Neonatal jaundice needs attention

  A male baby born 7 days after birth was admitted to the hospital because of skin yellowing for 4 days and aggravation with milk refusal for 1 day; born outside the hospital, skin yellowing appeared 3 days after birth and gradually aggravated, monitored transdermal jaundice value of about 20 mg/dl, the family refused to be hospitalized, given oral treatment such as Yinjian Huang, and one day before admission was given more oral Chuanlian water and was given yellow ginger water bath, after which the child’s jaundice rapidly aggravated, and appeared to refuse milk, poor response, solving tea-colored urine. The parents were of Guangdong and Guangxi origin. The baby was admitted with hypovolemic shock, renal insufficiency, metabolic acidosis, central respiratory failure, total bilirubin 640umol/L, HGB 72g/L, and G-6PD enzyme less than 200. Although treated with active volume expansion, acid correction, mechanical ventilation, blood transfusion, phototherapy, etc., he died due to multiple organ failure.  The baby was admitted to the hospital 5 days after birth due to yellow skin staining for 3 days, aggravation with refusal of milk and poor response for 1 day. The baby was born outside the hospital, and jaundice appeared 2 days after birth. 1 day before admission, the baby was given a bath with Huanglian water at home, after which the jaundice worsened with refusal of milk, poor response, and fever. Both parents were of Guangdong origin. After admission, he also had severe hyperbilirubinemia, shock, central respiratory failure, renal failure, G-6PD enzyme only 73, and Escherichia coli cultured in blood and cerebrospinal fluid.  G-6PD deficiency is an inherited enzyme deficiency disease that triggers an acute hemolytic reaction when a trigger is present. In the neonatal period, the disease mainly manifests as jaundice, usually ordinary hyperbilirubinemia, but when there are infections, drugs and other triggers, severe hemolytic reactions can occur causing bilirubin encephalopathy and multiple organ damage such as liver, kidney, heart and digestive tract, resulting in death or neurological sequelae. The incidence of jaundice is high in the south, especially in Guangdong, and in some areas of Guangdong, it is customary to give newborn babies Chinese herbal baths or oral medication, and we have treated many cases of children whose jaundice rapidly worsened after the application of Chinese medicine. Use medicine carefully!