, or even continue to deepen and worsen or recur. Pathological jaundice is often accompanied by pathological symptoms, such as poor spirit, convulsions, agitation, reluctance to feed, fever, low body temperature, and even some manifestations of the original disease. Pathological jaundice can affect the child’s hearing and nervous system, and requires adequate attention and treatment by parents and health care providers.
Second, what causes jaundice?
Many mothers also ask why some babies have jaundice and some do not, what causes jaundice in babies? There are more causes of jaundice, which are broadly divided into the following categories.
1, the mother prenatal medication: such as to the mother prenatal application of a large amount of oxytocin or vitamin K, etc.
2, asphyxia, hypoxia during labor: due to respiratory distress, hypoxia, on the one hand, aggravates the acidosis, on the other hand, inhibits the activity of glucuronosyltransferase, which affects the metabolic process of bilirubin.
3, bleeding from injury during delivery, which increases bilirubin production.
4, postpartum freezing, starvation: at this time the body free fatty acids and other organic anions increase, and bilirubin competition with albumin binding, and bilirubin free blood, delayed feeding, delayed discharge of fetal feces, can increase the intestinal a liver circulation, so that the blood unconjugated bilirubin increased.
5, excessive bilirubin production: erythrocytosis, internal bleeding, alloimmune hemolysis, infection, increased enterohepatic circulation, breastfeeding, red blood cell enzyme defects, abnormal red blood cell morphology, hemoglobinopathy.
6, impaired hepatic bilirubin metabolism: asphyxia, hypoxia, acidosis and infection, Crigier-Najjar syndrome, Gilbert syndrome, Lucey-Driscoll syndrome, drugs.
7, impaired excretion of bilirubin: neonatal hepatitis, congenital metabolic deficiency disease, congenital non-hemolytic conjugated bilirubin hyperplasia, bile duct obstruction.
Here, I still want to remind the baby’s mother, baby jaundice, can not be taken lightly, need to analyze the cause of the disease, for the cause of treatment.
Third, what harm can neonatal jaundice cause?
Excessive bilirubin can cause nuclear jaundice, also known as bilirubin encephalopathy, which is commonly associated with hearing damage and can cause cerebral palsy in severe cases.
Fourth, with jaundice, how to treat the baby jaundice, parents should not be anxious, here to tell a few ways to treat jaundice, according to the cause and degree of jaundice in babies choose different treatment methods:.
1, sunshine treatment.
If the degree of jaundice is not heavy, you can choose to use the blue light and green light in the sun to treat to reduce the baby’s jaundice, which is the most common and most direct treatment method. However, it is not suitable for this method when it is cold. Newborn babies are delicate and must be well protected when in the sun.
(1) First of all, to protect the baby’s eyes, you can make an eye mask at home with black cloth and put it on the baby.
(2) to do a good job to protect the external genitalia, in the sun when the baby wears a diaper (there are special blue diapers) will have a protective effect.
(3) sunlight across the glass to reduce the damage of ultraviolet rays on the skin of newborns; pay attention to the sun each time you change position, first on your back and then turn over to the sun.
(4) Sunbathing time needs to accumulate 2-4 hours a day, and after sunbathing, you need to feed your baby more milk or water to facilitate the discharge of bilirubin in the baby’s body.
2.Blue light treatment.
Blue light irradiation is a simple, effective and fast method of treating neonatal jaundice, that is, by shining light, the bilirubin in the body can be converted into other substances, so that the constant accumulation of bilirubin in the body finds another outlet, and the jaundice symptoms can gradually improve and eventually all subside.
This requires hospitalization, and also to protect the baby’s eyes and genitals.
3.Medication.
Oral gardenia jasminoides: for the treatment of jaundice has a certain role, but after eating some children will have diarrhea, if jaundice does not see good, and the child has serious diarrhea, stop using it; it is recommended that at the same time oral montelukast, bifidobacterium, on the one hand, can reduce the side effects of gardenia jasminoides, on the other hand, montelukast has adsorption of intestinal bilirubin, reduce bilirubin reabsorption, promote jaundice recede more quickly. Bifidobacterium is intestinal probiotics, which can improve intestinal microecology and promote bilirubin metabolism in order to facilitate jaundice subsidence.
V. Will jaundice recur once it is well?
Usually, physiological jaundice will not recur after getting well, but pathological jaundice will rise after a while even if the bilirubin is lowered by blue light treatment, so these people need to investigate the cause and cure the cause in order to treat jaundice completely.
Sixth, can a jaundiced baby be vaccinated?
Many babies come to the hospital with jaundice because they are found to be jaundiced during vaccinations and are told that they cannot be vaccinated. However, I want to tell the mothers of babies that physiological jaundice does not affect vaccination, and even pathological jaundice can be given if the bilirubin falls within a safe range. What is the safe range is jaundice that does not require special treatment.
Can I drink glucose or brown sugar water to treat jaundice?
In the clinic, we often meet some elderly people who immediately say that jaundice does not matter, just go back and drink some brown sugar water when they hear that their babies are jaundiced. I am here to tell baby mothers that this is not useful. Why would anyone think that drinking brown sugar water can cure jaundice? This is actually a misconception. The misconception arises from an enzyme: glucuronosyltransferase, an enzyme that is a protein and plays an important role in the metabolic process of jaundice. Some doctors mistakenly believe that the glucose produced by the metabolism of brown sugar can increase the amount or activity of this enzyme, but in fact the enzyme is a protein and it has nothing to do with glucose, so brown sugar water has almost nothing to do with jaundice treatment.
Eight, can rubbing horse teeth reduce jaundice?
In also meet some grandparents, see baby jaundice, take it upon themselves to rub the baby horse teeth. I don’t know where these old people heard that there is this method, and I don’t know when it was passed down. I want to remind mothers that they must be careful not to rub the horse’s teeth. In my work, I often encounter babies with sepsis caused by tooth rubbing infections, which not only do not subside, but also worsen the jaundice, and some even have serious infections that are not well controlled and end up being life-threatening! Remember!