What are the common causes of jaundice in newborns. How can parents identify jaundice symptoms at home. What are effective home remedies for treating newborn jaundice. When should parents seek medical attention for jaundiced babies.

Understanding Newborn Jaundice: A Common Condition

Jaundice is a prevalent condition among newborns, characterized by a yellowish tint to the skin and eyes. This occurs when there’s an accumulation of bilirubin, a chemical produced during the breakdown of red blood cells, in the baby’s bloodstream. While jaundice can affect infants of all ethnicities, it’s essential for parents to understand its causes, symptoms, and appropriate treatment methods.

Why is Jaundice Common in Newborns?

Jaundice is particularly common in newborns due to their developing liver function. Before birth, the mother’s liver processes bilirubin for the baby. After birth, it takes a few days for the newborn’s liver to adapt and efficiently remove bilirubin from the blood. This transition period often results in a temporary buildup of bilirubin, leading to jaundice.

Identifying Jaundice: Signs and Symptoms

Recognizing jaundice in newborns is crucial for timely intervention. The most noticeable sign is the yellowing of the skin, which typically starts on the face and progresses to the chest, abdomen, arms, and legs as bilirubin levels increase. The whites of the eyes may also appear yellow. It’s important to note that jaundice can be more challenging to detect in babies with darker skin tones.

Best Practices for Observing Jaundice

• Examine the baby in good lighting, preferably natural daylight or under fluorescent lights
• Gently press on the baby’s skin to check for yellowing
• Pay attention to changes in skin color over the first few days of life
• Consult a healthcare professional if you suspect jaundice

The Importance of Early Detection and Monitoring

While most cases of newborn jaundice are mild and resolve on their own, it’s crucial to monitor the condition closely. In rare instances, extremely high bilirubin levels can lead to brain damage. Therefore, healthcare providers recommend checking all newborns for jaundice, even if it’s not visibly apparent.

Recommended Screening Practices

1. Skin or blood tests within the first two days of life
2. Immediate bilirubin level testing if jaundice appears before 24 hours of age
3. Follow-up evaluations based on the baby’s age, jaundice severity, and risk factors

Breastfeeding and Jaundice: What Parents Should Know

Breastfeeding plays a significant role in managing newborn jaundice. Interestingly, jaundice is more common in breastfed babies compared to formula-fed infants. This increased prevalence is often related to insufficient milk intake, especially in the early days of breastfeeding.

Optimizing Breastfeeding to Manage Jaundice

To help manage jaundice through breastfeeding:

• Feed your baby 8 to 12 times a day in the first few days
• Ensure proper latching and positioning
• Seek support from a lactation specialist if experiencing difficulties
• Be aware that newborns typically consume very small amounts in the first 24 hours

Adequate breast milk intake helps maintain hydration and promotes regular bowel movements, both of which aid in reducing bilirubin levels.

Home Care Strategies for Jaundiced Newborns

While severe cases of jaundice require medical intervention, there are several home care strategies that parents can employ to help manage mild cases of newborn jaundice:

Frequent Feeding

Increasing feeding frequency can help lower bilirubin levels. Whether breastfeeding or formula-feeding, aim to feed your baby every 2-3 hours. This promotes hydration and encourages more frequent bowel movements, which help eliminate bilirubin from the body.

Sunlight Exposure

Controlled sunlight exposure can be beneficial for jaundiced newborns. Place your baby near a sunny window for short periods, ensuring they’re not overheated or sunburned. However, this should not replace medical treatment if prescribed.

Hydration

Keeping your baby well-hydrated is crucial. If breastfeeding, nurse more frequently. For formula-fed babies, you may need to increase the number of feedings. Always consult your pediatrician before making significant changes to your baby’s feeding routine.

Monitoring Diaper Output

Keep track of wet and soiled diapers. A well-hydrated baby should have at least 6-8 wet diapers in 24 hours. Regular bowel movements also help eliminate bilirubin from the body.

When to Seek Medical Attention for Jaundice

While many cases of newborn jaundice resolve on their own, it’s crucial to know when to seek medical help. Parents should contact their healthcare provider if they observe:

• Increasing yellowing of the skin, especially on the abdomen, arms, or legs
• Yellowing of the whites of the eyes
• Difficulty waking the baby or unusual fussiness
• Poor feeding or difficulty latching
• Fever or other signs of illness
• Dark, cola-colored urine or pale stools

Early intervention is key to preventing complications associated with severe jaundice.

Medical Treatments for Newborn Jaundice

In cases where home care isn’t sufficient, medical treatments may be necessary to manage newborn jaundice. The most common interventions include:

Phototherapy

This is the primary treatment for moderate to severe jaundice. The baby is placed under special blue lights that help break down bilirubin in the skin. This can be done in the hospital or at home with portable units.

Supplemental Feeding

In some cases, especially with breastfed babies, supplementing with formula can help increase fluid intake and promote more frequent bowel movements, aiding in bilirubin elimination.

Intravenous Immunoglobulin

For jaundice caused by blood type incompatibility between mother and baby, intravenous immunoglobulin may be used to reduce the need for exchange transfusion.

Exchange Transfusion

In rare, severe cases, an exchange transfusion may be necessary. This involves replacing the baby’s blood with donor blood to quickly reduce bilirubin levels.

Preventing Complications from Newborn Jaundice

While most cases of newborn jaundice are harmless, prevention of severe cases is crucial to avoid potential complications. Here are key strategies for preventing harmful jaundice:

Early and Frequent Feeding

Establishing a good feeding routine immediately after birth helps promote regular bowel movements and bilirubin elimination. Aim for 8-12 feedings per day in the first week.

Regular Check-ups

Attend all scheduled follow-up appointments, especially the crucial visit between 3-5 days after birth when bilirubin levels typically peak.

Bilirubin Screening

Many hospitals routinely screen all newborns for jaundice before discharge. Ensure your baby receives this screening and follow up as recommended.

Recognizing Risk Factors

Be aware of factors that increase the risk of severe jaundice, such as premature birth, blood type incompatibilities, or a family history of severe jaundice.

Long-term Outlook for Babies with Jaundice

The long-term prognosis for most babies who experience newborn jaundice is excellent. With proper monitoring and timely treatment, the vast majority of infants recover completely without any lasting effects. However, it’s important to understand the potential outcomes and follow-up care:

Normal Development

Most babies treated for jaundice go on to develop normally. Regular pediatric check-ups can help ensure that your baby is meeting developmental milestones.

Rare Complications

In extremely rare cases where severe jaundice goes untreated, there is a risk of bilirubin-induced neurological dysfunction (BIND). This underscores the importance of prompt treatment for high bilirubin levels.

Follow-up Care

After treatment for jaundice, your pediatrician may recommend follow-up visits to monitor your baby’s bilirubin levels and overall health. These check-ups are crucial for ensuring complete recovery.

Long-term Monitoring

In cases of severe jaundice, healthcare providers may recommend long-term monitoring of developmental milestones. This is typically a precautionary measure to catch any potential issues early.

Understanding newborn jaundice empowers parents to take appropriate action and seek timely medical care when necessary. By recognizing the signs, implementing home care strategies, and knowing when to consult healthcare professionals, parents can effectively manage this common condition and ensure their newborn’s health and well-being.

Jaundice in Newborns: Parent FAQs

​Jaundice is the yellow color seen in the skin of many newborns. It happens when a chemical called bilirubin builds up in the baby’s blood. Jaundice can occur in babies of any race or color.  

Q: Why is jaundice common in newborns?  

A: Everyone’s blood contains bilirubin, which comes from red blood cells and is removed by the liver. Before birth, the mother’s liver does this for the baby. Most babies develop jaundice in the first few days after birth because it takes a few days for the baby’s liver to get better at removing bilirubin.  

Q: How can I tell if my baby is jaundiced?  

A: The skin of a baby with jaundice usually appears yellow. The best way to see jaundice is in good light, such as daylight or under fluorescent lights. Jaundice usually appears first in the face and then moves to the chest, abdomen, arms, and legs as the bilirubin level increases. The whites of the eyes may also be yellow. Jaundice may be harder to see in babies with darker skin color.  

Q: Can jaundice hurt my baby?  

A: Most babies have mild jaundice that is harmless, but in unusual situations the bilirubin level can get very high and might cause brain damage. This is why newborns should be checked carefully for jaundice and treated to prevent a high bilirubin level.  

Q: How should my baby be checked for jaundice?  

A: If your baby looks jaundiced in the first few days after birth, your baby’s doctor or nurse may use a skin or blood test to check your baby’s bilirubin level. However, because estimating the bilirubin level based on the baby’s appearance can be difficult, most experts recommend that a skin or blood test be done in the first 2 days even if your baby does not appear jaundiced. A bilirubin level is always needed if jaundice develops before the baby is 24 hours old. Whether a test is needed after that depends on the baby’s age, the amount of jaundice, and whether the baby has other factors that make jaundice more likely or harder to see.  

Q: Does breastfeeding affect jaundice?  

A: Breast milk (human milk) is the ideal food for your baby. Jaundice is more common in babies who are breastfed than babies who are formula-fed. However, this occurs more often in newborns who are not getting enough breast milk because their mothers are not producing enough milk (especially if the milk comes in late) or if breastfeeding is not going well, such as babies not latching on properly.  

For the first 24 hours after birth, normal breastfed newborns receive only about 1 teaspoon of milk with each feeding. The amount of breast milk provided increases with each day. If you are breastfeeding, you should breastfeed your baby at least 8 to 12 times a day for the first few days. This will help you produce enough milk and will help keep the baby’s bilirubin level down. If you are having trouble breastfeeding, ask your baby’s doctor or nurse or a lactation specialist for help.  

Q: When should my baby get checked after leaving the hospital?  

A: It is important for your baby to be seen by a nurse or doctor when the baby is between 3 and 5 days old, because this is usually when a baby’s bilirubin level is highest. This is why, if your baby is discharged before age 72 hours, your baby should be seen within 2 days of discharge. The timing of this visit may vary depending on your baby’s age when released from the hospital and other factors.  

Q: Why do some babies need an earlier follow-up visit after leaving the hospital?  

A: Some babies have a greater risk for high levels of bilirubin and may need to be seen sooner after discharge from the hospital. Ask your doctor about an early follow-up visit if your baby has any of the following symptoms:  

• A high bilirubin level before leaving the hospital

• Early birth (more than 2 weeks before the due date)

• Jaundice in the first 24 hours after birth

• Breastfeeding that is not going well

• A lot of bruising or bleeding under the scalp related to labor and delivery

• A parent, brother, or sister who had a high bilirubin level and received light therapy

Q: When should I call my baby’s doctor?  

A: Call your baby’s doctor if:

• Your baby’s skin turns more yellow.

• Your baby’s abdomen, arms, or legs are yellow.

• The whites of your baby’s eyes are yellow.

• Your baby is jaundiced and is hard to wake, fussy, or not nursing or taking formula well.

Q: How is harmful jaundice prevented?  

A: Most jaundice requires no treatment. When treatment is necessary, placing your baby under special lights while he or she is undressed will lower the bilirubin level. Depending on your baby’s bilirubin level, this can be done in the hospital or at home. Jaundice is treated at levels that are much lower than those at which brain damage is a concern. In some babies, supplementing breast milk with formula can also help to lower the bilirubin level and prevent the need for phototherapy. Treatment can prevent the harmful effects of jaundice.  

Note: Exposing your baby to sunlight through a window might help lower the bilirubin level, but this will only work if the baby is undressed. Make sure the temperature in your home is comfortable and not too cold for your baby. Newborns should never be put in direct sunlight outside because they might get sunburned.  

Q: When does jaundice go away?  

A: In breastfed babies, it is common for jaundice to last 1 month or occasionally longer. In formula-fed babies, most jaundice goes away by 2 weeks. However, if your baby is jaundiced for more than 3 weeks, see your baby’s doctor. 

Additional Information & Resources:

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The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Jaundice in Newborns (for Parents)

What Is Jaundice?

Babies with jaundice have a yellow coloring of the skin and eyes. This happens when there is too much bilirubin in the baby’s blood.

Bilirubin (bill-uh-ROO-bin) is a yellow substance that comes from the normal breakdown of red blood cells. The liver removes bilirubin from the blood and passes it into the bowels so it can leave the body.

A newborn baby’s liver does not remove bilirubin as well as an adult’s does. Jaundice (JON-diss) happens when bilirubin builds up faster than the liver can break it down and pass it from the body.

Most types of jaundice go away on their own. Others need treatment to lower bilirubin levels.

What Are the Signs & Symptoms of Jaundice?

A baby with jaundice has skin that looks yellow. It starts on the face, then the chest and stomach, and then the legs. The whites of a baby’s eyes also look yellow. Babies with very high bilirubin levels may be sleepy, fussy, floppy, or have trouble feeding.

Jaundice may be hard to see, especially in babies with dark skin. If you’re unsure, gently press the skin on your baby’s nose or forehead. If it’s jaundice, the skin will appear yellow when you lift your finger.

Call the doctor if your baby:

• starts to look or act sick
• is not feeding well
• is sleepier than usual
• has jaundice that gets worse

What Causes Jaundice in Newborns?

Most healthy newborns have physiological (“normal”) jaundice. This happens because newborns have more blood cells than adults do. These blood cells don’t live as long, so more bilirubin is made when they break down. This kind of jaundice appears 2–4 days after the baby is born and goes away by the time a baby is 2 weeks old.

A baby is more likely to get jaundice when he or she:

• is born premature. Premature babies are even less ready to remove bilirubin. They also can have problems at lower bilirubin levels than babies born later. Doctors treat them sooner.
• isn’t getting enough breast milk. This often happens in the first few days of life, because a mother’s milk isn’t in yet or the baby is having trouble breastfeeding. If a baby has this type of jaundice (called breastfeeding jaundice), it’s best to feed more often. A breastfeeding (lactation) consultant can help.
• is breastfed. Breast milk prevents the liver from quickly removing bilirubin. This is called breast milk jaundice and happens after the first week of life. Bilirubin levels slowly improve over 3–12 weeks.
• has a different blood type from the mother. If mother and baby have different blood types, the mother’s body makes antibodies that attack the baby’s red blood cells. This happens when:
  • the mother’s blood type is O and the baby’s blood type is A or B (ABO incompatibility) or
  • the mother’s Rh factor (a protein found on red blood cells) is negative and the baby is Rh positive.
• has a genetic problem that makes red blood cells more fragile. Red blood cells break down more easily in health problems like hereditary spherocytosis and G6PD deficiency.
• is born with high red blood cell numbers (polycythemia) or a large bruise on the head (cephalohematoma)

How Is Jaundice Diagnosed?

Doctors can tell if a baby has jaundice based on a yellowing of the skin and whites of the eyes. All newborns are checked for jaundice before leaving the hospital or birth center.

Babies with jaundice will get a blood test to check bilirubin levels. Sometimes, a light machine that measures bilirubin in the skin is used. But if the level is high, a blood test must confirm the result.

High bilirubin levels can lead to serious problems. So doctors carefully watch babies with jaundice.

How Is Jaundice Treated?

Treatment depends on the cause of the jaundice, the bilirubin levels, and a baby’s age.

Mild jaundice goes away after 1 or 2 weeks as a baby’s body gets rid of the extra bilirubin on its own. For newborns with breastfeeding jaundice, mothers should breastfeed the baby more often. If the baby is not getting enough breast milk, the doctor may suggest supplementing with formula.

For more serious cases of jaundice, treatment should start as soon as possible. Babies may get:

• fluids. A loss of fluids (dehydration) will cause bilirubin levels to rise.
• phototherapy. Babies lie under lights with little clothing so their skin is exposed. The light changes the bilirubin to a form that can easily pass out of the body. Light-therapy blankets may also be used.
• exchange blood transfusion. This emergency procedure is done if very high bilirubin levels do not come down with phototherapy. The baby’s blood is replaced with blood from a donor to quickly lower bilirubin levels.
• 
  intravenous immunoglobulin (IVIg). Babies with blood type incompatibilities get this through an IV (into a vein). IVIg blocks antibodies that attack red blood cells and reduces the need for an exchange transfusion.

What Else Should I Know?

Call the doctor if your baby has jaundice that isn’t going away. Babies with jaundice for longer than 2 weeks need more testing to check for other things that cause jaundice. These include infections, and problems with the liver or bile system, metabolism, or genes.

Your Baby, Jaundice and Phototherapy

Your Baby, Jaundice, and Phototherapy

What is Jaundice?  

Jaundice is a common, temporary. and usually harmless condition in newborn infants. It affects both full-term and premature babies, usually appearing during the first week of the baby’s life.

Jaundice occurs when there is a build-up of a naturally occurring substance in the blood called bilirubin . Bilirubin is an orange/red pigment in the blood. Bilirubin is produced by the normal breakdown of red blood cells. It is normal for everyone to have low levels of bilirubin in their blood. As bilirubin begins to build up, it deposits on the fatty tissue under the skin causing the baby’s skin and whites of the baby’s eyes to appear yellow.

What are the Causes of Jaundice?

Jaundice can be caused by several different problems:

• Physiological jaundice: This is the most common cause of newborn jaundice and occurs in more than 50% of babies. Because the baby has an immature liver, bilirubin is processed slower. The jaundice first appears at 2 to 3 days of age. It usually disappears by 1 to 2 weeks of age, and the levels of bilirubin are harmless.
• Breast-feeding jaundice: Breast-feeding jaundice may occur when your baby does not drink enough breast milk. It occurs in 5% to 10% of newborns. The jaundice symptoms are similar to those of physiological jaundice, just more pronounced. The jaundice indicates a need for help with breast-feeding.
• Breast-milk jaundice: Breast-milk jaundice occurs in 1% to 2% of breast-fed babies. It is caused by a special substance that some mothers produce in their milk. This substance causes your baby’s intestine to absorb more bilirubin back into his body than normal. This type of jaundice starts at 4 to 7 days of age. It may last 3 to 10 weeks. It is not harmful.
• Blood group incompatibility (Rh or ABO problems): If a baby and mother have different blood types, sometimes the mother produces antibodies that destroy the newborn’s red blood cells. This causes a sudden buildup of bilirubin in the baby’s blood. This serious type of jaundice usually begins during the first 24 hours of life. Rh problems formerly caused the most severe form of jaundice. However, they are now preventable if the mother is given an injection of RhoGAM within 72 hours after delivery. This prevents her from forming antibodies that might endanger other babies she has in the future

What is the Treatment?

High levels of bilirubin can occur in the blood called hyperbilirubinemia. These high levels can be dangerous to a baby. It is important to obtain periodic blood samples to check the bilirubin levels and, if necessary, to treat jaundice to ensure the healthy development of your child. Feeding your baby every 2- 3 hours is recommended to reduce the jaundice levels. If you are breastfeeding, supplementation (ex. with formula via cup feeding, supplemental feeder, or bottle) may be recommended by your pediatrician if the bilirubin will not come down with frequent feedings. Phototherapy with or without a biliblanket is the most common form of treatment for jaundice. This treatment is used for a few days until the liver is mature enough to handle the bilirubin on its own.

What is Phototherapy?

Some normal jaundice will disappear within a week or two without treatment. Other babies will require treatment because of the severity of the jaundice, the cause of the jaundice, or how old the baby is when jaundice appears.

Phototherapy (light treatment) is the process of using light to eliminate bilirubin in the blood. Your baby’s skin and blood absorb these light waves. These light waves are absorbed by your baby’s skin and blood and change bilirubin into products, which can pass through their system.

For over 30 years, phototherapy treatment in the hospital has been provided by a row of lights or a spotlight suspended at a distance form a baby. This would provide light shining directly on an undressed baby (with diaper on) whose eyes would need protection from the light with soft eye patches applied. Today, advancements in technology have led to a new phototherapy system which gives effective treatment without the inconveniences of conventional phototherapy treatment.

Are there Side Effects of Using Phototherapy?

Babies under any type of phototherapy treatment will have frequent and loose bowel movements that are sometimes greenish in color. This is normal since this is the way the body removes the bilirubin. This will be temporary and should stop when treatment is completed. Contact your doctor if it persists after treatment is completed.

What is the BiliBlanket?

Your doctor may prescribe the biliblanket as an alternative and/or additional treatment for you child’s jaundice. This system uses fiber optics and represents advanced technology in phototherapy treatment given in the hospital or at home.

The biliblanket provides the highest level of therapeutic light available to treat your baby. This form of light is also found in sunlight. The strength of light form the biliblanket is about the same, as you would get in the shade on a sunny day, yet is safer because the biliblanket filters out potentially harmful ultraviolet and infrared energy.

A pad of woven fibers is used to transport light from a light source to your baby. This covered fiberoptic pad is placed directly against your baby to bathe the skin in light. Absorption of this light leads to the elimination of bilirubin.

The biliblanket can be used 24 hours a day to provide continuous treatment if prescribed by your doctor. Blood may be drawn and tested during treatment to check bilirubin levels and determine when normal levels are reached and phototherapy is no longer needed.

With this convenient form of phototherapy your child can be diapered, clothed, held, and nursed during treatment.

Can my baby sleep on a biliblanket?

Yes. Your hospital will outline the schedule for your child’s treatment. However, the biliblanket can be used 24 hours a day for as long as necessary.

Why is my baby’s skin bleached or reddened’ where the biliblanket pad has been in contact with the skin?

The skin in direct contact with the pad is the first area where bilirubin is broken down. This breakdown process is not harmful; in fact, it contributes to the treatment of your baby and causes this portion of skin to turn to its normal color. As the treatment process continues, bilirubin is removed from the blood and the rest of the skin. As the bilirubin is lowered to acceptable levels, all of you baby’s skin will return to its normal color.

Will my baby be rotated on the pad to treat all of his/her skin?

No, only a small portion of the bilirubin is in the fatty tissue of the skin. The majority of the bilirubin is in the blood. The circulation of the blood will bring the bilirubin to the lighted area where it will be broken down.

It is important that the plain lighted area of the covered pad-the area without writing- is against the baby’s skin at all times during treatment. Clothing can then be applied over the system.

How long will the biliblanket be used on my baby?

The length of time phototherapy treatment is needed varies from one baby to the next as each baby’s condition is different. Your health care provider will prescribe the amount of time your baby will be on the biliblanket each day.

Most babies have phototherapy treatment for several days. Your baby’s bilirubin level will be tested during treatment, usually by a small sample of blood taken from the baby’s heel. These tests will determine when normal levels of bilirubin are reached and phototherapy is no longer needed.

Reviewed by UMHS Newborn Care Committee, May 2005

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About This Article

Medically reviewed by:

Board Certified Pediatrician

This article was medically reviewed by Joel Warsh, MD. Dr. Joel Warsh is a board certified Pediatrician and the Owner & Founder of Integrative Pediatrics and Medicine in Los Angeles, California. With over a decade of experience, Dr. Warsh specializes in holistic and integrative medicine. He holds a Bachelor’s degree in Kinesiology and Health Sciences, a Master’s degree in Epidemiology and Community Health, and a Doctor of Medicine (MD) from Thomas Jefferson Medical College, where he was elected president of the Jefferson Pediatric Society. Dr. Warsh then completed his Pediatric Residency at Children’s Hospital of Los Angeles (CHLA), where he received the George Donnell Society Research Fellow. This article has been viewed 127,249 times.

Co-authors: 26

Updated: July 23, 2021

Views: 127,249

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Article SummaryX

To treat simple, uncomplicated jaundice in your newborn, expose them to filtered sunlight either through a polarized window inside or by taking them outside in a covered stroller for 5 minutes twice daily. The filtered sunlight will help your baby’s body to remove the excess bilirubin that causes jaundice from their system. Be careful not to expose your infant to direct sunlight, which can be harmful to their skin. You should also increase your baby’s daily feedings to help your baby have more bowel movements, which help to remove bilirubin. To treat more severe jaundice, your doctor might recommend light therapy for your baby. For this method, your baby will be placed under special lighting that helps them get rid of the harmful bilirubin more rapidly. If your baby’s bilirubin levels are still high, your doctor may order a blood transfusion to replace bilirubin-heavy blood with bilirubin-free blood to reduce the levels quickly. For more tips from our Medical co-author, like how to reduce the risk of jaundice, keep reading!

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Newborn Jaundice | Duke Health

Pathologic jaundice, however, involves a higher level of bilirubin and requires treatment to hasten the removal of bilirubin. This can occur in any newborn who has an exaggerated form of physiologic (normal) jaundice. There are also risk factors that can help guide clinicians as to which babies must be followed more carefully.

One risk factor is prematurity — babies born more than two weeks before their due date are more likely to develop higher levels of bilirubin. The more premature a child is, the less mature their liver is at the time of birth, and the harder it is for them to start eliminating the bilirubin.

A blood type incompatibility between the mother and baby is also a reason to track the newborn’s jaundice more closely. This exists when a mother has the blood type O (and therefore has antibodies against A and B cells) and her newborn is of blood type A or B. This may cause the newborn’s red blood cells to break down more quickly due to maternal antibodies that have leaked into the baby’s bloodstream.

A blood type incompatibility also exists if the mother has a Rh (Rhesus) factor negative blood type and the newborn is Rh factor positive. This had been a common cause of severe neonatal jaundice, but is now very uncommon because Rh immune globulin (Rhogham) is given to mothers at risk before delivery.

Although breastfeeding is also considered a risk factor, it is actually lack of effective breastfeeding that is the risk factor. The likelihood of problems with nursing are minimized by nursing the newborn as soon after birth as possible and to continue nursing eight to 12 times per day for the first several days. Breast milk is an ideal food for babies, and jaundice is usually not a reason to add formula to the diet.

Other risk factors for pathologic jaundice include excessive bruising of the newborn, having a sibling that required treatment for jaundice, and being of East Asian race.

Jaundice in the first 24 hours of life is never physiologic and always merits an evaluation.

There’s no Place Like Home: This Baby Blanket Heals Infant Jaundice From the Comforts of Home

This hospital in northern Finland incorporates home treatment for infants with jaundice

Every parent recalls the joy that comes with having a newborn. But it can also be a daunting experience with several questions running through a parent’s head. Is my baby healthy? Did I get everything she needs? Will I bond with my new baby? A long hospital stay can add to that stress.

All of Anna’s* four children were born with jaundice – a liver condition that causes yellowing of a newborn baby’s skin and eyes. “We were still in the delivery room with my newborn, when I noticed his skin had a yellow tone,” she says of her youngest. “After a couple days, the bilirubin levels in his blood were so high that phototherapy was necessary.”

Human blood contains bilirubin, a substance formed when red blood cells break down. Normally, the liver filters bilirubin from the bloodstream and releases it into the intestine so it can be passed out safely. However, sometimes, the liver cannot remove bilirubin fast enough and the excess causes jaundice, a condition resulting in a yellow skin tone. Jaundice is common in newborn babies, as they have a high number of red blood cells, which are broken down and replaced frequently. Moreover, a newborn baby’s liver is not fully developed, so it’s less effective at removing the bilirubin from the blood.

The symptoms of jaundice are usually visible during the first week after birth. Most babies recover from jaundice without needing treatment. However, infants with high bilirubin levels require phototherapy, a treatment that uses a special type of blue light. When exposed to the light, the bilirubin absorbs it, thus decreasing the jaundice levels. The lights help the bilirubin in the blood change, so it can be easily expelled by the body.

Fortunately, Anna delivered at a clinic in Finland that offers home treatment for infants with jaundice to help ease some of the stress parents face.  

In the past, phototherapy treatment was typically only offered at the hospital, increasing the length of stays. Today, phototherapy devices can be taken to the home, allowing families to go home sooner. At the Oulu University Hospital in Finland, GE Healthcare’s BiliSoft phototherapy devices have been available for home use for more than four years.

“My husband picked up the device and we watched the information video online,” Anna shared. “Our baby was treated for 24 hours but his bilirubin levels did not decrease. After two more days of treatment, the levels began to come down and we no longer needed the device.”

“Families are much happier when they’re able to go home with their baby,” says Terhi Tuomaala, a midwife at the Oulu University Hospital. “Home-based phototherapy helps establish an emotional connection between parents and the baby. The device is small, portable, and best of all, the baby can be held or carried during treatment.”

Tuomaala added, “GE Healthcare’s BiliSoft phototherapy device is easy to use. Instructional videos and a guide book are provided to each family. Once a treatment has been decided, we ask families to review these materials so they are informed about how to use the device.”

Six months later, Anna’s youngest child is a happy, healthy, and alert infant. Home-based phototherapy enabled his parents to stay close to all four of their children.

*Name changed for privacy

Newborn jaundice: What parents need to know

Most newborn babies turn at least a little bit yellow. Known as jaundice, this condition is a very common and usually normal part of the newborn period. But in some very rare cases it can lead to (or be a sign of) a more serious problem. That’s why parents need to know about it.

What causes jaundice?

The yellow color of newborn jaundice is caused by high levels of a substance called bilirubin in the blood. Bilirubin mostly comes from the breakdown of red blood cells. It gets processed in the liver to make it easier for the body to get rid of through the urine and stool.

Newborn livers need some time to get up and running when it comes to getting rid of bilirubin. Newborns also have more red cells than older children and adults, and those brand-new red cells don’t last as long as the ones that get made as babies grow older. The combination of these two factors is what makes jaundice so common.

Jaundice usually peaks in the first two to five days of life, and lasts about one to two weeks. In babies who are breastfed, it can last longer; we don’t know exactly why this happens, but it isn’t anything to worry about.

Jaundice may actually be protective of babies, because bilirubin is an antioxidant that may help fight infection in newborn infants. This is another reason why parents shouldn’t be too worried by a bit of yellowness: not only is it temporary, but it may also be helping their baby as he or she leaves the security of the womb.

Rarely, jaundice may signal a problem

Sometimes, though, jaundice can be a sign of another problem, and when bilirubin levels get very high it can affect the brain, sometimes in a permanent way. This is very, very rare, affecting far less than 1% of infants.

There are many conditions that can make it more likely that bilirubin levels will be high, including:

• Dehydration or inadequate calories. This most commonly happens when babies are exclusively breastfed and a problem with breastfeeding goes unrecognized.
• The systems that work to get rid of bilirubin may just not be ready yet.
• Infection, or a blockage of the intestine. Jaundice would not usually be the only symptom of this.
• ABO or Rh incompatibility. When mother and baby have differences in their blood types, it can lead to more breakdown of red cells than usual. This is something that obstetricians are very aware of, and testing is done whenever there is a concern.
• Bruising or a cephalohematoma (a lump or a bruise on the head). Both can happen during a difficult birth. These lead to more red cells breaking down.
• Liver diseases. There are a number of different liver problems that can make it harder for the baby’s body to get rid of bilirubin.
• Diseases that affect an important enzyme. Some diseases, such as Gilbert syndrome or Crigler-Najjar syndrome, lead to a problem with an enzyme that is important for getting rid of bilirubin.
• Genetic factors. Not all of these factors are well understood. If one baby in a family has jaundice, future babies may have a higher risk too. Babies of East Asian descent, for example, are more likely to have higher bilirubin levels.

Babies are monitored closely for jaundice in the newborn period. Very often, pediatricians use a blood test or a device that measures the bilirubin level through the skin. Based on the result and any risk factors, they decide whether more monitoring or tests are needed, and whether the baby needs therapy.

How is newborn jaundice treated?

The most common therapy, used for the vast majority of babies whose bilirubin levels get worrisome, is phototherapy. The baby is put under a special light (or wrapped in a special blanket with the light inside it) that helps the body get rid of bilirubin. This is safe and effective. When levels are extremely high and there is concern for the possibility of brain damage, therapies such as exchange transfusion, where blood is taken out and new blood put back in, are necessary. However, this is extremely rare.

Feeding is an important part of therapy as well, as it helps the body get rid of bilirubin through the blood and urine. Feeding a newborn frequently can also help prevent problems with jaundice. Babies should wet at least six diapers over a 24-hour period, and should have stools regularly. The stool should change from the normal newborn black, tarry stools to stools that are lighter in color, and looser and “seedy.”

What do parents need to know about newborn jaundice?

It’s important for parents to keep an eye on their baby’s jaundice when they go home from the hospital. Jaundice can be harder to see in dark-skinned babies. A good way to look for it is to press down for a moment on the baby’s skin in a spot where the bone is close (the forehead, nose, chest, or shin are good places to do this). This pushes out the blood briefly and should make the skin paler for a few seconds. If it looks yellow instead of pale, there may be jaundice.

Jaundice tends to spread from the face downward as bilirubin levels go up. For that reason, doctors worry far less about a baby who is yellow just in the face and upper chest than one who is yellow below the knees.

Call the doctor if your baby

• is looking more yellow, especially if it is spreading down below the knees
• is feeding poorly, and/or isn’t wetting at least six diapers in 24 hours and having regular stools
• is very sleepy, especially if they don’t wake to feed
• is very fussy and hard to console
• arches their head or back, or is otherwise acting strangely
• has a fever or is vomiting frequently.

Remember: jaundice is common, and serious problems are rare! But call your doctor if you are worried; it’s always better to be safe than sorry.

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90,000 home treatment, Pasman Clinic

Jaundice is a yellow discoloration of the skin, visible mucous membranes and sclera of the eyes. The yellow color is determined by a special bile pigment – bilirubin, which is formed in the body during the breakdown of red blood cells, or rather, the hemoglobin contained in them. The erythrocytes that have served their time are destroyed mainly in the spleen, while bilirubin is formed, which is called indirect, since it is not associated with proteins. This indirect bilirubin (NB) is insoluble in water, therefore, it is not excreted by the kidneys, but most importantly, it is a tissue poison, especially dangerous for the central nervous system.By binding to blood proteins, NB reaches the liver, where it is transformed by enzymatic systems into direct bilirubin (PB), which is no longer toxic, soluble in water and can be excreted by the kidneys, as well as with bile through the intestines.

If the level of bilirubin is significantly increased or insignificantly, but for a long time, this will undoubtedly weaken the entire body, delay the development and maturation of all organs and, first of all, the nervous and immune systems. Treatment of mild forms of jaundice is carried out on an outpatient basis – at home.If the level of bilirubin is high or there are signs of an intrauterine infection, it is better to treat the child in a hospital setting, where intravenous administration of glucose-saline solutions is carried out, which quickly reduce the level of bilirubin. At home, drugs are used that promote the excretion of bilirubin with bile, sorbents, hepatoprotectors. Currently, it has been proven that the most effective, gentle and physiological treatment for jaundice is treatment with light of a certain wavelength, phototherapy.Under the influence of light, toxic bilirubin passes into its photoisomer – lumirubin, which is absolutely non-toxic, soluble in water and excreted by the kidneys.

In our clinic there is a device for conducting phototherapy at home. It is safe for a child, simple and convenient, in fact it is the only reliably highly effective method of treating jaundice. With phototherapy, it is very important to assess the level of bilirubin and its decrease. To determine the amount of bilirubin, serum or blood plasma is examined, for which blood is taken from a child from a vein or from a finger.Of course, this is a trauma for the baby (and how difficult it is to take blood from a vein!) And even more trauma for the parents. We offer a transcutaneous (percutaneous) method for determining the level of bilirubin. A bilirubinometer – bilitester is applied to the skin in the forehead or sternum, and a number appears on its screen showing the level of bilirubin in the skin. Long-term studies have proven that the relationship between the level of bilirubin in the blood and in the skin is constant and parallel. For example, according to the result of a plasma study (blood taken from a vein), bilirubin is 114.5, and according to bilitest – 114-115.There is a difference, but is it relevant to treatment and follow-up plans? No, but definitely significant in the absence of trauma for the child and parents.

For the treatment of jaundice at home using the OFTN-03 “AXION” apparatus, please contact the pediatric department of the clinic, phone (383) 303-03-03, ext. 2.

How to lower the level of bilirubin in newborns at home

If jaundice in a newborn appears by the end of the second day, does not go below the umbilical line, while the child is active, he has a normal body temperature, he eats well, actively suckles, he has light urine, colored feces, then your child is fine.

You are required to provide care for him, adequate breastfeeding (i.e. sufficient, at least 12 times a day, including at night) and continue to monitor the development of jaundice.

There is reason for concern (

If jaundice appeared by the end of the second day and spreads below the umbilical line, to the knees and to the elbows, and at the same time the child is lethargic, drowsy, does not suck well, it is necessary to examine and determine the level of bilirubin

The same should be done if the jaundice has become protracted or appeared for the first time after the 7th day of the child’s life.

Remember that in physiological jaundice, the serum bilirubin level does not exceed 200 μml / L.

IMPORTANT! Breastfeeding and bilirubin levels.

Delayed initiation of breastfeeding and inadequate breastfeeding have been shown to be responsible for inadequate food intake.

This leads to an increase in the level of bilirubin in the blood.

An increase in the frequency of feeding at least 12 times a day significantly reduces the level of bilirubin in the blood serum, while the child’s intake of liquid (water or glucose solution) does not prevent the development of jaundice and does not affect the level of bilirubin.

It is therefore important not to restrict breastfeeding.

One of the main and most effective methods of reducing the level of bilirubin in a child’s blood is the effect of light on the skin – this is called phototherapy.

Phototherapy – read more …

For those who are interested in more details on the treatment of neonatal jaundice, we have found and posted clinical protocols for the treatment of neonatal jaundice. So you can read it.

At home you can use special lamps in installations that are mounted on a crib or on a tripod. They are easy to use and differ from the installations used in medical institutions only in the size and type of the installations themselves, and the lamps are the same everywhere. Two lamps are sufficient for an effective session.

In maternity hospitals there are installations with shades for 2-4 lamps, but 2 lamps are enough for effective phototherapy. One is not enough.

It is also possible to use LED illuminators where the light source can be located both above and below the child.

In the cold season, a heated medical mattress for newborns is also needed, where the temperature is regulated by degrees (30-37), since the baby must lie naked (the groin area is covered).

Scales for newborns will also be needed, because need daily weight control.

At our rental you can rent household lamps for the treatment of jaundice for home use at a price of 95 UAH per day.

WELCOME TO OUR WEBSITE FOR TRAVELING WITH CHILDREN 🙂

The norm of bilirubin in newborns – the answer of the pediatrician

What is bilirubin?

Slightly more than half of newborns become noticeably icteric in the first week of life. This baby jaundice usually clears up in 2-4 weeks. What causes jaundice in children? Jaundice is the yellowing of the skin and the whites of the eyes caused by hyperbilirubinemia – that is, an increase in serum bilirubin concentration.

Bilirubin is a yellow-orange natural pigment that is released during the natural destruction of red blood cells – erythrocytes: as a result of the breakdown of hemoglobin to unconjugated bilirubin. The liver frees the blood from excess bilirubin, filtering it out, and converting it from free form (unconjugated) to bound (conjugated with glucuronic acid), which enters the bile and digestive tract, leaving with feces, giving it its characteristic color.

Why can the level of bilirubin in the blood rise?

If the level of bilirubin in the blood is higher than normal, this may be due to:

• Red blood cells are destroyed faster than usual.
• The liver does not have time to cope with the disposal of erythrocyte waste.
• There is an obstacle in the way by which processed bilirubin is excreted from the liver to the gastrointestinal tract via the biliary tract.

Is neonatal jaundice dangerous?

Neonatal jaundice is common in healthy infants and is physiological in most cases.In adults and a small part of newborns, jaundice is pathological, that is, it means the presence of the disorder that causes it. Some of the more common causes of neonatal jaundice include:

Physiological:

• Physiological hyperbilirubinemia.
• Breastfeeding jaundice.
• Jaundice of breast milk.

Pathological:

• Hyperbilirubinemia due to hemolytic disease.
• Liver dysfunction (eg, caused by parenteral nutrition causing cholestasis, neonatal sepsis, neonatal hepatitis).

Physiological hyperbilirubinemia occurs in almost all newborns. The shorter life span of red blood cells in newborns increases the production of bilirubin, and the low level of bacterial microflora in the intestine (which converts bilirubin to an insoluble form),

, in combination with increased hydrolysis of conjugated bilirubin, increase enterohepatic circulation, as a result of which the liver cannot cope with the excess of incoming bilirubin.As a result, the level of bilirubin can rise to 308 μmol / L by 3-4 days of life (by the 7th day in Asian infants), and then decrease.

Breastfeeding jaundice develops in one sixth of infants during the first week of life. Breastfeeding increases the circulation of bilirubin from the intestine to the liver in some babies who do not consume enough milk and who are dehydrated and inadequate in calories.

Breast milk jaundice differs from breastfeeding jaundice.It develops after the first 5-7 days of life and peaks after about 2 weeks. It is thought to be caused by an increased concentration of beta-glucuronidase in human breast milk, which causes an increase in the conversion of insoluble bilirubin back to a soluble (unconjugated) form and its reabsorption in the large intestine.

Still have questions?

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Phototherapy – treatment of jaundice at home.

For phototherapy of newborns, special blue light lamps (photo-irradiators) are used. Treatment takes several days, the duration of therapy is determined by the pediatrician. Photoisomerization of bilirubin occurs in the skin, therefore, the more body area is used for phototherapy, the more effective the treatment process.The lamp is made of harmless plastic, in the base of which blue light lamps are mounted.

We have prepared an article on phototherapy, as well as information on where to rent a device in St. Petersburg: Phototherapy at home – treatment of jaundice

The causes of pathological jaundice in newborns can be:

• immune and non-immune hemolytic anemia
• resorption (resorption) of hematoma
• sepsis
• hypothyroidism

How to distinguish physiological from pathological jaundice?

Jaundice that develops in the first 24-48 hours of life or persists for longer than 2 weeks is most likely pathological.

Jaundice, which does not appear until 2–3 days of life, is most likely physiological.

An exception is pathological jaundice with Crigler-Najjar syndrome, hypothyroidism or drug exposure, which also manifests itself after 2-3 days. In this case, the concentration of bilirubin reaches a peak in the first week, increasing at a rate of up to 86 μmol / L per day, and can persist for a long period.

Diagnosis of jaundice in children

The diagnosis of hyperbilirubinemia is suspected by the color of the skin and whites of the infant’s eyes and is confirmed by measurement of serum bilirubin.

The serum bilirubin level required for the onset of jaundice varies with skin tone and body area, but jaundice usually becomes visible on the whites of the eyes when the normal concentration is exceeded and the concentration is from 34 to 51 μmol / L, and on the face from about 68 to 86 μmol / l. With an increase in bilirubin levels, jaundice progresses from the head to the legs, appearing in the navel at a concentration of about 258 μmol / L, and on the legs at a level of 340 μmol / L.

Bilirubin concentration> 170 μmol / L in preterm infants or> 308 μmol / L in term infants requires additional tests hematocrit, blood smear, reticulocyte count, direct Coombs’ test, total serum bilirubin and direct serum bilirubin concentration, blood group matching and Rh factor of the infant and mother.

Is physiological jaundice dangerous in infants?

Although an increase in the concentration of bilirubin in physiological jaundice is not caused by the disease and disappears over time, hyperbilirubinemia is neurotoxic, that is, it causes damage to the nerve cells in the child. For example, a high concentration of bilirubin in the blood can cause acute encephalopathy, accompanied by a variety of neurological disorders, including cerebral palsy and sensorimotor disorders.An even more severe consequence of the neurotoxicity of an increased concentration of bilirubin may be nuclear jaundice caused by the deposition of free (unconjugated) bilirubin in the basal ganglia and nuclei of the brain stem. Usually bilirubin associated with serum albumin remains in the intravascular space, but sometimes it can cross the blood-brain barrier:

• For high serum bilirubin concentration (acute or chronic).
• When the concentration of serum albumin decreases (eg, in premature infants).
• When bilirubin is displaced from albumin by competitive binders (drugs:
• sulfisoxazole, ceftriaxone, aspirin) or free fatty acids and hydrogen ions (eg, in malnourished and starving children).

For infants born less than 35 weeks of gestation, the threshold levels of bilirubin for treatment are lower because premature infants are at greater risk of neurotoxicity.

How to lower bilirubin in children?

Treatment of jaundice is aimed at both the cause of the increase in the concentration of bilirubin and the elimination of the hyperbilirubinemia itself.

Physiological jaundice usually resolves within 1–2 weeks. The use of frequent formula feeding can reduce the frequency and severity of hyperbilirubinemia by increasing gastrointestinal motility and stool frequency, thereby minimizing enterohepatic circulation of bilirubin. Any type of formula can be used.

Breastfeeding jaundice can be prevented or reduced by increasing the frequency of breastfeeding. If bilirubin levels continue to rise above 308 μmol / L in a breastfed full-term baby, temporary withdrawal of breast milk and a switch to formula may be required.Stopping breastfeeding is only necessary for 1 or 2 days. At the same time, the mother should express milk regularly so that breastfeeding can be resumed without problems as soon as the baby’s bilirubin level begins to decrease.

Also in these cases, the use of phototherapy is shown: using fluorescent blue light with a wavelength of 425 to 475 nm. Light allows unconjugated bilirubin to be converted into forms that are soluble in water and can be rapidly cleared from the body by the liver and kidneys. This provides definitive treatment for neonatal hyperbilirubinemia and prevention of severe kernicterus.

Because visible jaundice can disappear during phototherapy even if serum bilirubin levels remain elevated, skin color cannot be used to assess the severity of jaundice. Blood taken for the determination of bilirubin concentration must be protected from bright light, because bilirubin in test tubes can rapidly oxidize when exposed to daylight.

In severe hyperbilirubinemia, a blood transfusion is performed to rapidly decrease the bilirubin concentration.

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Jaundice in newborns

It happens that on the second or third day after birth, the child turns yellow. This is not a pathology, it is a natural process that occurs due to the infant’s adaptation to environmental conditions. And it is called physiological jaundice. Let’s see what jaundice is and how it develops.

Jaundice is a symptom, not a disease.And you need to treat not him, but the cause that caused the condition.

In human blood, there are red blood cells – erythrocytes, designed to carry oxygen and carbon dioxide in the body. The period of their existence is 120 days, after which they die. Thus, every day 1% of the total pool of red blood cells is destroyed. In the process of destruction, metabolic products are released into the blood. One of them is the pigment bilirubin, which gives the skin its yellow color. Bilirubin is toxic to the body, so it detoxifies and removes it with the help of the liver. In it, liver enzymes neutralize, and the pigment is excreted by the intestines. If this process is disrupted, the level of bilirubin rises, which is manifested by jaundice.

Physiological jaundice of newborns

And now about a specific condition – jaundice in newborns. It is not dangerous. Immediately after birth, a large amount of fetal hemoglobin breaks down in the baby’s body, as a result of which a lot of bilirubin is released into the blood. And in the liver, the liver enzymes necessary to neutralize bilirubin have not yet matured.Therefore, 50-60% of newborns develop physiological jaundice 2-3 days after birth. It takes time for the liver to learn how to neutralize and eliminate bilirubin. The likelihood of development is higher in premature babies and is 80-90%. And that’s okay.

• How do I know if my child has physiological jaundice? Not dangerous jaundice?

Only a doctor can accurately determine the cause of jaundice and the degree of danger. However, it is worth knowing that with physiological jaundice, the yellowness of the sclera, skin and mucous membranes is not accompanied by other symptoms.For jaundice caused by other causes, the baby does not feel well, cries, eats poorly, and does not gain weight.

• Can I be vaccinated against hepatitis B with physiological jaundice?

Neonatal jaundice does not appear to be a contraindication for hepatitis B and other vaccinations.

• Does physiological jaundice affect the child’s condition in the future?

No, jaundice of newborns does not affect the health of the child in any way.

Peculiarities of treatment of neonatal jaundice

In most cases, jaundice resolves in 2 to 3 weeks. Complications in such jaundice are extremely rare, however, an excessive increase in bilirubin (especially indirect) is dangerous with toxic effects, and the lack of appropriate treatment can lead to adverse consequences.

The doctor takes into account all the accompanying factors in order to plan the frequency of examinations and find out the risk of an increase in bilirubin:

• current bilirubin content;
• the presence of prematurity;
• activity and appetite of the child;
• mother’s lactation level;
• a hereditary predisposition to severe jaundice.

Treatment that lowers the level of bilirubin in the blood may be as follows.

• Phototherapy. The child is placed under special lamps with high intensity blue-green light. Such light has the ability to transform the structure and shape of indirect hemoglobin so that it becomes water-soluble, sufficient for its utilization in urine and feces. This procedure is harmless, as the ultraviolet spectrum is blocked by a special filter and does not get on the baby’s skin.
• Intravenous injection of immunoglobulin. If the cause of jaundice is the incompatibility of the blood of the mother and the child, intravenous immunoglobulin can be used. This will help lower your antibody levels. This may be enough.
• Blood transfusion. It is used to rapidly lower bilirubin and is performed in the intensive care unit. A certain amount of blood is taken from a child with a high level of bilirubin, and donated blood with normal levels is injected at the same time.Thus, bilirubinemia decreases and hemoglobin is normalized.
• Plasmapheresis. This method is applicable in complex medical cases. Repeated sampling of small volumes of blood from a child is performed, they are cleaned of plasma with a high level of bilirubin and antibodies, diluted with saline or donor plasma and injected back intravenously. Like transfusion, plasmapheresis is very effective. However, both methods are used in extreme cases, for example, when hemolytic disease is present.
• If jaundice is not severe, some dietary changes can be dispensed with. More frequent feedings stimulate the bowel movement, so that bilirubin is excreted more actively.

Remember that only a doctor can determine whether jaundice in a newborn is a pathology or a norm. In any suspicious cases, sign up for a consultation with a pediatrician!

90,000 Phototherapy (light therapy) of neonatal jaundice – “Neonatal jaundice on the 3rd day of life and the second time in 3 weeks.Is there an effect of phototherapy and why is it dangerous? Our detailed treatment experience. ”

Hello!

Most likely, most have heard about jaundice in newborns, but only when faced with it do you begin to understand the details.

What is newborn jaundice? Causes and consequences.

Neonatal jaundice is the yellowing of the skin and sclera (the white part of the eyeball) in a newborn baby or a child in the first months of life, associated with an excess of bilirubin, a yellow pigment released during the destruction of red blood cells.

The main reason for the appearance of jaundice is the immaturity of the child’s liver, but there are a lot of factors for the appearance of jaundice. All of them are detailed on the Internet, so I will not list them.

We managed to collect several of them:

– the son was born prematurely, at 36.5 weeks;

– my Rh factor is positive, my son’s is negative;

– the son refused breast milk, and in the maternity hospital the formula was canceled so that the child would begin to suckle.As a result, the child was hungry for 2 days, and fasting can also provoke jaundice.

Consequences.

Normal physiological jaundice is not dangerous and either goes away by itself or is treated with phototherapy.

If bilirubin rises too high (more than 400 μMol / L) and kernicterus begins to develop, then serious consequences can arise.

Involuntary and uncontrolled movements (athetoid cerebral palsy

Fixed look up

Hearing loss

Incorrect development of tooth enamel

0336

So, we encountered jaundice on the 4th day of life, when we were still in the hospital. I noticed that the child turned yellow-bronze and rushed to the pediatrician. After all, the day before, the baby was blood taken for bilirubin and should have noticed changes. In addition, every day the pediatrician walks with a device that somehow also controls the appearance of jaundice.

The pediatrician answered very simply, as if there was nothing wrong with that, “We know whether we just watched the bilirubin rise or not.”

After that, we were prescribed Phototherapy.

Phototherapy (light therapy) of newborn jaundice is a method of treating physiological jaundice of newborns, which consists in exposing the tissues of the newborn’s body to light of the blue radiation spectrum.

The first

We treated jaundice for 24 hours in the perinatal center. A lamp was brought to the ward. I want to note that it was very comfortable. It was an ordinary cradle for a newborn, a special overalls were attached on top in which you dress the child.The lamp itself is at the bottom. Thus, it turns out that the child is shone from the back and does not need to close his eyes and genitals.

This photo is a top view. There is a diaper under the head. This lamp is called Mobile.

Then we were transferred to the regional children’s hospital. Here the lamp was no longer so comfortable. It was an ordinary lamp on a tripod, which was directed at the child from above. It is called Stationary.

Phototherapy of neonatal jaundice

In this case, the child must necessarily cover his eyes and genitals with a bandage or clothing.

I put my son in a diaper, and put a hat on his back to his eyes. The hat must be carefully monitored, as the baby constantly pulled it on the nose or, on the contrary, raised it on the forehead. In order for the child to take off his hat less and scratch himself, I put on a vest, and opened my stomach. Although the more the child’s body is open, the faster the jaundice will go away. In addition, to protect the eyes, a diaper was attached to the cradle.

On both lamps, the intensity of the irradiation is regulated and the time of the session is set.These parameters are set by the doctor.

Is phototherapy dangerous?

Phototherapy is considered a safe method of treatment, but despite this it has contraindications.

Child has a high level of bound bilirubin fraction , which does not decrease.

The baby has liver problems.

The baby was diagnosed with obstructive jaundice .

Constant supervision of the baby is also required. Ideally, the child should be looked after by medical staff.

But neither in the perinatal center, nor in the children’s hospital, no one looked after the child during the session. They showed me how to turn the lamp on and off, and that’s it.

I watched the child constantly, if it was necessary to leave the ward, I turned off the lamp. The baby was shining around the clock, to the maximum. I took breaks for feeding, hygiene procedures and if the child was crying.It was very difficult at night, I was afraid to fall asleep and not follow the baby. Therefore, as soon as the bilirubin decreased, I asked the doctor to take a break for the night from 23:00 to 06:00.

From constant observation of the baby, the lamp hurt my eyes. So try to look at the lamp yourself as little as possible.

What should be monitored during treatment?

I followed:

– the baby’s fluid intake. Constantly offered him water so that there would be no dehydration;

– for body temperature.Ideally, it should be measured with a thermometer every two hours, I just tried my son with my hand so that it would not be hot;

– behind the cap. If he shifts to the forehead and opens his eyes, the child can get a burn of the mucous membrane. If the cap slips over the nose, breathing becomes difficult;

Side effects.

Of the side effects, I encountered only drowsiness and lethargy. But this is even for the best. It is very difficult to keep a child under a lamp if he is constantly crying. These symptoms disappeared as soon as the lamp was canceled.

Rash, fever, etc. did not affect us.

Treatment results.

The primary results of the analysis for bilirubin were not told to me, they answered that they were slightly more than 250. At that time I was still in the perinatal center.

A day later we were transferred to the children’s hospital, at the time of discharge, free bilirubin was 223 μM / L (November 14). In the children’s hospital, the lamp was brought as soon as we entered the ward.

15.11. at the children’s hospital they again took an analysis. The result is 196.9 μMol / L.

This is a photo from an extract, but another bilirubin test result is missing here. 20.11 – this was the last day under the lamp. I don’t remember the exact result, about 130 μMol / L.

11/26 is the result of the analysis on the day of discharge. Bilirubin rose, but the pediatrician did not begin to prescribe phototherapy again and leave us in the hospital. We were prescribed treatment with Ursofalk suspension, which also proved to be effective.

TOTAL.

In total, my son spent 7 days under the lamp. Bilirubin in the blood has decreased, the skin color has acquired a normal shade. The fact that the jaundice came a second time, sometimes it happens. In our case, the early massage was most likely to blame.

Phototherapy is a very effective and safe method of treatment. There are practically no side effects, and even if something appears in the child (redness, drowsiness, lethargy, etc.), it goes away on its own and quickly.

Now there are announcements about the delivery and rental of lamps. So if the doctor allows you to be treated at home, you can rent a lamp, since its cost is very high (about 50-100 thousand rubles).

Choosing between Mobile and Stationary lamp, the more user-friendly Mobile.

That’s all for me, be healthy! I definitely recommend phototherapy!

P.S. If you liked my review, I invite you to visit My profile.

You may be interested in

– Children’s City Clinical Hospital No. 1

– Ambulance Hospital No. 8

– Maternity Hospital No. 2, Voronezh

– Perinatal center, Voronezh

– treatment of babies

– Elkar Levocarnitine 20% solution

– Means for improving cerebral circulation PIK-PHARMA LLC 902 – Suspension Ursofalk

– Blood test for bilirubin

Treatment of jaundice | glavrach.com | Yandex Zen

Jaundice is a pathological condition characterized by an increase in the level of bilirubin in the blood. It manifests itself quite brightly – the mucous membranes, the sclera of the eyes and the skin acquire a yellow tint. It is diagnosed mainly in newborns, as well as people suffering from hepatic pathologies.

Bilirubin is a final metabolic product formed as a result of the breakdown of hemoglobin. In a normal state, it is excreted from the body by the liver along with feces.In the presence of various diseases, the organ does not cope with its work. Part of the bilirubin passes through the kidneys or skin, which provokes the appearance of yellowness.

Causes and types of jaundice

Pathologies of the liver, gallbladder, bone marrow or spleen can provoke the appearance of jaundice.

With liver damage, hepatic or parenchymal jaundice develops. The reason is the inability of hepatocytes to capture and utilize bilirubin. This happens, as a rule, with various forms of hepatitis or cirrhosis.

Physiological jaundice occurs mainly in newborn babies. This is due to the onset of spontaneous breathing and the rapid renewal of blood, as well as imperfect functioning of the body. The liver does not cope with its functions, which leads to the appearance of jaundice.

The cause of the disease can be anemia, severe intoxication of the body (in particular, chemical or poisonous substances) and some autoimmune diseases. In rare cases, the pathology develops after undergoing surgery on the heart muscle.

Obstructive jaundice occurs when the gallbladder is affected. The cause is blockage of the ducts with stones, postoperative scar or neoplasm. Due to pathological changes, the liver is not able to remove all decay products from the body and bilirubin returns to the blood.

Symptoms of jaundice

Symptoms of the disease are quite bright and noticeable to everyone around. First of all, yellowness of the skin, sclera and mucous membranes appears. It is the yellowing of the patient that determines the name of the disease.

It is important to distinguish true from false jaundice. In the second case, only yellowing of the skin is observed and this is due to an excess of carotene, which can provoke excessive consumption of carrots, pumpkins, oranges and beets. In true form, the whole body turns yellow and there is a discoloration of feces and darkening of urine.

Other signs of jaundice:

• Acute or aching pain in the right side.
• Dry skin accompanied by severe itching.
• Weakness, lethargy, headache and dizziness.
• Unpleasant belching.
• Decreased or no appetite.
• Increase in the size of the spleen and liver.

Rare symptoms of jaundice include fever, ascites, hepatic colic, diarrhea and vomiting, and mental disorders.

Diagnosis of jaundice

In case of yellow skin staining, you should definitely consult a gastroenterologist. The doctor will conduct a visual examination of the patient, collect a history of the presence of chronic, autoimmune or hereditary diseases, and also clarify the clinical picture.

To confirm the diagnosis and establish the cause of the disease, laboratory tests and instrumental research methods are prescribed:

• General and biochemical blood and urine tests.
• Study of the level of bilirubin.
• Ultrasound and CT of the liver, spleen, gallbladder and ducts.
• FEGDS.
• Liver biopsy in case of suspicion of malignant organ damage.
• How to cure jaundice
  Treatment depends on the cause.In case of viral liver damage (for example, with hepatitis), the patient is hospitalized in the infectious diseases department. This will prevent the spread of the infection to those around you.
  Drug therapy is prescribed by a doctor and depends on the general condition of the patient, the cause of the ailment and accompanying diseases:
• For parenchymal jaundice, drugs are prescribed to improve the functioning of the liver. So, in case of intoxication, the use of “Gepabene”, “Allohol”, “Karsila”, etc. is recommended.In case of hepatocyte pathology, Interferon, Ribavirin, Paritaprevir and others are prescribed.
• Jaundice provoked by anemia is treated with drugs based on iron, ascorbic acid and vitamin B12: Hemostimulin, Ferroplex or Ferbitol “.
• In case of intoxication growth of bilirubin, “Albumin”, “Enterosgel” or “Atoxil” are prescribed.

• Vitamin preparations will help to improve the functioning of the liver. Vitamins A, C, E and group B are especially useful.
• For obstructive jaundice, Ursonan, Henosan, Holosas and other drugs are prescribed.

The main physiotherapy method is phototherapy. Bilirubin is destroyed by ultraviolet rays, which facilitates its elimination from the body. Sunbathing is an alternative to physiotherapy. A patient with such a diagnosis should walk in the sun as long as possible in order to speed up the healing process.

In some cases, surgical intervention is recommended.For example, if conservative methods cannot eliminate the blockage of the bile ducts. In especially difficult cases, with significant liver damage, organ transplantation is performed.
Physiological jaundice that occurs in babies in the first months of life, as a rule, does not require specific treatment. To speed up recovery, the pediatrician recommends breastfeeding on demand and frequent walks in the fresh air for the baby. Following these simple tips will speed up the liver’s recovery process and lead to recovery.An important component of therapy is adherence to a special diet. The patient is strictly forbidden to eat fatty, fried and smoked foods, pickles, canned food and garlic. Alcoholic drinks are also banned. The use of carrots, pumpkin, carbonated drinks, chocolate and coffee should be minimized. These foods put a strain on the liver, which inhibits the elimination of bilirubin.
The basis of the diet should be high-vitamin foods – fresh fruits and vegetables, quality meat and fish.Cereals, nuts, dried fruits and dairy products will be useful.
You should eat in small portions 5-6 times a day. It is better to steam or boil food.
Lack of timely treatment can provoke a number of complications, since bilirubin in high concentration is a poison for the body. For example, in babies, this can provoke developmental delay. In adults, jaundice can cause irreversible damage to the liver or kidneys and neurological disorders.
Traditional methods of treating jaundice
Traditional medicine will also help cure jaundice.Milk thistle has a beneficial effect on the functioning of the liver. You can take dried herb in its pure form in a tablespoon on an empty stomach, washed down with water. You can also use a decoction. For this, 3 tbsp. l. seeds, pour 0.5 liters of boiling water and boil in a water bath. The broth should boil and evaporate so that 1⁄2 of the original volume remains. Take 15 ml half an hour before meals for two months.

Celandine with dill. Despite the specific smell and taste of the drug, it helps to remove excess bilirubin.To prepare a home remedy, combine 3 tbsp. l. dill, 1 tsp. celandine and a liter of boiling water. Boil in a water bath and let it brew for another hour. The filtered broth is taken in 100 ml one hour after a meal.
Mix 630 g of honey, 680 ml of cahors and 380 g of chopped aloe in a container. Insist the product in a cool, dark place for 2 weeks. Drink 1 tsp on an empty stomach, and after a week increase the dosage to 1 tbsp. l.
Jaundice is a symptom of malfunctioning of internal organs (liver, spleen, or gallbladder).The disease manifests itself quite acutely, causing pain, discomfort and other inconveniences. It is important to diagnose the pathology in a timely manner and begin its treatment in order to prevent the development of complications.

The main physiotherapeutic method of treatment is phototherapy. Bilirubin is destroyed by ultraviolet rays, which facilitates its elimination from the body. Sunbathing is an alternative to physiotherapy. A patient with such a diagnosis should walk in the sun as long as possible in order to speed up the healing process.In some cases, surgical intervention is recommended. For example, if conservative methods cannot eliminate the blockage of the bile ducts. In especially difficult cases, with significant liver damage, organ transplantation is performed.
Physiological jaundice that occurs in babies in the first months of life, as a rule, does not require specific treatment. To speed up recovery, the pediatrician recommends breastfeeding on demand and frequent walks in the fresh air for the baby.Following these simple tips will speed up the liver’s recovery process and lead to recovery.

An important component of therapy is adherence to a special diet. The patient is strictly forbidden to eat fatty, fried and smoked foods, pickles, canned food and garlic. Alcoholic drinks are also banned. The use of carrots, pumpkin, carbonated drinks, chocolate and coffee should be minimized. These foods put a strain on the liver, which inhibits the elimination of bilirubin.
The basis of the diet should be high-vitamin foods – fresh fruits and vegetables, quality meat and fish.Cereals, nuts, dried fruits and dairy products will be useful.
You should eat in small portions 5-6 times a day. It is better to steam or boil food.
Lack of timely treatment can provoke a number of complications, since bilirubin in high concentration is a poison for the body. For example, in babies, this can provoke developmental delay. In adults, jaundice can cause irreversible damage to the liver or kidneys and neurological disorders.
Traditional methods of treating jaundice
Traditional medicine will also help cure jaundice.Milk thistle has a beneficial effect on the functioning of the liver. You can take dried herb in its pure form in a tablespoon on an empty stomach, washed down with water. You can also use a decoction. For this, 3 tbsp. l. seeds, pour 0.5 liters of boiling water and boil in a water bath. The broth should boil and evaporate so that 1⁄2 of the original volume remains. Take 15 ml half an hour before meals for two months.

Celandine with dill. Despite the specific smell and taste of the drug, it helps to remove excess bilirubin.To prepare a home remedy, combine 3 tbsp. l. dill, 1 tsp. celandine and a liter of boiling water. Boil in a water bath and let it brew for another hour. The filtered broth is taken in 100 ml one hour after a meal.
Mix 630 g of honey, 680 ml of cahors and 380 g of chopped aloe in a container. Insist the product in a cool, dark place for 2 weeks. Drink 1 tsp on an empty stomach, and after a week increase the dosage to 1 tbsp. l.
Jaundice is a symptom of malfunctioning of internal organs (liver, spleen, or gallbladder).The disease manifests itself quite acutely, causing pain, discomfort and other inconveniences. It is important to diagnose the pathology in a timely manner and begin its treatment in order to prevent the development of complications.

Jaundice of newborns phototherapy treatment

Why does jaundice of newborns cause so much anxiety and anxiety in young parents? Is the concern justified? How dangerous can it be? How can you help your baby to normalize his bilirubin levels? Let’s answer these questions together and deal with the jaundice once and for all.

Phototherapy lamps. On a tripod, resource net. See here.

So, at the hospital or at home you notice the yellowing of the baby’s skin. This is probably your child’s first “abnormal” condition, and a direct reason to start worrying. Although, if this is the first-born, the “normal” state will still have to learn to determine, nevertheless, yellow skin is clearly a deviation. Do not rush to get nervous and panic. Jaundice in newborns is determined in 60% of full-term babies and 80% of premature babies.You are clearly not alone, the case is not an isolated one, doctors have learned to understand this issue well. This is the first reason to calm down. Further. Yellowing of the skin and mucous membranes occurs for a variety of reasons, but in the vast majority of cases it is physiological jaundice of newborns. So this is a normal, natural process. Therefore, calmness, only calmness.

Now a little theory.

Physiological jaundice of newborns is not a disease, but a condition in the period of adaptation associated with the replacement of fetal hemoglobin (HbF) with hemoglobin A (HbA), immaturity of enzyme systems and adaptation of the child’s body to new environmental conditions.

In other words, the amount and composition of hemoglobin in the blood of a newborn is different from the composition of hemoglobin required for later life. Nature triggers the blood renewal mechanism, which results in the release of bilirubin. The liver of the newborn has not yet begun to work fully and cannot excrete all the bilirubin that is released. It is this bilirubin that has a yellow pigment that stains the baby’s skin. This staining occurs on the 2nd – 3rd day, sometimes later.Bilirubin itself is toxic and can have a bad effect on the cells of the nervous system and brain. However, this can only happen if the level of bilirubin in the blood is significantly higher than normal. The content of bilirubin in the blood of a healthy adult is 20 μmol / L, with physiological jaundice of newborns, the content of bilirubin can reach 200 μmol / L – this is normal. More than 200 μmol / L is a reason to take action.

How to determine the amount of bilirubin in the blood?

In a hospital or maternity hospital, bilirubin is most often measured through the skin, simply by applying a special measuring device to the baby.It is the pediatrician or neonatologist who, after several measurements, must determine what action should be taken. If bilirubin does not exceed the permissible concentration and has no dynamics to increase, you just need to wait, the baby’s body will cope on its own. There is no cause for concern.

And what if the mother and the baby have already been discharged from the hospital, and the jaundice made itself felt? There is an easy way to visually determine the level of bilirubin. Not as accurate as measuring with a special device, however, allowing you to react in time and keep the situation under control.

• If an icteric staining appears on the face, the level of bilirubin in the blood is approximately 100 μmol / L
• If the staining of the skin reaches the level of the navel on the trunk, to the elbows on the arms, then the level of bilirubin is probably 150 μmol / L.
• If the staining of the skin reaches on the handles to the hands, covers the lower abdomen and reaches the knees on the legs, then the bilirubin level can reach 200 μmol / L.
• And if we see stained stacks and palms, then the level of bilirubin reaches 250 μmol / L.

It is important to examine the child completely undressed, in daylight, against the background of a white diaper.

Let’s summarize the when you need to be persistent, see a doctor and help your baby cope with jaundice.

• if it occurs in the first 24 hours of a child’s life.
• if it occurs within the first 24 to 48 hours after birth and has spread to the extremities
• if it occurs after 48 hours of the child’s life, and the icteric staining has spread to the feet and palms.

Do not hesitate to see a doctor in such cases and do not be afraid, the modern treatment of jaundice is a safe and painless process.

How is neonatal jaundice treated?

Medicines for the treatment of physiological jaundice in newborns are practically not used in modern medicine.

We have determined that it is worth fearing a high concentration of bilirubin in the blood, so modern methods of treatment are struggling with it.Several decades ago, medical scientists found out that bilirubin absorbs light with a wavelength of 450-460 nm, chemically transforming into a water-soluble form – lumirubin. Lumirubin calmly leaves the body with urine and feces, staining it in a dark green color. So the idea of ​​the most effective method today came up – phototherapy, or phototherapy. With this method of treatment, the baby’s skin is illuminated with a special lamp for a certain time. Sometimes, as a result of such treatment, the baby may experience slight irritation or peeling of the skin, drowsiness.But all these phenomena disappear without a trace after the completion of the course. The average duration of phototherapy is 96 hours, however, your doctor will tell you the exact time. Phototherapy is performed in a maternity hospital, hospital, or at home. Where it will be more comfortable and convenient for you, decide for yourself. Special lamps for the treatment of jaundice are equipped both in medical facilities and a jaundice treatment unit that you can rent and take a course of phototherapy at home.

This is how a lamp rental from jaundice looks like

Please note that jaundice lamps have a limited “useful” resource.The healing resource is 2000 hours. That is, it will shine longer, but it will not heal. It is very convenient when the lamp for the treatment of jaundice is equipped with a counter that shows the total lamp life and counts the time your little one has spent under the lamp.

When carrying out phototherapy, you need to know that:

• During phototherapy, the child’s eyes are protected with glasses or a bandage that does not allow light to pass through. Perfectly copes with a hat pulled over the eyes of a baby
• The phototherapy lamp is installed closer to the child.
• The child must be completely undressed (diaper, hat, scratches do not count)
• It is advisable to change the position of the baby’s body (preferably after each feeding) so that the exposure to light is carried out on the entire surface of the newborn’s body.
• Phototherapy is carried out continuously, except during periods of feeding the child.
• Phototherapy must be supervised by an adult
• Phototherapy may have side effects such as dry skin or an allergic rash.If you experience any side effects, consult your doctor
• It is normal and correct if the baby’s feces acquire a greenish tint, it is excreted split bilirubin

Rent of a lamp for phototherapy of jaundice is available at Baby Service Zaporozhye. Few technical details:

• The unit with two lamps stands on a mobile stand. You can move the lamp to the crib, sofa, stroller. Any place where your baby is comfortable.
• Uses two special lamps Phillips TL 20W / 52 . We guarantee an effective healing lamp life.
• When assembled, the installation has a size of 75 * 25 * 25 cm.