What are the common causes of jaundice in newborns. How can jaundice be treated at home. What are the signs and symptoms of jaundice in babies. When should parents seek medical attention for infant jaundice.

Understanding Jaundice in Newborns: An Overview

Jaundice is a common condition in newborns, characterized by a yellowing of the skin and sometimes the whites of the eyes or gums. While mild cases are usually harmless and resolve on their own, severe jaundice can be potentially harmful. It’s crucial for parents to recognize the signs and understand when to seek medical attention.

What Causes Jaundice in Newborns?

The primary cause of jaundice in newborns is the accumulation of a yellow substance called bilirubin in the blood. Bilirubin is a natural byproduct of the breakdown of red blood cells. In newborns, several factors contribute to this buildup:

• Rapid production and breakdown of red blood cells in the first days of life
• Immature liver function, which struggles to process bilirubin efficiently
• Slower elimination of bilirubin through urine and feces

As the baby’s liver matures and becomes more efficient, jaundice typically resolves on its own. However, in some cases, underlying conditions may contribute to persistent or severe jaundice.

Recognizing the Signs and Symptoms of Infant Jaundice

Identifying jaundice in newborns is crucial for timely intervention. The most apparent sign is the yellowing of the skin, which typically follows a specific pattern:

1. Begins on the baby’s face
2. Progresses to the chest and abdomen
3. Extends to the legs
4. Finally reaches the palms of the hands and soles of the feet

In babies with darker skin tones, jaundice may be more noticeable in the whites of the eyes or the gums. Additional symptoms can include:

• Increased sleepiness
• Poor feeding
• Yellowing of the mouth or gums

When Do Symptoms Typically Appear?

Jaundice often becomes visible within the first 2-4 days after birth. In some cases, it may appear earlier or later, depending on the underlying cause and the baby’s individual characteristics.

Diagnosing Jaundice in Newborns: What to Expect

If you suspect your baby has jaundice, it’s essential to consult a healthcare professional. The diagnosis process typically involves:

• Visual examination by a doctor
• Consideration of factors such as birth weight, gestational age, and feeding patterns
• Blood tests to measure serum bilirubin levels (SBR)
• Possible additional tests to rule out underlying disorders

The serum bilirubin test is the most accurate method for assessing jaundice severity. It involves collecting a small blood sample, usually from the baby’s heel, arm, or hand.

How Is the Severity of Jaundice Determined?

The severity of jaundice is primarily based on the bilirubin levels in the blood. Doctors consider several factors when interpreting these results:

• The baby’s age in hours
• Whether the baby was born full-term or preterm
• The presence of other risk factors

Based on these factors, the healthcare provider will determine if treatment is necessary and what type of intervention is most appropriate.

Treatment Options for Newborn Jaundice

The treatment approach for jaundice in newborns depends on the severity of the condition and the baby’s overall health. In many cases, mild jaundice resolves on its own without intervention. However, for moderate to severe cases, several treatment options are available:

Phototherapy: The Primary Treatment for Jaundice

Phototherapy is the most common and effective treatment for newborn jaundice. This non-invasive method uses special blue-colored lights to help break down bilirubin in the baby’s skin. The process works by:

• Exposing the baby’s skin to specific wavelengths of light
• Altering the structure of bilirubin molecules
• Making it easier for the body to eliminate bilirubin through urine and feces

There are two main types of phototherapy used in treating jaundice:

1. Overhead lights: The baby is placed in a special cot called an isolette, naked except for a diaper and protective eye pads. The light shines directly on the skin to maximize exposure.
2. Bilisoft or Biliblanket: A fiber-optic pad emitting the special light is placed directly against the baby’s back. This method allows for more flexibility, as the baby can be clothed and held during treatment.

Exchange Transfusion: For Severe Cases

In rare cases of severe jaundice or when phototherapy is not effective, an exchange transfusion may be necessary. This procedure involves:

• Gradually removing small amounts of the baby’s blood
• Replacing it with donor blood or plasma
• Rapidly reducing bilirubin levels and correcting anemia if present

Exchange transfusions are typically reserved for cases where there’s a risk of kernicterus, a form of brain damage caused by extremely high bilirubin levels.

Medication: Supplementary Treatment

In some cases, medication may be used alongside other treatments to manage jaundice. These medications can help:

• Enhance the liver’s ability to process bilirubin
• Reduce the production of bilirubin
• Address underlying causes of jaundice

The use of medication is determined on a case-by-case basis by healthcare professionals.

Home Care and Management of Jaundice in Newborns

While severe cases of jaundice require medical intervention, there are several steps parents can take at home to help manage mild cases and support their baby’s recovery:

Feeding Strategies to Help Reduce Jaundice

Proper feeding is crucial in managing jaundice, as it helps the baby eliminate bilirubin through bowel movements. Consider the following strategies:

• Increase feeding frequency to 8-12 times per day for breastfed babies
• Ensure proper latching and positioning during breastfeeding
• Supplement with formula if recommended by your healthcare provider
• Wake your baby for feeds if they’re too sleepy

Monitoring Your Baby’s Output

Keeping track of your baby’s wet diapers and bowel movements can help you gauge their hydration and bilirubin elimination:

• Aim for at least 6-8 wet diapers per day
• Note the color and consistency of bowel movements
• Report any significant changes to your healthcare provider

Natural Light Exposure

While not as effective as medical phototherapy, gentle exposure to natural sunlight can help in mild cases of jaundice:

• Place your baby near a sunny window for short periods
• Ensure the baby is not overheated or in direct sunlight
• Limit exposure to 10-15 minutes, 2-3 times a day

Remember, this should not replace medical advice or treatment for moderate to severe jaundice.

Preventing Complications: When to Seek Medical Attention

While most cases of newborn jaundice are harmless, it’s crucial to be vigilant and seek medical attention if you notice any of the following:

• Yellowing of the skin that spreads or becomes more intense
• Fever or difficulty waking your baby
• Poor feeding or weight loss
• High-pitched crying or arching of the back
• Jaundice lasting more than 2 weeks

Early intervention is key in preventing rare but serious complications such as kernicterus, which can lead to long-term neurological problems.

Follow-up Care and Monitoring

After initial treatment or for mild cases managed at home, follow-up care is essential:

• Attend all scheduled check-ups with your pediatrician
• Continue monitoring your baby’s skin color and behavior
• Discuss any concerns or changes with your healthcare provider

Regular follow-ups allow for timely adjustments to treatment if needed and ensure your baby’s healthy development.

Long-term Outlook and Developmental Considerations

For most babies, jaundice is a temporary condition with no long-lasting effects. However, it’s natural for parents to have concerns about potential impacts on their child’s development.

Developmental Milestones After Jaundice

In the vast majority of cases, babies who have experienced jaundice go on to meet their developmental milestones normally. However, it’s important to:

• Continue regular check-ups with your pediatrician
• Monitor your baby’s growth and development
• Discuss any concerns about developmental delays with your healthcare provider

Rare Cases of Prolonged Jaundice

In some instances, jaundice may persist beyond the newborn period or recur. This could indicate:

• Underlying liver conditions
• Metabolic disorders
• Blood type incompatibilities

If jaundice persists or returns, further investigation may be necessary to identify and address any underlying causes.

Supporting Parents Through Newborn Jaundice

Dealing with a newborn’s health concerns can be stressful for parents. Here are some ways to cope and find support:

• Educate yourself about jaundice and its treatment
• Communicate openly with your healthcare provider
• Join support groups for parents of newborns
• Seek help from family and friends for practical support
• Practice self-care and stress-management techniques

Remember, it’s normal to feel anxious, but with proper care and support, most babies with jaundice recover fully and thrive.

Resources for Further Information

For parents seeking additional information on newborn jaundice, consider the following reputable sources:

• American Academy of Pediatrics (AAP)
• World Health Organization (WHO)
• National Institutes of Health (NIH)
• Local hospitals and pediatric clinics

These organizations provide up-to-date, evidence-based information on jaundice and other newborn health topics.

Jaundice in newborns fact sheet

Jaundice is a yellowing of the skin, and sometimes the whites of the eyes or the gums. If your baby has dark skin, the main sign may be a yellowing in the whites of their eyes or the gums. Mild jaundice is quiet common in newborn babies and is usually a temporary condition that causes no problems. However, severe cases of jaundice can be harmful, so if you think your baby has jaundice, it is always best to let your doctor know.

What causes jaundice?

Jaundice is caused by an accumulation of yellow substance called bilirubin in the blood. Bilirubin is a normal part of the waste produced when used red blood cells are broken down, and is normally passed out of the body in urine and faeces (poo).

Newborn babies produce and break down a large amount of red blood cells very quickly and while their young livers are fully maturing in the first days of life, they may not function efficiently and bilirubin may accumulate in the blood. Usually, as soon as the liver matures and functions more effectively, the jaundice will go away. There are other rare causes of jaundice which your doctor will discuss with you.

Signs and symptoms

The yellow colour of the skin is the main symptom of jaundice usually beginning on the baby’s face and moving down to the chest, abdomen, legs and finally to the palms of the hands and soles of the feet. The whites of the eyes or the inside of the mouth or gums may also look yellow. Sleepiness and poor feeding may also be present in infants who have significant jaundice.

How is jaundice diagnosed?

• Your child’s doctor will look for visual signs of jaundice, as well as consider other factors such as birth weight and gestational age, feeding since birth, and level of hydration.
• A blood test to measure the level of bilirubin in your baby’s blood, called serum bilirubin level (SBR), may be ordered. This is the most accurate way to measure an SBR and involves collecting a small amount of blood from the arm, hand, head or heel.
• Additional blood tests or urine tests may also be ordered if there is evidence your baby’s jaundice is caused by an underlying disorder that will need treatment.

Will my baby need treatment?

Mild jaundice often goes away without treatment, however babies with high levels of bilirubin may require treatment. Treatment may include phototherapy, exchange transfusion or medication.

How does phototherapy work?

Phototherapy is very safe and effective in reducing SBR levels. As bilirubin absorbs light, jaundice and increased bilirubin levels usually decrease when the baby is exposed to these special blue coloured lights. The lights help the bilirubin in the blood to change so it can easily be eliminated from the body in the urine and faeces. Phototherapy may take several hours to begin working and is used throughout the day and night.

Types of phototherapy

Your baby will receive phototherapy from overhead lights or through a Biliblanket® or Bilisoft®.

Overhead lights – Your baby will be placed in a special cot called an isolette to keep him/her warm while a certain type of light is shone onto them. This light helps to break down the bilirubin, which will then be passed out of your baby’s body in their urine and stools.

Your baby will be placed under the light naked, apart from their nappy, to make sure that the light shines on as much of their skin as possible.

Eye pads will be placed over your baby’s eyes to protect them.

Bilisoft or Billiblanket – A fiber-optic pad with a special type of light that breaks down the bilirubin is placed directly against your baby’s back to make sure that the light shines on as much of their skin as possible. Your

baby may still wear clothing and wraps over the outside of the pad as normal. Your baby is able to feed while the treatment is taking place.

What will happen while my baby is having phototherapy?

A doctor or phlebotomist will take a blood test to measure the amount of bilirubin in your baby’s blood at least once a day.

• You will be encouraged to take your baby out from under the light for short breaks for feeds, nappy changes and cuddles. You can usually continue to breastfeed your baby during phototherapy. If your baby’s bilirubin level is very high, more than one lamp will be used at the same time and your baby will need to stay under the lamps without breaks.
• The nurses will monitor your baby’s feeding closely to make sure they are feeding enough.
• The nurses will monitor the wet nappies and bowel motions from your baby, by weighing them and documenting to enable ongoing assessment.
• Your baby will be lying on their back under the phototherapy lights, this is recommended for safe sleeping.
• Your baby will be weighed each day to allow the nurses to monitor fluid status
• Your baby’s temperature will be checked regularly to prevent him/her from becoming too cold or hot.

What will happen if the phototherapy doesn’t work?

In majority of cases phototherapy is very effective in reducing bilirubin levels. In very rare cases an exchange transfusion may be required to reduce the bilirubin levels. These are usually done in intensive care environments.

Side effects of phototherapy

Minor side effects may include

• Loose, green bowel motions
• Dehydration
• Skin rash

Phototherapy may increase fluid loss; if you are breastfeeding you will be encouraged to continue to breastfeed your baby at least 8 to 12 times a day. This will help increase your milk supply, and decrease your baby’s bilirubin levels. Increased feedings will increase bowel movements, which will help remove the bilirubin. A lactation consultant is available in the hospital if you require any assistance

with breastfeeding. If your baby is unable to feed enough the nursing staff can give extra fluids either by oral, nasal gastric or intravenously to make sure your baby is hydrated.

If you have questions about your baby’s treatment or condition, please ask the nurse or the medical team caring for your baby.

Does jaundice cause any long-term problems?

For most babies, jaundice does not cause any long-term problems. In very severe cases, the amount of bilirubin in a baby’s blood is so high that it can damage parts of the brain including parts that affect hearing, vision and control of movement (this is called kernicterus). With the right treatment this small risk is reduced even further.

Going home

When your baby’s SBR reaches a safe level, phototherapy will be stopped. At this time your baby may still appear jaundiced, this is not uncommon. It may take two to three weeks for jaundice symptoms of skin discolouration to disappear after phototherapy has stopped. Before you go home with your baby, the doctors and nurses will make sure your baby is alert and feeding well.

Seek medical advice if:

• The jaundice lasts more than two weeks in a term baby and three weeks in a preterm baby
• Your baby’s skin becomes more yellow
• Your baby’s bowel motions are pale, chalky coloured
• Your baby’s urine is dark coloured, not as many wet nappies as usual
• Your baby is not feeding well
• Your baby isn’t gaining weight, seems listless or difficult to wake

Contact us

Division of Medicine/General Paediatrics Service
501 Stanley Street, South Brisbane 4101
t: 07 3068 1111 (general enquiries)

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

References:

Children’s Hospital Boston. (2006). Jaundice. http://www.childrenshospital.org
GE Healthcare. (2009). Phototherapy. www.gehealthcare.com
Hockenberry, M., & Wilson, D. (2007). Wong’s nursing care of infants and children (8th edition). Missouri: Mosby, Inc. LifeTronics Medical Inc. (2005). Bringing Techology to life, viewed 4 September 2009 www.lifetronics.com
Mater Health Services. (2009). Jaundice in newborn baby. (MHS-WCH-W-N-138) Milliman Incorporated. Milliman
Milliman Care Guidelines -Neonatal Jaundice (16th edition). Seattle: 2012.
National Institute for Health and Clinical Excellence (2012). Jaundice in newborn babies: information for parents and carers. Accessed 22nd August 2012. Queensland Maternity and Neonatal Clinical Guideline (2012). Neonatal jaundice. http://www.health.qld.gov.au/qcg/documents/g_jaundice5-1.pdf
Clinical Practice Guidelines. Jaundice in early infancy. RCH. 2009. http://www.rch.org.au/clinicalguide
Wong, R. J. & Bhutani, V. K. (2009). Patient Information: Jaundice in newborn infants.
A Practical Approach to Neonatal Jaundice. American Family Physician. May 2008; 77 (9): 1255-1262.
Neonatal Jaundice: prevention, assessment and management. Queensland Maternity and Neonatal Clinical Guideline, Nov 2009. www.health.qld.gov.au/qcg

Neonatal Jaundice – American College of Gastroenterology

Overview

Neonatal jaundice describes a condition in which an infant’s skin appears yellow within the first few days of life. The yellowish appearance is a sign of an increased blood pigment called Bilirubin, which then settles in the skin. In many cases this is a normal process and occurs in about 2/3 of all healthy newborns.
However, it may at times be a sign of a problem with the baby’s feeding, level of hydration or red blood cells lifespan. Other rare causes such as metabolism disorders, gland malfunction or liver disease can also present with jaundice. Only the health care provider can determine if the infant’s jaundice is normal and may order a blood test to help with diagnosis. In some cases, a specialist in liver disease or blood disorders may be called in to help take care of the newborn. Treatment can be very simple from increasing the baby’s water intake and modifying the feeding to very complex treatment. The choice of treatment is made according to the severity of the jaundice, the cause for the increase of bilirubin or the type of bilirubin.

Symptoms

The first symptom is yellow appearance of the skin and the eyes. The infant’s skin may appear yellow as early as the 1st or 2nd day of life. The jaundice starts around the head and the face then progresses to the shoulders, arms and the rest of the body including the legs and feet. The appearance may become more yellow when the baby is 3 to 4 days old and then slowly gets better. This is called “physiologic” or normal neonatal jaundice. Most infants have this pattern so no testing is needed.

At times, the yellow appearance may occur earlier (shortly after birth), last longer than 5-6 days or may be much more pronounced. A consultation with your health care provider is then needed to determine if testing is indicated.

Along with the skin becoming more yellow, the color of the baby’s urine can change from very light yellow or very dark brown. In the same manner, the color of the baby’s stool can vary from a yellow mustard color (normal) to light beige. These 2 color changes in the urine or the stool can indicate that the jaundice is due to different pigments. Although very rare in the first days of life, the presence of a very dark urine or light beige stool should be evaluated by a doctor immediately.

Causes

The yellow appearance comes from the accumulation of a yellow pigment called bilirubin in the skin. Right after birth, the infant body has to break down the red blood cells used while in the womb and make new ones now that the baby breathes the ambient air. The red color of the blood comes from a protein called hemoglobin, which carries the oxygen. As cells are being broken down, the hemoglobin gets modified in the liver and becomes bilirubin. Because the infant’s liver is so young and immature, it cannot keep up with all the produced bilirubin, which then leaks into the blood stream and settles in the skin.

Risk Factors

A variety of conditions or diseases may present with an increase of the amount of pigment (bilirubin) produced. Poor feeding due to decreased breast feeding or the amount of breast milk can contribute to the increase in bilirubin. The same can happen with formula if the infant is not able to drink a sufficient amount. Maternal diabetes, exposure to some medications such as sulfa drugs or being underweight can also cause an increased bilirubin level.

Other conditions may be more serious:

1. Increased production of bilirubin: In certain diseases, the red blood cells of the baby are destroyed at a faster rate than normal (this is called hemolysis). An example of such a disease is when the baby’s and mother’s blood type are different and not compatible. When this occurs, the mother’s immune system reacts and will form antibodies that attack the baby’s red blood cells. Babies also become anemic (low number of red blood cells) due to rapid destruction (hemolysis).
2. Birth trauma: When vacuum extractors or forceps are used to deliver the baby a very large bruise over the scalp or the head may occur. This very large bruise will be re-absorbed. The old blood from the bruise will break down to make more bilirubin, which needs to be cleared by the liver. Some also may leak into the blood stream.
3. Infection: Babies with infections may not be able to process bilirubin normally resulting in increased levels in the blood. This can occur with infection in the urine, blood, liver or other organs.
4. Problems with bilirubin metabolism: In very rare cases the baby’s liver is not able to change the bilirubin into a form that can easily be removed from the body. This occurs in a condition called Crigler-Najjar syndrome. This is a very rare disease; the level of bilirubin increases very rapidly within hours. Immediate attention by a newborn specialist is then needed.
5. Problems with digesting galactose: Rarely, babies cannot normally break down the sugar in breast milk (lactose) or in regular formulas made using the protein from cow’s milk. The sugar of the milk (lactose) is broken down into 2 smaller sugars called glucose and galactose. Rarely, the baby’s liver cannot process galactose. This is called galactosemia. This disease can present with jaundice in the newborn period and is associated with other severe symptoms (such as lethargy, vomiting, irritability and possibly convulsions). Galactosemia is often detected by a blood test (heel prick) before discharge from the nursery as part of the mandatory state screening for newborn diseases. Galactosemia is treated with strict dietary avoidance of galactose. This is not the same as being lactose intolerant and the two conditions should not be confused.

Screening/Diagnosis

If the doctor is concerned about the severity of the jaundice, a blood test called a serum total bilirubin level is performed using a very small amount of blood. Other tests such as a transcutaneous (through the skin) test may be used to determine the bilirubin level in certain hospitals. This test is less accurate and needs to be confirmed with blood testing.

If the result is high, your doctor will order a blood test that will measure the different types of Bilirubin pigments, which make up the total bilirubin:

1. Unconjugated or indirect bilirubin: This pigment is increased mostly in infants with neonatal jaundice. It is the bilirubin associated with normal destruction of older red blood cells. This is called physiologic jaundice. The baby’s urine is usually light yellow and the stool color is mustard yellow or darker.

   In some cases, the level of indirect bilirubin can go very high. Then, a neonatal specialist or blood specialist may be called in to help care for the newborn. Doctors are concerned if the bilirubin levels are more than 20-25 mg/dl (deciliter) and will start treatment to prevent the bilirubin from getting to this level. A level of indirect bilirubin at or above 20-25 mg/dl may cause irritation in some areas of the brain. This is called acute encephalopathy (inflammation of the brain). If the bilirubin remains very high, above 25 mg/dl, babies can be at risk for significant brain damage. This very rare condition is called kernicterus. Because of that risk, the doctor will start testing early for the bilirubin level and repeat the test often to identify the trend and start treatment rapidly.

2. Conjugated or Direct bilirubin: The previous pigment (indirect or unconjugated bilirubin) is packaged in the liver into a form ready for removal into the bile and the gallbladder. This pigment is called conjugated (packaged) or direct bilirubin. For a variety of reasons, the liver cannot get rid of it, the direct bilirubin leaks back into the blood and also settles in the skin. At times the urine of the baby can be dark “coca cola” color and the stool can be light beige.

   The symptoms can be very different from those of normal neonatal jaundice. Babies can be very irritable, fussy, may have fever or they can have no symptoms. In addition to blood work to look for infections, other testing may be performed. A specialist in liver disease in children, called a pediatric gastroenterologist, may be called in consultation to help sort out the diagnosis. Liver disease is diagnosed with additional blood tests; the specialist may order an ultrasound or other specialized testing. These may lead to a procedure called a liver biopsy, where a small sample of liver tissue is taken for examination under a microscope.  

Treatment

The treatment varies based on the cause of the jaundice and the bilirubin level. For the purpose of this information we will discuss only the treatment for the elevation of the unconjugated or indirect bilirubin pigment. We will not discuss the jaundice associated with liver disease or the rare diseases causing an elevation of the pigment called conjugated or direct bilirubin.

Usually in normal physiologic neonatal jaundice, the process will be self-limiting and the baby does not need to be treated. The unconjugated bilirubin is broken down just with some exposure to the indirect sunlight. This is by far the vast majority. The baby may be able to be discharged home from the nursery within 48 hours of life without problems. The baby will need to be followed up by the pediatrician to ensure that the bilirubin level is going down and the baby’s weight is appropriate. This is especially true with breast-fed babies.

If the unconjugated or indirect bilirubin level remains high or is increasing, the baby may need further treatment to decrease the bilirubin level. Treatments might include:

1. Some babies have a high indirect bilirubin level associated with breast feeding. Holding breast feeding and supplementing with infant formula for 48 hours may in some cases decrease the bilirubin in babies with “breast feeding jaundice.” A small amount of breast fed babies may continue to have elevated indirect bilirubin after 10-14 days. Once again holding breast feeding for 2 or 3 days may be sufficient and breast feeding can resume when the level of indirect bilirubin is lower. Breast feeding is by far the best option for neonates and should not be stopped completely because of a mild elevation of the unconjugated or indirect bilirubin. Families should speak with their physician or health care provider to determine if stopping breast feeding is appropriate and for instructions on how to proceed.
2. Phototherapy is a treatment that allows the bilirubin under the skin to be broken down by a special light that illuminates the baby’s body. These lights are usually blue-green. They are placed about 4 inches above the baby. The more skin that is exposed to the lights, the better they work to break down a larger amount of unconjugated or indirect bilirubin. The lights do not prevent the baby from drinking formula or being breast-fed. The baby can be safely removed from the phototherapy at feeding times without decreasing the efficacy of the treatment. There are generally no significant risks with phototherapy. The eyes of the baby will have shields to prevent the light from harming the baby’s eyes and retina. There are no risks to the genitals of the baby. As long as the level of bilirubin is not very high, the phototherapy treatment can be done at home with a special blanket called a “bili” blanket. The physicians will then arrange for blood tests to be done regularly to ensure that the treatment is working. Most insurance will pay for this treatment at home.
3. For a few babies, the level of unconjugated or indirect bilirubin is so high (greater than 20-25 mg/dl) that physicians are concerned about brain damage. The level has to be brought down very fast using a technique called exchange transfusion. An exchange transfusion is performed in the neonatal intensive care unit. The baby’s blood is exchanged and replaced very slowly and carefully with a donor’s blood. This allows for the indirect bilirubin to be removed faster, which will decrease the risk of further complications. This treatment is reserved for the most serious cases at risk for developing kernicterus (a condition where the indirect bilirubin is stored in areas of the brain and causes abnormal movements and seizures.)

Author(s) and Publication Date(s)

Daniel L. Preud’Homme, MD, University of South Alabama, Mobile, AL – Published August 2006. Updated December 2012.

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New smartphone app can detect newborn jaundice in minutes

Engineering  |  Health and medicine  |  News releases  |  Science  |  Technology

August 27, 2014

Parents or physicians can monitor a newborn baby’s jaundice with their smartphones through BiliCam.U of Washington

Newborn jaundice: It’s one of the last things a parent wants to deal with, but it’s unfortunately a common condition in babies less than a week old.

Skin that turns yellow can be a sure sign that a newborn is jaundiced and isn’t adequately eliminating the chemical bilirubin. But that discoloration is sometimes hard to see, and severe jaundice left untreated can harm a baby.

University of Washington engineers and physicians have developed a smartphone application that checks for jaundice in newborns and can deliver results to parents and pediatricians within minutes. It could serve as a screening tool to determine whether a baby needs a blood test – the gold standard for detecting high levels of bilirubin.

“Virtually every baby gets jaundiced, and we’re sending them home from the hospital even before bilirubin levels reach their peak,” said James Taylor, a UW professor of pediatrics and medical director of the newborn nursery at UW Medical Center. “This smartphone test is really for babies in the first few days after they go home. A parent or health care provider can get an accurate picture of bilirubin to bridge the gap after leaving the hospital.”

The research team will present its results at the Association for Computing Machinery’s International Joint Conference on Pervasive and Ubiquitous Computing in September in Seattle.

“This is a way to provide peace of mind for the parents of newborns,” said Shwetak Patel, a UW associate professor of computer science and engineering and of electrical engineering. “The advantage of doing the analysis in the cloud is that our algorithms can be improved over time.”The app, called BiliCam, uses a smartphone’s camera and flash and a color calibration card the size of a business card. A parent or health care professional would download the app, place the card on her baby’s belly, then take a picture with the card in view. The card calibrates and accounts for different lighting conditions and skin tones. Data from the photo are sent to the cloud and are analyzed by machine-learning algorithms, and a report on the newborn’s bilirubin levels is sent almost instantly to the parent’s phone.

A noninvasive jaundice screening tool is available in some hospitals and clinics, but the instrument costs several thousand dollars and isn’t feasible for home use. Currently, both doctors and parents assess jaundice by looking for the yellow color in a newborn’s skin, but this visual assessment is only moderately accurate. The UW team developed BiliCam to be easy to use and affordable for both clinicians and parents, especially during the first several days after birth when it’s crucial to check for jaundice.

Jaundice, or the yellowing of the skin, can happen when an excess amount of bilirubin collects in the blood. Bilirubin is a natural byproduct of the breakdown of red blood cells, which the liver usually metabolizes. But newborns often metabolize bilirubin slower because their livers aren’t yet fully functioning. If left untreated, severe jaundice can cause brain damage and a potentially fatal condition called kernicterus.

The UW team ran a clinical study with 100 newborns and their families at UW Medical Center. They used a blood test, the current screening tool used in hospitals, and BiliCam to test the babies when they were between two and five days old. They found that BiliCam performed as well as or better than the current screening tool. Though it wouldn’t replace a blood test, BiliCam could let parents know if they should take that next step.

Screenshots of the data collection app showing where to enter basic information, how to position the phone and a live feed from the camera with a view finder for aligning the color card.U of Washington

“BiliCam would be a significantly cheaper and more accessible option than the existing reliable screening methods,” said Lilian de Greef, lead author and a UW doctoral student in computer science and engineering. “Lowering the access barrier to medical applications can have profound effects on patients, their caregivers and their doctors, especially for something as prevalent as newborn jaundice.”

The researchers plan to test BiliCam on up to 1,000 additional newborns, especially those with darker skin pigments. The algorithms will then be robust enough to account for all ethnicities and skin colors. This could make BiliCam a useful tool for parents and health care workers in developing countries where jaundice accounts for many newborn deaths.

“We’re really excited about the potential of this in resource-poor areas, something that can make a difference in places where there aren’t tools to measure bilirubin but there’s good infrastructure for mobile phones,” Taylor said.

Within a year, the researchers say BiliCam could be used by doctors as an alternative to the current screening procedures for bilirubin. They have filed patents on the technology, and within a couple of years hope to have Federal Drug Administration approval for the BiliCam app that parents can use at home on their smartphones.

Other members of the research team are Mayank Goel and Min Joon Seo, UW doctoral students in computer science and engineering; Eric Larson of Southern Methodist University; and James Stout of the UW pediatrics department. Southern Methodist University is a collaborator on the machine learning design and app development.

This research is funded by the Coulter Foundation and a National Science Foundation Graduate Research Fellowship.

###

For more information, contact the research team at [email protected].

Tag(s): College of Engineering • Department of Electrical & Computer Engineering • James Taylor • Paul G. Allen School of Computer Science & Engineering • Shwetak Patel

Jaundice in newborns : Neonatal Journey to Home

What is jaundice?

Jaundice (jawn-diss) is an abnormal yellow skin color sometimes found in newborn babies. It can also make the whites of the eyes yellow.

What causes newborn jaundice?

When red blood cells break down, a substance called bilirubin (bill-ee-roo-bin) is released into the blood. This is normal. Usually, the bilirubin is processed by the liver and removed from the body through the stools (bowel movements). But too much bilirubin (called hyperbilirubinemia hie-per-bill-ee-roo-bih-nee-me-ah) can lead to jaundice.

Bigger babies can handle higher bilirubin levels better than smaller babies. Whether a baby needs treatment may depend on weight, age of infant, and baby’s history.

Several factors may lead to increased risk for jaundice: prematurity, baby’s blood type being different from the mother’s, and bruising during birth.

How is newborn jaundice treated?

In most cases, newborn jaundice is mild and will go away without treatment. Full-term infants who are breastfed may have jaundice if they are not getting enough breast milk to stool very often. Treatment in this case is to breast-feed more often, at least 8 to 12 times per day. In some cases, more treatment may be needed.

Premature babies are often not able to take in enough nourishment to stool often and remove enough bilirubin. These infants may need intravenous (IV) fluids to help them until the bilirubin level has lowered.

Phototherapy (light therapy) can help break down bilirubin into a form that is easier for the liver to remove. This treatment is usually needed for 2 to 5 days. The baby’s clothes are removed and the light from a special lamp shines on the skin, either over or under the baby. While receiving light therapy, your baby may need to be kept warm with an isolette or a warmer. Eye protection is placed over the eyes. Your baby may be held during feedings for a limited time. 

Babies can receive phototherapy at home. If this is needed, you will be taught how to use the equipment.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please ask the doctor or nurse.

Children’s Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404

Last Reviewed 7/2015 © Copyright

How to Care for Your Baby with Jaundice

This leaflet will provide you with information about Neonatal Jaundice causes, symptoms, diagnosis, treatment and home care advice.

 Download this Guide

What is Neonatal Jaundice?

• Jaundice is the medical term for a yellow tinge in the skin’s colour. The yellow colour is caused by a substance called bilirubin, which is made normally in the body—a higher level of bilirubin called “hyperbilirubinemia”.
• Jaundice itself is not a disease but rather a sign of high blood bilirubin level. The excess of bilirubin at more than a certain level can cause brain damage.
• Different reasons can cause babies to have high bilirubin levels. For example:
  • If babies are not getting enough milk.
  • If babies are born early.

What are the symptoms of Neonatal Jaundice?

• Yellow discolouration of the skin. It starts first in the face, and then the chest, stomach area, arms, and then finally to the legs.
• In some babies, jaundice may appear over the entire body like a tan.
• The poo looks chalky or very pale, or the urine (pee) is continuously dark in colour.

How is Neonatal Jaundice diagnosed?

The doctor will ask few questions about your child’s health and examine your child, and will request blood lest to check bilirubin levels in the blood

How is Neonatal Jaundice treated?

• Most babies do not require treatment. Mild jaundice in newborns usually gets better without treatment.
• The goal of treating jaundice is to efficiently and safely reduce the level of bilirubin

General treatment options include:

1.     Increasing your baby’s milk intake.

• Provide adequate breast milk to prevent and treat jaundice because it helps eliminate bilirubin in stools and urine.
• Aim for at least six wet diapers per day, the colour of your baby’s stools will change from dark green to yellow, and s/he seems satisfied after feeding.
  
   

2.    Phototherapy

• Phototherapy (“light” therapy) is the most common medical treatment for jaundice in babies.
• The baby’s skin surface is exposed to special blue light, which breaks bilirubin and makes it easier to go away through the stool and urine.
• Treatment with phototherapy is successful for almost all babies.
  
   

3.    Blood transfusion

• A blood transfusion may be considered in more severe cases, as very high bilirubin can cause harm to the baby.
• The transfusion replaces a baby’s blood with donated blood to quickly lower bilirubin levels

When should I seek medical advice?

Seek medical advice if your baby:

• Has Jaundice during the first 24 hours after birth or yellowing of the palms of the hands and soles of the feet
• Is not feeding well.
• Is peeing and pooping less than usual.
• Has jaundice for more than two weeks.
• Your baby’s jaundice goes away and then comes back.

Infant jaundice | Sparrow

Yellowing of the skin and the whites of the eyes — the main sign of infant jaundice — usually appears between the second and fourth day after birth.

To check for infant jaundice, press gently on your baby’s forehead or nose. If the skin looks yellow where you pressed, it’s likely your baby has mild jaundice. If your baby doesn’t have jaundice, the skin color should simply look slightly lighter than its normal color for a moment.

Examine your baby in good lighting conditions, preferably in natural daylight.

When to see a doctor

Most hospitals have a policy of examining babies for jaundice before discharge. The American Academy of Pediatrics recommends that newborns be examined for jaundice during routine medical checks and at least every eight to 12 hours while in the hospital.

Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours after birth, make a follow-up appointment to look for jaundice within two days of discharge.

The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin. Call your doctor if:

• Your baby’s skin becomes more yellow
• The skin on your baby’s the abdomen, arms or legs looks yellow
• The whites of your baby’s eyes look yellow
• Your baby seems listless or sick or is difficult to awaken
• Your baby isn’t gaining weight or is feeding poorly
• Your baby makes high-pitched cries
• Your baby develops any other signs or symptoms that concern you

Causes

Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of “used” red blood cells.

Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract. A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.

Other causes

An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of infant jaundice. Diseases or conditions that can cause jaundice include:

• Internal bleeding (hemorrhage)
• An infection in your baby’s blood (sepsis)
• Other viral or bacterial infections
• An incompatibility between the mother’s blood and the baby’s blood
• A liver malfunction
• Biliary atresia, a condition in which the baby’s bile ducts are blocked or scarred
• An enzyme deficiency
• An abnormality of your baby’s red blood cells that causes them to break down rapidly

Risk factors

Major risk factors for jaundice, particularly severe jaundice that can cause complications, include:

• Premature birth. A baby born before 38 weeks of gestation may not be able to process bilirubin as quickly as full-term babies do. Premature babies also may feed less and have fewer bowel movements, resulting in less bilirubin eliminated through stool.
• Significant bruising during birth. Newborns who become bruised during delivery gets bruises from the delivery may have higher levels of bilirubin from the breakdown of more red blood cells.
• Blood type. If the mother’s blood type is different from her baby’s, the baby may have received antibodies through the placenta that cause abnormally rapid breakdown of red blood cells.
• Breast-feeding. Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition from breast-feeding, are at higher risk of jaundice. Dehydration or a low caloric intake may contribute to the onset of jaundice. However, because of the benefits of breast-feeding, experts still recommend it. It’s important to make sure your baby gets enough to eat and is adequately hydrated.
• Race. Studies show that babies of East Asian ancestry have an increased risk of developing jaundice.

Complications

High levels of bilirubin that cause severe jaundice can result in serious complications if not treated.

Acute bilirubin encephalopathy

Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there’s a risk of bilirubin passing into the brain, a condition called acute bilirubin encephalopathy. Prompt treatment may prevent significant lasting damage.

Signs of acute bilirubin encephalopathy in a baby with jaundice include:

• Listlessness
• Difficulty waking
• High-pitched crying
• Poor sucking or feeding
• Backward arching of the neck and body
• Fever

Kernicterus

Kernicterus is the syndrome that occurs if acute bilirubin encephalopathy causes permanent damage to the brain. Kernicterus may result in:

• Involuntary and uncontrolled movements (athetoid cerebral palsy)
• Permanent upward gaze
• Hearing loss
• Improper development of tooth enamel

Prevention

The best preventive of infant jaundice is adequate feeding. Breast-fed infants should have eight to 12 feedings a day for the first several days of life. Formula-fed infants usually should have 1 to 2 ounces (about 30 to 60 milliliters) of formula every two to three hours for the first week.

Diagnosis

Your doctor will likely diagnose infant jaundice on the basis of your baby’s appearance. However, it’s still necessary to measure the level of bilirubin in your baby’s blood. The level of bilirubin (severity of jaundice) will determine the course of treatment. Tests to detect jaundice and measure bilirubin include:

• A physical exam
• A laboratory test of a sample of your baby’s blood
• A skin test with a device called a transcutaneous bilirubinometer, which measures the reflection of a special light shone through the skin

Your doctor may order additional blood tests or urine tests if there’s evidence that your baby’s jaundice is caused by an underlying disorder.

Treatment

Mild infant jaundice often disappears on its own within two or three weeks. For moderate or severe jaundice, your baby may need to stay longer in the newborn nursery or be readmitted to the hospital.

Treatments to lower the level of bilirubin in your baby’s blood may include:

• Enhanced nutrition. To prevent weight loss, your doctor may recommend more-frequent feeding or supplementation to ensure that your baby receives adequate nutrition.
• Light therapy (phototherapy). Your baby may be placed under a special lamp that emits light in the blue-green spectrum. The light changes the shape and structure of bilirubin molecules in such a way that they can be excreted in both the urine and stool. During treatment, your baby will wear only a diaper and protective eye patches. Light therapy may be supplemented with the use of a light-emitting pad or mattress.
• Intravenous immunoglobulin (IVIg). Jaundice may be related to blood type differences between mother and baby. This condition results in the baby carrying antibodies from the mother that contribute to the rapid breakdown of the baby’s red blood cells. Intravenous transfusion of an immunoglobulin — a blood protein that can reduce levels of antibodies — may decrease jaundice and lessen the need for an exchange transfusion, although results are not conclusive.
• Exchange transfusion. Rarely, when severe jaundice doesn’t respond to other treatments, a baby may need an exchange transfusion of blood. This involves repeatedly withdrawing small amounts of blood and replacing it with donor blood, thereby diluting the bilirubin and maternal antibodies — a procedure that’s performed in a newborn intensive care unit.

Lifestyle and home remedies

When infant jaundice isn’t severe, your doctor may recommend changes in feeding habits that can lower levels of bilirubin. Talk to your doctor if you have any questions or concerns about how much or how often your baby is feeding or if you’re having trouble breast-feeding. The following steps may lessen jaundice:

• More-frequent feedings. Feeding more frequently will provide your baby with more milk and cause more bowel movements, increasing the amount of bilirubin eliminated in your baby’s stool. Breast-fed infants should have eight to 12 feedings a day for the first several days of life. Formula-fed infants usually should have 1 to 2 ounces (about 30 to 60 milliliters) of formula every two to three hours for the first week.
• Supplemental feedings. If your baby is having trouble breast-feeding, is losing weight, or is dehydrated, your doctor may suggest giving your baby formula or expressed milk to supplement breast-feeding. In some cases, your doctor may recommend using formula alone for a couple of days and then resuming breast-feeding. Ask your doctor what feeding options are right for your baby.

Preparing for an appointment

Bilirubin levels in the blood tend to peak when your baby is between three and seven days old. So it’s important for your doctor to examine your baby for jaundice during that time.

When your baby is discharged from the hospital, your doctor or nurse will look for jaundice. If your baby has jaundice, your doctor will assess the likelihood of severe jaundice based on a number of factors:

• How much bilirubin is in the blood
• Whether your baby was born prematurely
• How well he or she is feeding
• How old your baby is
• Whether your baby has bruising from delivery
• Whether an older sibling also had severe jaundice

Follow-up visit

If risk factors for severe jaundice are present, your doctor may recommend a follow-up visit a day or two after the baby leaves the hospital.

When you arrive for your follow-up appointment, be prepared to answer the following questions.

• How well is your baby feeding?
• Is your baby breast-fed or formula-fed?
• How often does your baby feed?
• How often does your baby have a wet diaper?
• How often is there stool in the diaper?
• Does your baby wake up easily for feeding?
• Does your baby seem sick or weak?
• Have you noticed any changes in the color of your baby’s skin or eyes?
• If your baby has jaundice, has the yellow color spread to parts of the body other than the face?
• Has your baby’s temperature been stable?

You may also prepare questions to ask your doctor at your follow-up appointment, including:

• Is the jaundice severe?
• What is the cause of the jaundice?
• What tests will my baby need?
• Does my baby need to begin treatment for jaundice?
• Will I need to readmit my baby to the hospital?
• Is the jaundice severe?
• Will my baby need to go back into the hospital?
• When should my baby have a follow-up visit?
• Should I keep feeding my baby the way I am now?
• Do you have any brochures about jaundice and proper feeding?

Content From Mayo Clinic Updated: 12/22/2020

© 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. Terms of Use

Jaundice in Newborn Babies: Causes, Treatment and More

If your newborn’s beautiful skin has started turning a bit yellow, it could be jaundice. But your baby is in good company: Many infants experience this usually benign condition shortly after birth. Here are the basics on jaundice in newborn babies.

What is jaundice in babies?

Jaundice is a common, short-term condition in newborns that turns a baby’s skin and the whites of the eyes yellow. Jaundice occurs in about 60 percent of all babies born full-term and about 80 percent of babies born prematurely when a chemical called bilirubin builds up in the baby’s blood.

Most cases show up two to three days after birth and are caught by in-hospital screens for babies, while others can appear later. Jaundice usually goes away on its own (or sometimes with mild treatment) with no ill effects. It usually lasts a week to 10 days, sometimes longer for premature babies. 

What causes newborn jaundice?

Jaundice in a newborn baby is caused by excess levels of bilirubin, a condition known as hyperbilirubinemia. Bilirubin is an enzyme that’s produced in the blood when the body breaks down old red blood cells.

Since a newborn’s liver is underdeveloped, the bilirubin often doesn’t get eliminated as efficiently, which can cause the skin, and sometimes the whites of the eyes, to turn yellow.

If your baby has jaundice, you’ll be able to notice the yellow tinge of her skin by gently pressing on her forehead or chest and watching the color return.

There are various causes for newborn jaundice depending on type:

• Physiologic jaundice due to an underdeveloped liver. This is the most common type of jaundice, affecting 50 percent of all newborns. Why so common? A newborn’s liver needs a little extra time to mature and get rid of the bilirubin in her body. Some experts call this type of jaundice a “normal” response in the first few days of life; it usually disappears within a week or two. This type of jaundice is very common in preemies, as their livers may not be fully developed.
• Breast milk jaundice due to interference with liver function. Though relatively rare, about 10 percent of breastfed babies develop jaundice when a protein in their breast milk blocks the liver’s breakdown of bilirubin, causing elevated levels. It’s not harmful, but it can last anywhere from three to 12 weeks.
• Jaundice due to breastfeeding problems or malnutrition. This type of jaundice occurs in about 5 to 10 percent of newborns due to low breast milk and calorie intake while Mom and baby are getting acclimated to breastfeeding. While breastfeeding is still recommended for newborns who have jaundice, certain babies with this type of jaundice may require supplementing with pumped breast milk or formula in a bottle. 
• Jaundice from hemolysis. This rare but serious type of jaundice begins within the first 24 hours after birth. These babies have what is called hemolytic disease of the newborn, which means that either the baby’s blood type does not match the mother’s or their Rh factors are incompatible. Prenatal testing looks to prevent this condition. Moms-to-be who are Rh-negative will likely be treated with a RhoGAM injection because their Rh factor is negative and incompatible with the baby’s.
• Poor liver function. Again, this type of jaundice is rare but serious. The main clues that something is off are light gray or pale yellow stools in a newborn with jaundice that doesn’t go away. It’s caused by an infected liver (hepatitis) or blockage of the bile ducts of the liver (biliary atresia).

What are the symptoms of jaundice in a newborn baby?

Although there isn’t anything you can do to prevent jaundice, it’s important to watch for the telltale signs and symptoms, especially since the condition may not develop until after you bring your baby home from the hospital. That way, you can seek treatment if necessary.

The main symptoms of newborn jaundice are:

The American Academy of Pediatrics (AAP) recommends babies be assessed by a pediatrician for jaundice again at 3 to 5 days of age. This is the time when bilirubin levels are the highest. 

Jaundice often appears on the face first and then spreads to the rest of the baby’s body, including the chest, tummy, arms, legs and whites of the eyes. A good way to check is to place your baby in natural sunlight or under fluorescent lights and gently press her forehead and nose with your fingers. 

If the skin appears yellow where you made the impressions, call your pediatrician. The doctor will probably want to examine your baby and take a blood sample to look at the bilirubin levels in her blood.

Jaundice can be harder to see in babies with darker skin. In darker-skinned babies, the yellowing may be more visible on the palms of the hands and soles of the feet, so check there. Also look at the pink skin inside your baby’s mouth in the gums and inner lips.

What are risk factors for jaundice?

While most babies have mild jaundice, some are at a greater risk, including:

• Babies born prematurely (before 37 weeks) or at a low birth weight 

• Babies who lost a lot of weight right after delivery or had a lot of bruising or bleeding under the scalp related to labor and delivery

• Babies of East Asian or Mediterranean descent

• Babies with a parent or sibling who had a high bilirubin level and received light therapy

• Babies who aren’t breastfeeding well (because of poor latch, low milk supply, etc.)

If you’re breastfeeding, feed your baby every two to three hours, or about eight to 12 times a day. Feeding this often helps keep your baby’s bilirubin level down. If you’re having trouble breastfeeding, ask your baby’s doctor, nurse or a lactation specialist for help. It takes time to get the hang of it.

How is newborn jaundice treated?

If there are moderate to high levels of bilirubin detected in your baby, you may be advised to expose her to sunlight or another type of phototherapy at home, which helps to break down the enzyme, making it easier for the body to eliminate.

However, because of newborns’ substantial risk of sunburn with direct sunlight exposure, doctors these days are more likely to offer treatment with phototherapy (which places the baby under a certain type of bright lamp) or a special blanket or pad.

You may also be told to feed your baby as often as possible, without overfeeding, to encourage frequent bowel movements. That will also help get rid of the excess bilirubin, which gives stools a brownish-yellowish color.

In the most extreme form of jaundice, when bilirubin levels are abnormally high, the enzyme can build up in the brain. Left untreated, very severe jaundice can lead to an extremely rare condition called kernicterus, which can result in permanent brain damage.

Some hospitals are taking extra measures to monitor the levels of bilirubin in babies’ blood through blood tests and follow-up visits to ensure that these very uncommon instances of kernicterus are not missed.

If your baby has more severe jaundice, she may need treatments such as:

• Phototherapy treatment (also called light therapy or bili lights). Your baby will be undressed and put under special lights, but fear not: The lights don’t hurt. Sometimes, you may need to bring your baby back to the hospital for treatment under the bili lights. 

• Supplementing breast milk with formula. This is done on a case-by-case basis at the recommendation of your pediatrician and can sometimes help lower the bilirubin level and prevent the need for phototherapy. 

• Red cell exchange transfusion. This treatment is called upon if the bili lights don’t work and the bilirubin levels are abnormally high. In an exchange transfusion, your baby’s blood is replaced with fresh donor blood or plasma. The need for this treatment is rare.

• Intravenous immunoglobulin (also called IVIg). This is a product made up of antibodies that can be given intravenously (through a vein). This is also only used rarely.

How long does it take for newborn jaundice to go away?

Typically, jaundice goes away in a week to 10 days, though it sticks around for longer in premature babies.

If your baby is breastfed, jaundice can last a month or occasionally longer. If your baby is formula-fed, jaundice typically clears up within two weeks. If it lasts three weeks or longer, be sure to call the doctor.

How can newborn jaundice be prevented?

There’s no way to prevent the most common type of newborn jaundice. Most cases occur because a baby’s liver is not mature enough to get rid of bilirubin in the bloodstream.

You can reduce your baby’s risk of jaundice by:

• Getting a RHo-GAM shot if your blood type is identified as Rh-negative during pregnancy and again 72 hours after delivery if your baby is Rh-positive
• Feeding your baby at least eight to 12 times a day, which helps her have regular bowel movements and removes bilirubin from her body. 

Though it’s important to watch for the symptoms of jaundice and talk to your pediatrician right away if you suspect your baby could have it, take comfort in the fact that in most newborns, jaundice is an extremely treatable, manageable and mild condition that will likely go away in a matter of weeks.90,000 “Jaundice” of newborns. Calm, only calm

Mom. You have a baby. Look at him. He is your little copy. Still, in order to become an adult, he needs to change, go a long and difficult way, adapt to an independent life. Therefore, in the neonatal period, so-called “transitional states” are frequent, characteristic only for these children. One of the most famous of these conditions is neonatal jaundice. We, neonatologists, call it affectionately – “jaundice”.

It has nothing to do with infectious jaundice – hepatitis. Jaundice in newborns is physiological and pathological. Physiological jaundice disappears without a trace within a short period of time. Pathological jaundice of newborns is caused by diseases and often requires close medical supervision. And yet the most common jaundice in babies just born is physiological.

It occurs in about 60-70% of babies and appears 3-4 days after birth.This condition is not a disease, it goes away over time. It is associated with the immaturity of some systems of the child’s body responsible for the exchange of a special substance – bilirubin. With physiological jaundice, the general condition of children, as a rule, does not suffer. It is very quick and easy to heal. Now more and more specialists and clinics around the world refuse to use special drugs for the treatment of jaundice in newborns.

To date, the most effective and proven method of reducing the toxicity of bilirubin in physiological jaundice is proper breastfeeding, which allows the child to “heal himself”.The best prevention and treatment of physiological jaundice is early and frequent feedings. If necessary, the specialists of the Clinical Maternity Hospital carry out “phototherapy” for their little patients. It is completely safe for the child.

Special recommendations for observation in the clinic in such cases are not required. From the mother, only love, affection and proper feeding with the most useful breast milk are needed.

S. V. Lapeko – Head of the observational department of newborns
GBUZ JSC “Clinical Maternity Hospital”

90,000 newborn jaundice treatment

One of the most common and effective methods of treating newborn jaundice is phototherapy.It is carried out using a special Philips TL 20W / 52 T12 G13 lamp. Under the influence of light with a wavelength of 400-500 nm (the beginning of the visible spectrum is violet, blue) bilirubin becomes a harmless water-soluble substance that is easily excreted in urine and feces. After a few days, the effect is noticeable, but it is necessary to complete the full course prescribed by the doctor. Most often, treatment sessions for newborns are carried out in a hospital setting. At the same time, the level of bilirubin in the blood is monitored daily.As a rule, it stabilizes in the first two days. The procedure is carried out either in a heated bed or in a special incubator. The baby’s eyes must be protected with a special bandage, and then placed under the apparatus. Additional side lamps increase efficiency by increasing the irradiated area. The duration of the session is prescribed by the doctor, taking into account the condition of the child. It is important to observe safety measures, do not leave the baby alone under the lamp, do not bring him closer to the radiation source than was shown by the medical staff.Regularly you need to change its position so that the light evenly affects the baby’s body. In addition, the temperature should be measured from time to time to prevent overheating. With non-critical indicators, it is possible to conduct phototherapy sessions at home. Lamps for the treatment of jaundice Philips TL 20W / 52 T12 G13 https://lampalux.ru/p23530342-lampa-dlya-lecheniya.html can be rented or purchased from us together with the lamp. But all the same, one cannot do without the supervision of specialists. It is the doctor who must determine the duration of the sessions and the duration of the general course.Also, you will constantly need to be tested. And in no case should you forget about the precautions, so you need to study all the nuances of using the selected device.

Phototherapy has proven its effectiveness more than once. It accelerates the passage of jaundice in newborns, reduces the risk of complications and consequences. But it cannot be considered completely safe. Digestion and stool disorders, changes in the child’s behavior are possible: he becomes lethargic and irritable. With some symptoms, the use of a lamp for treatment must be abandoned: if the skin of the newborn becomes bronze; pallor; burns; the appearance of skin rashes.Since phototherapy affects the entire body of the child, it is not prescribed for milder forms of jaundice. Also, you can not self-medicate, without the advice of specialists, the baby can be harmed. But at a critical level of indirect bilirubin, the procedure is almost irreplaceable. It is especially effective together with taking certain medications and breastfeeding. If you follow all the appointments, you will be able to avoid side reactions.

90,000 home treatment, effectiveness

Physiological jaundice of newborns is completely normal.It is associated with the active destruction of fetal hemoglobin, as a result of which a large amount of free (unbound bilirubin) appears in the baby’s body at once. Clinically, this is manifested by the fact that on the 2nd or 3rd day of life in almost all newborns, the skin acquires a yellowish tint, and by the tenth day of life, if everything is in order, the yellowness completely disappears. But this is not always the case. In some cases, processes are triggered in the baby’s body, in which the destruction of red blood cells is more active than normal, which leads to a significant increase in the concentration of free bilirubin and an increase in jaundice.

These are the reasons for this condition:

• Internal bleeding (hemorrhage, e.g. cephalohematoma)
• Viral or bacterial infections in the fetus and newborn
• Incompatibility of mother and child by Rh factor and blood group
• Diseases of the liver that impair its function
• Diseases of the child’s erythrocytes, leading to their excessive destruction.

Such an excessive increase in the concentration of this substance can be dangerous for the baby’s body, in particular, for his brain.Bilirubin does not have time to be utilized and excreted by the body, so it (as a fat-soluble substance) is deposited first in the subcutaneous fatty tissue, and then, when there is not enough space, it begins to accumulate in the brain nuclei, irreversibly damaging them. This condition is called kernicterus, and it is directly dangerous to the life and health of the child.

In order to prevent such formidable complications, with an increase in the concentration of bilirubin above 256 μmol / L in term infants and above 171 μmol / L in premature infants, therapeutic measures are started.

The first in the list of such measures is phototherapy (ultraviolet treatment).

What is phototherapy?

Phototherapy for neonatal jaundice is one of the most gentle and effective ways to deal with the problem. The process uses lamps, the ultraviolet waves of which convert bilirubin into a harmless soluble substance (lumirubin), which is then naturally excreted from the body. … As a result, the concentration of the yellow pigment rapidly decreases, and its negative effect on the newborn is neutralized.

Features of phototherapy for neonatal jaundice

The harmless water-soluble isomer is excreted within 12 hours after the completion of the procedure along with feces.

Radiation characteristics similar to natural sunlight, but has a blue tint. The phototherapy procedure is painless and does not cause discomfort to the child.

The procedure is prohibited for children with obstructive jaundice, liver abnormalities, or the level of bilirubin is critically high.Under these conditions, other methods of therapy are chosen.

How long does phototherapy last?

It is difficult to name the optimal duration of the procedure. It will depend on the condition of the newborn.

If the child is very overheated and / or his body turns red, the treatment must be stopped urgently.

The minimum duration of phototherapy is 2 hours. If the level of yellow pigment remains consistently high, then the child is left under the lamp for up to 4 days.The baby should be under it constantly for 96 hours with breaks only for feeding. In order not to reduce the effectiveness of the procedure, the mother should take the baby to the breast for a maximum of 2-3 hours. It happens that after light therapy, the child becomes drowsy, the stool is disturbed, or an allergic rash appears. Often, the skin of a small patient also acquires a bronze tint, begins to dry out. These side effects do not require special procedures and go away on their own in a few days.

Phototherapy at home

Most often, the procedure is carried out in a hospital setting, since it requires dynamic monitoring of the child and prompt updating of the blood test data for the level of free bilirubin.However, there are cases when, for whatever reason, phototherapy is carried out at home (usually we are talking about “light” children with a slight excess of the concentration of free bilirubin in the blood). Parents can buy or rent a special lamp.

It is very important to carry out phototherapy for jaundice in newborns only after prior agreement with the pediatrician, strictly observing all his prescriptions. It is important that the specialist visits the newborn every day (and preferably not once) to make sure that the treatment is going according to plan.It is also necessary to promptly provide blood tests for the level of free bilirubin at home.

For home treatment, a special lamp is attached to the side of the crib. It is permissible to turn it on at a distance of at least 50 cm from the newborn. It is imperative to close the eyes and genitals of the child with a dense, clean cloth folded in 4-5 layers, and also take care of heating if the room is cool. Parents should carefully monitor the baby’s condition when using a special ultraviolet lamp at home.

To avoid burns, do not leave a newborn alone with the device turned on. It is necessary to control the temperature of the child’s body during therapy and make sure that redness does not appear on his skin.

When using home phototherapy, the baby should be regularly turned over and taken out for feeding. Under the influence of ultraviolet light, the baby’s body quickly loses moisture, and breast milk not only avoids dehydration, but also accelerates the excretion of bilirubin.

If, despite ongoing treatment, jaundice continues to increase and / or symptoms such as appear:

• Excessive unexplained lethargy or difficulty waking up
• Loud shrill scream (“nuclear” scream)
• Poor Sucking
• Overextension of the neck and back extension (arching the body and tilting the head back)
• Increased body temperature
• Vomiting

urgent hospitalization is required and, most likely, exchange transfusion.

Phototherapy is an effective procedure for treating jaundice in newborns. It is safe if you carefully follow all the doctor’s instructions and carefully look after your baby during treatment.

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See also: causes of conjugational jaundice in newborns

Jaundice in newborns

In most newborns (about 60%), on the second or third day of life, the skin suddenly turns yellow for no reason.“This is jaundice, there is no need to treat it,
it will go away on its own, ”says the pediatrician, but mom is still a little anxious. After all, the very name “jaundice” sounds
somehow unpleasant, and why not need to be treated – the child is yellow? Let’s talk about this condition in detail.

Where does it come from

Jaundice is a yellow staining of the skin and mucous membranes. But this is just a symptom of the disease, not the disease itself. How does jaundice occur? In our
the body, many processes follow a chain.For example, there are erythrocytes (red blood cells) in the blood, and they already contain a special protein – hemoglobin. The main task of red blood cells with hemoglobin
– to carry oxygen and carbon dioxide throughout the body. If we imagine the scheme of work of the erythrocyte in a very simplified way, then everything looks like this: every day there is a large
part of the erythrocytes works (carries oxygen), and a smaller part perishes. So, when the erythrocyte is destroyed, a special bile pigment – bilirubin (it has yellow
Colour).On the one hand, this pigment is a necessary thing (it participates in many metabolic processes), and on the other hand, it is toxic to internal organs by itself. Therefore, as soon as bilirubin is released from
erythrocyte, it immediately enters the liver, where it is immediately rendered harmless by liver enzymes. Then bilirubin enters bile (it is because of this pigment that it has a dark yellow color), from there to
intestines and ultimately excreted in the feces (by the way, bilirubin also gives the color to the stool). This is such a chain, and if some link is broken in it, then there is a lot of bilirubin in the blood, a pigment
penetrates into the skin and, together with the mucous membranes, it turns yellow.In adults, jaundice usually appears when the liver is suffering in a chain: with hepatitis, acute poisoning, or if the bile ducts are blocked
stone. That is, there must be some kind of disease.

Causes of jaundice in newborns

But in newborns, jaundice most often occurs not at all due to illness. Even during pregnancy, the baby’s erythrocytes, if I may say so, “take” hemoglobin from the mother’s erythrocytes simply because
that the baby needs it more. And as soon as a child is born, he has a lot of hemoglobin, but he no longer needs so much in a new life, and therefore hemoglobin in a newborn begins abruptly
decline.And if a lot of hemoglobin is destroyed, then a lot of bilirubin appears. But a newborn is not an adult, his liver enzymes have not yet fully matured, therefore,
they cannot neutralize bilirubin. Plus, the intestines and many other systems have not matured, that is, the baby’s body simply cannot cope with so much bilirubin in the blood. As a result –
bilirubin accumulates and the child turns yellow.

Consequences of jaundice in newborns

Such jaundice appears in a child approximately on the 2-3rd day of life, then its peak comes, but already somewhere on the 6-7th day (maximum on the 14-21st
day) the bilirubin level returns to normal.The yellowness disappears and the skin becomes its usual pale pink color. This jaundice is completely normal and does not threaten the child. Doctors and
they call it – physiological jaundice , that is, natural, normal.

By the way, it is believed that 100% of newborns have it, but only 2/3 of children have it.

That is why you should not be afraid of such jaundice – it is not a disease, but a temporary phenomenon. In addition, the general condition of the child with her is not disturbed in any way, she is not
infectious, no anemia, liver, spleen are not enlarged, stool and urine are of normal color.Therefore, it is not necessary to treat physiological jaundice.

In full-term babies, jaundice goes away quickly, but in premature babies or babies from twins, it can linger for more than three weeks. Therefore, in order for the bilirubin to decrease more quickly, it is necessary to attach the baby to the breast as soon as possible.
(in the delivery room), feed him not by the hour, but on demand. If the weather permits, you can take a walk with your baby in the sun – it also speeds up the elimination of this substance.

Jaundice from breast milk

There is another type of also safe jaundice, which can last more than three weeks in a child.This is the so-called breastfeeding jaundice . She
sometimes appears in babies who are breastfeeding. The reason for it is as follows: there is a substance in mother’s breast milk that blocks the action of liver enzymes in a child.

Why nature invented this is still unknown, but such a mechanism exists.

Tellingly, the child has no other symptoms. The kid actively eats, gains weight well, grows and generally feels great.Peak
such jaundice occurs not in the first days of life, but somewhere on the 10-21st day. Then the amount of pigment gradually decreases and the yellow color of the skin disappears. Often, to determine if jaundice is associated with
mother’s milk, for two or three days, stop breastfeeding and give a mixture. If during this time the baby’s skin has lightened, then yes, the cause of jaundice is in human milk. Moreover, breastfeeding is possible
continue, just the doctor should regularly monitor the baby’s condition and monitor the level of bilirubin in the blood.This jaundice usually resolves by the end of the third month.

Disease symptom

Much less often, the reason that the child turned yellow lies in some kind of disease, and then jaundice is called pathological . What else can cause jaundice in newborns:

• Hemolytic disease. It occurs with Rh-conflict. If a woman’s Rh factor is negative, and her child’s is positive, then even during pregnancy, the mother’s body reacts to the blood factors of the future
  baby.He considers them foreign and produces antibodies that destroy the baby’s red blood cells. Moreover, too many of them are destroyed, and as a result, the amount of bilirubin rises very much. Jaundice in
  such children appear already in the first days and even hours after birth. All doctors know that such a situation is possible, therefore, an expectant mother with a negative Rh factor during pregnancy carefully
  watching a woman give birth in a specialized maternity hospital, where the newborn is immediately assisted.

• Various viruses, bacteria, toxins such as hepatitis, cytomegalovirus or severe bacterial infection. They “hit” the liver, its work is disrupted, and it increases in size together with the spleen.
  Since the liver does not produce the necessary substances, the stool becomes whitish, and the urine, on the contrary, darkens. Skin color in liver diseases is greenish-yellow, and not just yellow, as in physiological jaundice.

• If the outflow of bile is disturbed, for example, the biliary tract is impassable due to underdevelopment.Bile becomes viscous and thick, accumulates in the bile ducts, and when they are overflowed, it enters the bloodstream, as a result, the skin immediately turns yellow.

What to do

If the child turned yellow while still in the hospital, then everything is clear: he will be examined immediately and, if necessary, will be treated. But now children are discharged early (on the 3rd day), and if the baby has turned yellow at home, then how to find out what is the reason
and what to do with it, this jaundice? A pediatrician will come to each newborn immediately after discharge, and then every week, he will help determine what is the matter.

• Let’s say right away that if jaundice appeared at home (on the 2nd-4th day after birth) and the baby is feeling well, then most likely it is physiological,
  and they don’t do anything with it, but just wait for it to pass (on average, in six to seven days). Bilirubin, although toxic, does not harm the child in small quantities. Therefore, parents and
  the doctor just looks to see if the child is eating well, gaining weight and developing. It used to be recommended to give children water and glucose (to lower their bilirubin levels), but now it is believed that
  normal breastfeeding is sufficient, and the more often you feed, the better.

• If everything is in order with the baby, but the jaundice has not gone away in a week, or two, or three, it does not grow, but simply stays at the same level, then perhaps
  it is breastfeeding jaundice. Here, the doctor will offer to take a blood test, which will show the level of bilirubin. Only after that it will become clear whether something needs to be done or not.

• If jaundice grows or against its background from the first day (or even after some time) other symptoms appear – the child is lethargic, does not suck well, the skin color is not just yellow, but with a greenish tint, or
  suddenly the temperature rises, the color of urine and feces has changed, then an examination and treatment is immediately prescribed.

Now, by the way, many doctors do not wait long, and if they see that jaundice does not go away quickly or it is not very similar to physiological jaundice, they immediately prescribe a blood test for bilirubin. By the way, in
modern maternity hospitals have a device that measures the level of bilirubin without an injection. A special apparatus with a sensor is brought to the skin, it analyzes the color of the skin and shows the value of bilirubin on the display.
Usually this method is used as a screening test in order to identify newborns with high levels of bilirubin already in the hospital.

In full-term babies, jaundice goes away quickly, but in premature babies or babies from twins, it can linger for more than three weeks.

If everything is in order with the baby, but the jaundice has not gone away within a week, not two, or three, it does not grow, but simply stays at the same level, then perhaps it is breastfeeding jaundice.

In full-term newborns, the critical level of bilirubin in the blood is 324 µmol / l, in premature infants – 150–250 µmol / l.

Memo for parents

1. Physiological jaundice usually appears on the 2-3rd day of life and gradually disappears on average by the 6-7th day. Sometimes it is delayed until 14–21 days.

2. With physiological jaundice, the child feels well, he is cheerful, eats actively, gains weight, his urine and stools are of the usual color.

3. If you are worried about something, ask your doctor to prescribe your child a blood test for bilirubin.

4. If the jaundice does not decrease, but grows, the child has become lethargic, does not suck well, some other symptoms appear (the temperature has risen, the color of urine and stools has changed), you should immediately consult a doctor.

So if the baby turns yellow at the right time, then there is no need to worry. A doctor’s supervision and good care are enough: in most cases, jaundice goes away on its own.

Smartphone application for screening jaundice in newborns

Jaundice is a common condition in infants in the first days after birth. A group of scientists at the University of Washington is developing a smartphone application that should make it easier for doctors and parents to monitor newborns by helping to track the dynamics of jaundice.

As you know, hyperbilirubinemia is manifested by yellow staining of the skin. However, it is not always easy to notice it with the naked eye, and even more so to track the dynamics. Meanwhile, an excessive increase in hyperbilirubinemia, which is a consequence of untimely diagnosis and treatment, can cause irreparable harm to the brain of a newborn, and even threaten his life.

Jaundice is the result of a buildup in the blood and body tissues of a substance called bilirubin, a natural by-product of the breakdown of red blood cells.Under normal conditions, this substance is processed by the liver, but in newborns this process can be slowed down, since the liver is not yet functioning optimally.

If left untreated, jaundice causes brain damage and can be fatal, a condition called kernicterus.

A biochemical blood test is an accurate and reliable method for determining the level of bilirubin in the blood. However, this method is invasive, requires special conditions and cannot be performed at home, therefore there is a need for non-invasive screening methods that may not be very accurate, but be available, fast and inexpensive.Based on such methods, it would be possible to determine whether a biochemical blood test is needed.

In some hospitals, doctors have specialized photometric devices for non-invasive measurement of blood bilirubin levels, but these devices are very expensive and are also not suitable for home use.

The tool, which scientists from the University of Washington offer, consists of just a smartphone, a software application for it, and a color-calibrated paper card.Place a paper card on the baby’s belly and take a photo of the baby. After that, the program independently calculates the error in color rendering (comparing the colors on the card with the standard), evaluates the degree of yellowness of the child’s skin, and gives out the estimated values ​​of the blood bilirubin level. One of the authors of this development, Professor of Pediatrics James Taylor explains:

“Today, babies are discharged home from the hospital very early, which means even before their bilirubinemia reaches its peak.This smartphone-based rapid test will indeed help reduce the risk of late diagnosis of critically high levels of bilirubinemia. It can be useful not only for parents, but also for family doctors, as it is objective and fairly accurate. ”

The smartphone app is called BiliCam.

Scientists have tested their application in a clinical study involving 100 newborn babies.

All infants underwent a blood test for bilirubin levels and screened using the BiliCam method between two and five days of age.The results showed that the BiliCam method was more accurate than the visual observation method, and had non-critical deviations in accuracy compared to the blood test.

The idea of ​​BiliCam is not to replace the blood test, but to make it clear to the parents and the doctor in time that a blood test should be performed.

The program places the detection algorithms not on the smartphone, but on the “cloud”, so an Internet connection is required for its operation. This is important so that in the event of a change in algorithms, you do not have to reinstall the program on all devices.

Scientists are currently planning to test BiliCam on 1,000 newborns, with a wide range of skin pigmentation levels, to make the algorithms accurate enough for babies of all ethnicities and skin colors.

Professor Taylor hopes that their invention will be especially useful in developing countries, where jaundice causes many deaths in newborns; and the diagnostic base of hospitals is very weak.

90,000 Jaundice in newborns – “Healthy Child Internet Cabinet”

Jaundice (hyperbilirubinemia) is a common condition that develops in children during the neonatal period.While in most cases safe , it still requires observation, and in some cases, treatment.

Where does jaundice come from?

The yellow color of the skin is given by bilirubin, a substance that is found in the blood of both children and adults and is a product of the destruction of red blood cells – erythrocytes, whose main function is to carry oxygen.

The number of such cells in the blood of a newborn is significantly higher than that of an adult.

Bilirubin is processed in the liver and excreted in urine and stool. In a newborn child, the process of decay of erythrocytes occurs quite intensively, and the excretion of bilirubin is slowed down due to the immaturity of the liver enzyme systems.

This leads to an increase in the concentration of bilirubin in the blood. Bilirubin is a fat-soluble substance, therefore, penetrating through the walls of blood vessels, it accumulates in tissues rich in fat (including subcutaneous adipose tissue) and causes its icteric staining.

What jaundice looks like in newborns:

Is jaundice dangerous?

In most cases, neonatal jaundice is mild and does not require treatment.

However, excessively high levels of bilirubin in the blood can lead to the fact that it penetrates through the walls of blood vessels and into the brain tissue, which is also rich in fat, and cause severe irreversible damage to the central nervous system.

Therefore, especially in the first week of life, it is necessary to carefully monitor the presence and progression of jaundice in a child.

How does jaundice manifest?

If your child has jaundice, their skin looks slightly yellow or dark. Sometimes the whites of the eyes or the mucous membranes of the mouth acquire a yellow tint. The face and forehead are the first to become icteric, then the process extends to the chest, abdomen, and the arms and legs are stained last.

The presence and degree of jaundice is best determined in bright daylight, gently pressing your finger on different parts of the child’s skin.

The doctor or nurse of the maternity hospital or clinic at each examination assesses the degree of jaundice in the child and, in accordance with this, prescribes additional examination and treatment.

However, you should also pay attention to the color of your child’s skin and inform your doctor if the yellowness is increasing rapidly.The reason for an emergency call to a doctor (including an ambulance) should be the appearance of lethargy in a child with jaundice, decreased sucking, an increase in body temperature, a shrill cry, and throwing his head back.

Preventing jaundice

The most effective method of preventing and reducing the intensity of jaundice is correct and frequent feeding . The child should be applied to the breast as often as possible (at least 12 times a day).

Bilirubin is excreted in the feces and urine. With insufficient feeding, the rate of urine flow and stool frequency decrease, therefore, the accumulation of bilirubin is accelerated. Inadequate feeding also leads to severe weight loss and, accordingly, to an increase in the level of bilirubin in the blood. In addition, with insufficient nutrition, bilirubin is reabsorbed from the intestine. Additional fluids (other than breast milk) are usually not required if the baby does not have symptoms of dehydration.By itself, water does not remove bilirubin, since the substance does not dissolve in water.

Jaundice treatment

With high levels of bilirubin, the only effective method of treatment is phototherapy – irradiation of the child’s skin with light of a special spectrum, which destroys bilirubin and promotes its excretion in urine and feces.

The indications for home or inpatient treatment are determined by the doctor. Carefully follow all the doctor’s orders for the treatment and supervision of your child! This will make it possible to prescribe therapy in a timely manner and prevent the development of complications.

90,000 Why newborns have jaundice. Treatment of physiological jaundice of newborns at home. The norm of bilirubin with jaundice in newborns

Do not be alarmed! For all the severity of the name “jaundice in newborns” is by no means a disease, but just a physiological symptom of certain processes that take place in the baby’s body while he is adapting to new living conditions. What to do with the “golden” child, how the physiological jaundice in infants proceeds, whether negative consequences of this phenomenon are possible and whether jaundice in newborns requires any treatment – we will figure it out.

Jaundice in newborns: why did my baby turn yellow?

For the sake of your maternal peace of mind, let us repeat ourselves: the fact that your newborn baby suddenly turned orange hues on the second or third day of life should in no way make you nervous and frightened. Jaundice in newborns is not a disease! This is just an indicator (a kind of marker) of certain physiological processes that occur in the child’s body due to his “move” from the mother’s womb to the light of day.

In order to understand how exactly the skin of a newborn changes color from romantic pink to hysterical yellow, it makes sense to recall some paragraphs of the school course of anatomy:

The mechanism of jaundice.
In the blood of a person there are special red blood cells – erythrocytes, whose task is to carry oxygen and carbon dioxide throughout the body. Every day, about 1% of all red blood cells that are carried around our body die (the lifespan of each red blood cell is no more than 120 days).Destroying, these cells release a substance contained inside red blood cells – bilirubin – a special yellow pigment that is actively involved in the exchange of hemoglobin. By itself, bilirubin is a rather dangerous and toxic substance for internal organs, therefore, normally, as soon as the blood brings it to the liver, it is immediately rendered harmless by special liver enzymes. In medical terms, the process of neutralizing harmful yellow pigment in the liver is called “bilirubin conjugation”. The neutralized bilirubin then passes through the bile ducts and is excreted from the body by the excretory system.

If any link is disturbed in this chain of bilirubin formation and excretion, the level of this substance rises, the yellow pigment penetrates into the skin, painting the face and body in “autumn tones”. And if we were talking not about newborns, but about older people, then we should consider jaundice as a clear symptom of a serious illness (for example, liver disease like hepatitis, acute poisoning, intoxication, inflammation of the gallbladder, stagnation of the bile ducts, etc.).NS.).

Physiological jaundice in newborns is within the normal range

But jaundice in newborns is most often a physiological norm. The bottom line is that a child, barely born, has a very high level of hemoglobin, which begins to decline sharply in the new conditions of the infant’s life. In addition, a newborn baby has an incompletely formed “army” of liver enzymes. In other words, the newly-born baby in the first days of life is simply physically unable to cope with the high level of bilirubin in his blood.That is why the baby turns yellow rapidly.

At least 60% of absolutely healthy full-term newborn babies turn yellow on the second or third day of life. This is normal and does not threaten the child with any troubles. In medicine, there is even a term – physiological jaundice of newborns. Physiological means natural, normal, without pathology.

So, even if you get into these 60%, there is no reason to be afraid. And if it so happens that the child was born prematurely (which means that he has even less capable liver enzymes than a healthy toddler), then you have even more chances to admire him yellow – 80-90% of all babies born prematurely , are experiencing physiological jaundice of newborns.

The company at risk for jaundice in newborns is made up of babies whose mothers are sick with diabetes, as well as twins (twins, triplets, etc.)

Normally, a newborn baby’s jaundice should go away in two to three weeks. And what to do in cases where the child turns yellow naturally, but turns pink back, even after three weeks, as if he is not going to?

Why doesn’t the baby’s jaundice go away after 21 days?

If the “golden” color of the baby’s skin has not disappeared in three weeks (which means that the process of neutralizing toxic bilirubin with liver enzymes has not worked out), it is imperative to consult a doctor who, with the help of analyzes and tests, will determine at what stage cycle of “existence” of bilirubin in the baby’s body malfunctions and why.The reasons can be, relatively speaking, dangerous. For example:

• 1
  As a result of any illness of the child, the destruction of the erythrocytes of his blood occurs intensively and constantly (for example, with hemolytic disease, which often develops in children whose Rh factor differs from the mother’s). Accordingly, the level of bilirubin in the blood is constantly increased.
• 2
  The liver has never developed properly (for example, due to hepatitis). In this case, jaundice is rightly called hepatic.
• 3
  Normally, after bilirubin is neutralized in the liver, it enters the gallbladder and is excreted from the body through the bile ducts. Often, jaundice in a newborn does not go away due to a disruption in the work of this particular organ. For example, a baby may have an obstruction of the biliary tract – in this case, jaundice is called mechanical.

If the cause of jaundice in a newborn lies in one of such serious diseases, then with the help of special tests and tests, doctors will determine this and prescribe adequate treatment, in which not the symptom itself will be treated, but the disease.

Physiological (that is, absolutely normal, non-dangerous) jaundice in newborns can also last more than three weeks – in some babies, liver enzymes quickly “master their purpose”, in others – slower.

Jaundice in newborns can last more than 21 days for no reason at all. After all, each baby is individual and predict the exact dates when he will learn to walk, when – to speak, and when – his liver will learn to process bilirubin, not a single child’s “doctor”, even the most outstanding genius from medicine, is able to predict.

As a caring and intelligent parent, you need to understand that a newborn baby (like an older baby) is an excellent indicator of its physical condition in itself. Simply put, if your baby has turned yellow and continues to adhere to this sunny tonality for more than three weeks, but at the same time he does not show any signs of anxiety – does not cry, eats with appetite, gains weight, regularly refills his diapers and sleeps soundly, then there is no reason to worry about prolonged jaundice, you should not have.

The only thing that needs to be done is with the help of an experienced and observant pediatrician to start regularly monitoring your baby’s bilirubin level.

Jaundice in newborns – consequences for everyone

During those two or three weeks, while the level of toxic bilirubin in the blood of a newborn was increased and his skin shone with “golden” shades, nothing bad could happen to the child. Although bilirubin is toxic, its amount (even though it is elevated in the baby during this period) is still not enough to cause significant harm to the baby.

But if the jaundice dragged on and went beyond 21 days (which means that the level of bilirubin in the body continues to remain high), it is imperative to consult a pediatrician and put the baby’s bilirubin “on the counter” – that is, it must be constantly measured and monitored. If the level of bilirubin is kept above normal, but does not tend to increase, you should not be afraid, under the systematic supervision of a reasonable doctor, such jaundice does not threaten the child with any serious consequences.

Jaundice in newborns can threaten real problems only in those situations in which the level of bilirubin in the blood rises 10 times higher than normal and has a progressive tendency to increase. In such cases, damage can be caused to the central nervous system of the baby, his liver, etc. But if you turned to the pediatrician in time, no responsible doctor will simply allow such a development of the event.

Critical indicators of bilirubin in the blood are for full-term and premature babies, respectively: 324 µmol / L and 250 µmol / L.You, parents, do not need to know these numbers, the main thing is that the doctor who observes the condition of the newborn remembers them.

Methods of treating jaundice in newborns

Talking about the treatment of jaundice itself in the context of newborns is not entirely correct – since, as has already been said fifty times, it is not a disease, but only a symptom.

If jaundice is a symptom (indicator or consequence) of some serious disease, then, of course, it is not jaundice that is treated, but this very disease.But not a single disease is treated overnight and there are situations when, simultaneously with therapy, it is necessary to reduce the level of bilirubin in the blood, which dangerously “creeps” to the critical level.

Even 15-20 years ago, in a situation when the level of bilirubin became dangerously dangerous and could cause irreparable damage to the baby’s central nervous system, the child was given a replacement blood transfusion.

Today, this method of treating jaundice in newborns is also used, but only in extreme cases.And in less severe situations, in recent decades, they have been practicing another effective method of dealing with elevated bilirubin – a bright lamp!

Phototherapy for jaundice: let there be light!

This discovery was made by scientists by chance – in the course of medical research it was discovered that toxic bilirubin in human skin begins to actively break down under the influence of bright light rays, turning into a non-toxic isomer. This is how the most widespread method of treating jaundice in newborns – phototherapy – was “born”.

The bottom line is simple: if the baby’s bilirubin level is increased and there is no positive dynamics, he – naked, but with protection in front of his eyes – is laid out under a bright lamp: sometimes for several hours a day, sometimes for several days (around the clock with break only for feeding , hygiene and massage).

Phototherapy is good, safe and very common. He returned many babies to their usual skin color, and to their parents – peace of mind.

Breastfeeding Jaundice: Mom Gilded

There is another kind of, thankfully, perfectly safe jaundice that can be seen in newborns and which can last more than three weeks.This is the so-called breastfeeding jaundice. As the name suggests, it only happens to babies who feed on their mother’s milk.

The bottom line is this: a substance is present in the mother’s breast milk that blocks the action of liver enzymes in the baby.

Not a single “health scientist” has yet been able to figure out why nature came up with this mechanism. Nevertheless, it works and is very active – in the first days of life, many babies turn yellow noticeably precisely because the milk of their mothers “slows down” the activity of enzymes in the child’s liver.

Moreover, this type of jaundice, as a rule, smoothly “takes a change” in physiological jaundice and can be completely safe for a baby to last much longer than 21 days.

If you are scared and by all means want to make sure that your “orange” baby has safe breastfeeding jaundice, and not a symptom of some dangerous illness – stop breastfeeding for 1-2 days (give a mixture ). If the yellow skin color brightens noticeably – this is what it is, you can calm down and return your baby to his natural nutrition.

Jaundice in newborns: Epilogue

Despite the fact that the child is entirely yours, you do not have to decide what to do with it if it turns yellow. And the paramedics. And come to terms with it.

Find out: is your baby’s jaundice dangerous (that is, is it a symptom of a serious illness?) Or completely harmless, treat it or have patience and just wait, and if treated, then in what way – all these issues can only be resolved by children doctor. Your task is to present your newborn to him for examination and analysis.

Because in the case of jaundice in newborns, the probability of making a mistake is very high: you can take a completely normal physiological state for a symptom of a serious illness, and vice versa. Are you really ready to guess if the health of your beloved, “golden” in every sense of the word, baby is at stake?

Sometimes the first long-awaited meeting with a newborn baby turns into various troubles. For example, a baby’s skin has a yellow tint, which shocks the woman in labor. After giving birth, it is difficult for mothers to reason logically, and any pathologies in a baby seem to be a disaster.Today, the topic of the article is relevant precisely for such mothers: jaundice in newborns, the causes and consequences of the disease, when it can be really dangerous.

Jaundice in newborns is a pathological condition characterized by yellow staining of the baby’s skin. Most often, the physiological type of the disease is diagnosed – it occurs when fetal hemoglobin passes into its adult form, the disease does not require drug therapy, manifests itself 2-3 days after birth, disappears on its own on the eighth day.

A type of physiological jaundice is a passing (transient) form of the disease. Appears 30-36 hours after the baby is born, lasts 8-10 days. The level of bilirubin in this case is not more than 200 microns / l, hourly indicators should increase by 2-3 units. The general condition of the baby is normal, drug treatment is not carried out.

If jaundice appears earlier or later, lasts longer than the established time, a pathological form of the disease is diagnosed.

Why does the disease occur

The main reason for the yellow color of the skin is an increased level of bile pigment (bilirubin), it is synthesized from hemoglobin and protein compounds that contain iron.The higher the level of bilirubin, the brighter the shade of the epidermis will be.

Physiological (neonatal) jaundice is a consequence of the immaturity of the liver, the infant’s adaptation to new living conditions, fetal hemoglobin is replaced by the usual one, but does not have time to be excreted naturally.

Pathological jaundice can occur in the first hours after the baby is born, lasts 2 weeks or longer, this form of pathology is called prolonged. The bilirubin level is 220 microns / l, while the indicators daily increase by 80-90 units.

Why pathological jaundice occurs in newborns:

• Rh-conflict – erythrocytes rapidly disintegrate, the level of bilirubin rises rapidly, jaundice appears 24-48 hours after birth;
• high levels of vitamin K in the mother’s blood – Vikasol, Ditsinon, and other synthetic analogs of this vitamin are often prescribed to expectant mothers to reduce the risk of bleeding during childbirth, with poor blood clotting, hepatitis, drug overdose provokes the breakdown of red blood cells;
• diabetic fetopathy – the disease occurs in children whose mothers suffer from diabetes, the pathology arises due to the slow development of the liver enzyme system, the organ does not have time to process all bilirubin;
• hereditary and congenital hepatic pathologies;
• congenital underdevelopment of the biliary tract – pathologists require surgical intervention, otherwise children rarely live up to a year;
• in case of blockage, compression of the ducts of the biliary tract, mechanical jaundice is diagnosed;
• with Crigler-Nayyar syndrome, nuclear jaundice develops, in which the nuclei of the cerebral cortex are damaged, the pathology is dangerous, without emergency assistance, blood transfusion is highly likely to be fatal;
• Some intrauterine infections can provoke the development of jaundice;
• milk jaundice occurs against the background of an increased content of pregnandiol in milk, this substance prevents the normal breakdown of bilirubin, this form of the disease can last up to 6 weeks, doctors recommend stopping breastfeeding;
• taking antibacterial, hormonal drugs during pregnancy, most of them are able to penetrate the placental barrier, end up in the fetal liver, which negatively affects enzymatic processes, this form of jaundice can last longer than 4 weeks.

Different forms of jaundice are most often diagnosed in premature babies, even the physiological form of the disease can last 3-5 weeks.

How is jaundice manifested

In case of jaundice, the child’s skin can be colored in any shades of yellow: from pale lemon to rich orange. Sometimes it acquires a greenish tint.

With a physiological shape, the baby’s palms, feet and legs have a normal color.

Signs of illness:

• symptoms of impaired functioning of the nervous system appear;
• dark urine, almost white stool;
• child is lethargic, lethargic, or constantly crying;
• there is an increase in the spleen and liver;
• newborn sleeps little, wakes up often;
• the baby does not suckle well or refuses to eat at all;
• hemorrhagic syndrome – frequent bleeding of a different nature against the background of poor blood clotting, ascites, itching, symptoms occur against the background of vitamin K deficiency, underdevelopment of the biliary tract.

To determine the type and severity of the disease, a clinical blood test is done to determine the level of hemoglobin, erythrocytes, platelets, reticulocytes. The content of cholesterol, the amount of liver enzymes and protein shows a biochemical blood test. With the help of a coagulogram, the degree of blood coagulability is determined, and urinalysis can determine the exact color of urine.

Possible complications

Bilirubin belongs to toxic pigments, at an increased concentration the substance penetrates into the tissues of the nervous system, severe consequences develop that affect various parts of the brain.

Why jaundice is dangerous:

• encephalopathy;
• Partial or complete hearing loss;
• convulsive syndrome, epileptic seizures;
• violation of motor functions;
• vegetative-vascular dystonia;
• mental retardation, deviations can occur in a child at any age;
• death.

With physiological jaundice, severe complications rarely occur, mainly increased moodiness, tearfulness, drowsiness, poor appetite in the baby.

Treatment and prevention

One of the most effective methods of therapy is phototherapy, exposure to light, excess bilirubin is converted into a liquid state, it is excreted from the body in urine and feces. The child spends under the lamp up to 16 hours daily, every 2 hours they take a break, the duration of the course is 3-5 days.

Of the medicines used in therapy, hepatoprotectors – Flamin, Plantex, for convulsions – Phenobarbital, for dissolving stones – Ursosan, for cleansing the body of toxins – Polysorb, Enterosgel.Treatment is carried out in a hospital under constant medical supervision.

Physiological jaundice is not a contraindication for the hepatitis B vaccine given in the hospital. In pathological forms of the disease, the doctor makes a decision about the safety of vaccination based on the general condition of the baby.

Prevention is aimed at preventing the development of conditions that can provoke the development of jaundice in newborns. During pregnancy, it is necessary to treat all infectious pathologies on time, especially sexually transmitted diseases.With the threat of premature birth, do not refuse hospitalization, it is against the background of prematurity that babies develop various health problems.

Conclusion

What causes jaundice in a month-old baby, why does it happen, and what is dangerous? What are the reasons for the appearance of jaundice, when it passes, and are the consequences of such a condition in newborns dangerous? Young mothers are very worried when they hear from doctors about the appearance of jaundice in a newborn, even milk may disappear from excitement.But is it worth it to worry? Consider the question: jaundice in newborns, causes and consequences.

Infantile jaundice occurs due to an increase in the pigment of bilirubin in the bloodstream. From an excessive amount of this element, the skin and eyeballs are stained with a yellowish tint. The baby is getting dark right before our eyes! What is bilirubin and how is it made? After birth, a newborn’s blood composition begins to change and, first of all, fetal hemoglobin, which was responsible for transporting oxygen through the fetal bloodstream, is excreted from it.

When fetal hemoglobin is destroyed, bilirubin is released.
The processes of replacing important parts of the circulatory system are accompanied by the body getting rid of excess bilirubin, and at this moment mom can observe the yellowed baby. But this condition soon disappears in infants. The body tries to get rid of bilirubin: first it is broken down in the liver, then from the liver it enters the bladder and exits with urine.

However, sometimes the bilirubin pigment becomes too much, and it accumulates in the skin and stains the eyeballs.These are the causes of jaundice. And that’s not all: there is a physiological jaundice, and there is a pathological jaundice. The symptoms of physiological jaundice have been described above. And how does pathological arise, and what is it? How dangerous is the pathology, as well as its consequences?

Nonhazardous jaundice

The physiological type of jaundice is a common postpartum condition in newborns. Doctors do not consider this a disease, but only one of the types of condition of newborns during the adaptation period of the transition to a new world.Physiological jaundice is of several types:

• breast milk jaundice;
• neonatal jaundice.

Breast milk contains all information about the state of the mother’s body. Sometimes there are many estrogens (sex hormones) in the mother’s blood, which the child’s body tries to remove. Moreover, the newborn’s body first tries to get rid of estrogen, and then – from bilirubin. As a result, the baby gets jaundice.

How long does physiological jaundice go through in newborns? She should go no earlier than three months.Breast milk jaundice in newborns is not dangerous and does not cause consequences. The baby eats with appetite and gains weight well, does not suffer from anything.

A newborn should not be weaned from the breast for the physiological jaundice to pass: it will pass on its own after the body is freed from estrogens.

Neonatal jaundice occurs in every baby. This condition does not pose a danger to children. How many days does neonatal jaundice last and when, are there any consequences? This type of jaundice occurs in the second month of life.Why the baby turns yellow, we found out. You can help the baby cope with the excretion of bilirubin, and this is the task of the doctors and mom.

Important! Even if doctors recognized the jaundice as physiological, constant monitoring is needed for the crumbs: so as not to miss the moment of the possible appearance of pathology.

Borderline state

Sometimes the body’s struggle with bilirubin becomes intense, and the so-called borderline state appears in children: the jaundice is no longer physiological, but not yet pathological.However, the borderline state almost always leads to pathology if it is not recognized in time. Usually, the borderline state in children occurs with long-lasting yellowing .
This includes the following types of jaundice:

• conjugation;
• hepatic;
• nuclear.

With the conjugated form of the disease, the liver is unable to cope with the excretion of bilirubin on its own. The hepatic form in children occurs when a virus infects the liver cells.The nuclear form occurs when the birth jaundice has not passed, and the level of bilirubin has increased sharply. In this case, bilirubin also affects the nervous system of infants.

Important! If the birth jaundice has not passed and has developed into nuclear jaundice, the sucking reflex gradually begins to fade in the baby. The baby sleeps a lot, seizures are possible.

Pathological jaundice

Pathological types of jaundice are rare, but you need to know about them. Pathology includes:

• hemolytic disease;
• mechanical jaundice.

The causes of pathological conditions are of a special nature. They are usually caused by:

• Rh incompatibility;
• blood group incompatibility;
• congenital genetic pathology of metabolic processes;
• infectious liver disease;
• hormonal disorders;
• mechanical damage to liver tissue.

The listed reasons contribute to the inactivation of the outflow of bile from the body and lead to its dysfunction.The bile did not pass, but lingered in the tissues of the body. Reasons for incompatibility in blood group, rhesus and antigens (less often) lead to the appearance of hemolytic disease

Symptoms of this disease appear even in the maternity hospital, so the babies are immediately prescribed therapy.

In hemolytic disease, the liver / spleen increases sharply in size.

If children look sleepy and inactive, and the sclera begin to turn yellow almost immediately after birth (several days), doctors will immediately examine the baby.

Obstructive jaundice is associated with problems of the gallbladder and obstruction of the ducts that excrete bile. This condition is caused either by genetic structural features or mechanical damage to the liver at birth. This disease cannot be detected immediately (there are no symptoms), it becomes noticeable after 15 or 30 days after discharge.

Children literally turn green, and the stool becomes colorless. At the same time, the spleen and liver become enlarged and harden.If such symptoms appear, the baby is prescribed an ultrasound scan and additional examinations. Therapy is prescribed in accordance with the type of mechanical damage.

Important! If the jaundice has not gone away and lasts more than three / four weeks, examine the baby with a pediatrician.

Dangerous condition

Mom should know that physiological processes in babies are not always calm. When the baby turns very yellow, constant monitoring is necessary for him. The jaundice usually clears up in a couple of weeks.However, if this condition has been going on for a month, the jaundice has not passed, but is growing, – there is reason for suspicion of pathological processes. We carefully watch the baby:

• jaundice lasts longer than a calendar month;
• the jaundice disappeared and reappeared;

90,031 skin tones have acquired a greenish tint.

The listed qualities are grounds for concern. In addition to skin discoloration, there are indirect reasons for concern:

• urine has acquired a dark shade, and feces have become discolored;
• bruises appear on the skin;

90,031 children look sickly;

• liver / spleen enlarged.

Important! Closely monitor the change in feces and urine in infants. They are often the first messengers of ailments.

We treat babies

Of course, a doctor conducts therapy in pathological cases. It is about helping to overcome the physiological jaundice. Mom can help the baby if:

Important! Do not leave the baby in direct sunlight to avoid skin burns. The kid should sunbathe in the shade.

How is the indicated treatment useful for the baby? The listed items contribute to the activation of metabolic processes and the acceleration of the excretion of bilirubin from the body.It is important for mom to remember that with each breastfeeding, she transfers vitality to the baby to fight a dangerous ailment.

Colostrum is especially useful – the first milk.

Colostrum contains special laxative components that help remove excess bilirubin from the crumbs’ body.

Important! Do not worry about physiological jaundice: it does not harm the baby. Most children cope with the elimination of bilirubin in a month.Mom notices that the skin of the baby is gradually brightening and getting rid of the jaundice tint, the baby becomes plump and rosy. It’s all over!

How to get rid of stretch marks after childbirth?

Oh, how much they got nervous, and they continue to do this, I’m already scared to watch myself. They were immediately transported to the hospital for observation, they will be treated. And I decided to conduct my own investigation and collect more information on this topic for my friend and for myself, so to speak, to improve the qualifications of an amateur medical mother.

It turns out that postpartum jaundice in newborns is quite common! They only distinguish between a dangerous and a non-dangerous form of this condition. I decided to find out why this is happening.

If a child suddenly turns yellow on the 2-3rd day of life, as well as the sclera of the eyes have acquired a yellow tint, this is a newborn’s jaundice. Distinguish between physiological

and pathological

jaundice in children, which is detected in the first week of a baby’s life.

Physiological jaundice

occurs in 60% of newborns.As a rule, the skin and sclera turn yellow on the 2nd or 3rd day of life, and the whole thing goes away in 2-3 weeks.

What is the reason for the yellowing of the skin and mucous membranes in children? It turns out that this is due to the still immature liver of the newborn, which is not able to convert the bile pigment to bilirubin and it begins to stain the skin, whites of the eyes, mucous membranes.

When a child is in the womb, his liver does not process bilirubin and a special type of hemoglobin is produced in the blood, which is saturated with oxygen from the mother’s blood.When a baby is born, it begins to breathe on its own, and is disconnected from the mother’s umbilical cord, which supplies blood and oxygen.

At this time, a large number of erythrocytes are thrown into the bloodstream into a small immature organism, and the “maternal” hemoglobin is replaced by its own.

Over time, the liver adapts and processes bilirubin fully, while normal hemoglobin is formed, and “unnecessary” bilirubin is excreted in the urine and bile from the body.

This happens in absolutely all newborns, but not noticeably in all. And some who are unlucky at all may develop a dangerous form of jaundice – pathological.

While still in the maternity hospital, the mother and the neonatologist must observe the baby, check his skin and whites of the eyes – have they turned yellow? But, since the development of physiological jaundice falls at a time when almost everyone is already discharged from the hospital, you need to monitor this at home as well.

Most often physiological, that is, a non-dangerous form of jaundice, does not need treatment and goes away by itself.Nevertheless, at home, the child should be more often applied to the breast or given water if he is bottle-fed. Then the excess bilirubin comes out with the liquid. The color of the newborn’s urine and stool should be checked.

If the doctor in the maternity hospital or the visiting district pediatrician sees the threat of jaundice in the child, they can prescribe special drugs and phototherapy. Phototherapy for jaundice

is a common thing, carried out in a clinic or even at home with special white or blue lamps.

It is not recommended to carry a naked newborn out into the open sunlight, as it is not so effective. And even more so that frightened and nervous mothers can freeze the child or burn it in the sun, in pursuit of ridding him of jaundice with sunlight.

Of course, sunbathing is necessary, we all know about vitamin D, which is produced in the sun. But it is better not to take risks in the first month of a child’s life, especially for inexperienced mothers of first-borns.

In many children the rate of jaundice

is just some yellowing of the face and body, the whites of the eyes, which disappears by the end of the first month of life.If the yellowness increases, this is a good reason to urgently consult a doctor!

Often, jaundice is detected in the hospital and the child is placed under a lamp there. Tests for the level of bilirubin in the blood will clarify the picture. When the child turns yellow, the body is colored gradually.

First the face, then the body and legs. When the jaundice passes, the face will turn pink last.

Premature babies suffer from jaundice much more often, because their liver is even more vulnerable.

Jaundice of prematurity

is detected in about 80% of children.In this case, the child is transferred to a hospital or left in a maternity hospital for special treatment.

I was even more surprised to learn that there is jaundice from breast milk. This occurs due to the indigestibility of breast milk fats by the child’s body. To recognize this, you need to observe the baby’s reaction to breastfeeding.

If the baby turns yellow during feeding, and in the intervals the yellowness subsides, the doctor may identify jaundice of breast milk

. At the same time, feeding is not stopped.As the well-known doctor Komarovsky said: “If a breastfed baby turns yellow, but feels good, gains weight, and when the feeding stops, the bilirubin level drops sharply, then this is not scary, it will pass by itself.” With other types of jaundice, the child does not gain weight.

The situation is worse if the jaundice turns out to be not harmless, but pathological, like that of my friend’s son. This occurs in a number of cases for various reasons and threatens with complex, dangerous diseases that affect the brain.

Pathological jaundice is characterized by:

1. The birth field is detected immediately or on the first day;
2. Accompanied by bruises, pallor, lethargy;
3. Lasts longer than 2-3 weeks;
4. Bilirubin level: direct – more than 25 μmol / l, indirect – more than 220 μmol / l;
5. It passes in waves – it decreases, then it increases again.

These symptoms are most often detected by doctors in the hospital, and the child is quickly sent for treatment.If you do not identify and start treatment in time, there is a significant risk of developing “nuclear” jaundice

, which will lead to dangerous consequences – damage to the central nervous system and brain, cerebral palsy, deafness, retardation.

As I myself found out, comparing the facts and the information I processed, my friend’s baby had hemolytic jaundice

, which is due to. She has a negative Rh factor, and the child has a positive one, which is why there are problems.

And she was also afraid of getting pregnant because of this negative rhesus.The pregnancy went well, but the consequences were reflected on the baby after giving birth. This can also occur with a conflict of blood groups, if the mother has the first group.

Subsequent newborns, that is, the second and the next, are especially at risk. This is due to the production of antibodies in the mother’s body during the first pregnancy.

Modern medicine has developed immunoprophylaxis for the mother after the first birth, which significantly reduced the incidence of hemolytic disease in subsequent children.

Hemolytic jaundice is detected in the first day after the birth of a child, while a low hemoglobin and an enlarged liver are detected.

When this type of jaundice is detected on days 2-5, the clinical picture becomes clear, whether “nuclear” jaundice will develop.

Even the name itself is creepy, it evokes terrible associations.

This does not mean that the child will turn into a special vigorous yellow color, sorry for the inappropriate humor. This means that this species is especially dangerous for the body by irreversible processes that cannot be treated.

Manifestations of “nuclear” jaundice:

1. General depression, lethargy, some lethargy, weak sucking reflex;
2. The child cries monotonously, irritability, muscles in hypertonicity;
3. Convulsions, apnea, bradycardia, high-pitched cry.

When the stage of “nuclear” jaundice is irreversible, the child falls into a stupor, and then into a coma. Then there are irreversible brain damage, disability. In addition to the conflict with the mother’s blood, this type of disease can develop due to congenital infections of the fetus (toxoplasmosis, rubella, herpes, syphilis).

Conjugated jaundice

can occur due to problems with the structure of the liver and bile ducts. The development of this type of jaundice occurs due to congenital cholestasis. Although cholestasis itself can occur with normal liver function.

Neonatal cholestasis also causes the release of bilirubin into the bloodstream and the formation of jaundice, while bile accumulates in the ducts and gallbladder.

My information turned out to be useful for my friend, because the doctors explain little to her, they only stuff her with drugs.Hopefully someone else will find this article useful. Share it on social networks using the buttons below.

I invite all young mothers and fathers to visit the unique free webinar “ Life after childbirth

“.

On it you will learn:

• How to take care of your baby and not be afraid that you will harm him;
• How to be a good mom;
• What is the care of a newborn baby in the first year of life;
• What to do if the baby has a cold, started coughing and snotty, and much more.

My children did not have a pronounced jaundice of newborns – somehow everything turned out well. But one not very pleasant incident happened with the youngest son. We were discharged with him from the hospital after the COP on the 6th day. As expected, the next day the district pediatrician, 75 years old, showed up.

It was a bright sunny day in early June. Max slept peacefully in one diaper. And in the room where he slept, I had a joyful orange curtain (I love this color). Accordingly, the whole room was flooded with sunny orange light.

The doctor went into the room and looked at the child from afar. And suddenly she whispered in a terrible voice: “He’s all yellow! You have a jaundice! We urgently need to go to the hospital !!! ”

All my arguments that the child has dark skin, that we have orange curtains, the sun is shining brightly and everything around seems yellow – even you and I – had no effect. She continued to insist on hospitalization … I had to quickly say goodbye to her and the next time we saw her when Max was already 1 year old.Well, so, just to seem to her – what a healthy and not yellow baby it turned out).

Watch the video of Dr. Komarovsky “Jaundice of newborns”

:

Mommies, don’t panic, everything is being treated! The main thing is to identify and seek help in time. Do not forget to subscribe – there is still a lot of useful information ahead.

Jaundice in newborns is a fairly common pathology that parents have to deal with. Any mother will easily notice her signs.The baby’s skin becomes unusually dark, as if it is filled with yellowness. The whites of the eyes also take on a characteristic shade. When does the pathology have to pass? The answers to these and other questions can be found in the materials of this article.

Mechanism of development of the disease

Jaundice in newborns is a condition when the skin and whites of the eyes acquire a characteristic color, a blood test shows an increase in the level of bilirubin. This substance is present in the body of every person, but in infants it is found in large quantities.Why is u progressing rapidly?

This phenomenon can be due to many reasons. Among them, one should highlight the functional immaturity of the child’s liver and the rapid decay of red cells – erythrocytes. Their main role during pregnancy is to carry oxygen. After the birth of the baby, as unnecessary, they are destroyed, and the bilirubin indicators increase sharply. This substance is insoluble, the liver is involved in its excretion.

Even in absolutely healthy children, after birth, the body lacks a special protein responsible for the transfer of bilirubin to liver cells.The peak of the manifestation of symptoms usually falls on the 3-5th day from the moment the crumbs are born.

Pediatricians distinguish two types of this condition: physiological and pathological jaundice in newborns. In the first case, bilirubin is excreted from the body in 1-2 weeks. In such a situation, the pathology does not affect the condition of the baby. When the concentration of bilirubin remains at a high level for several weeks, they speak of pathological jaundice. The prognosis with such a diagnosis is not the most favorable, since the nerve cells of the brain gradually begin to die off.

Physiological jaundice

This variant of pathology occurs most often. What is the physiological jaundice associated with in newborns? Doctors explain the reasons for its appearance by the massive disintegration of fetal hemoglobin in the baby’s blood. It binds faster with oxygen, which is necessary for the fetus. On the other hand, it has a short duration of activity. After the baby is born, fetal hemoglobin begins to rapidly deteriorate. This entails an increase in direct indicators, which is necessarily accompanied by staining of the skin.Thus, jaundice gradually develops in newborns.

Komarovsky (a well-known pediatrician) warns that you should not be afraid of such a diagnosis. Physiological jaundice is diagnosed in 80% of newborns. It starts around the third day of the child’s life and ends on the fifth day. In this case, the level of direct bilirubin does not exceed the permissible norms, the pathology does not affect the state of the crumbs.

The consequences of jaundice are not reflected in the child. If he is breastfed, the pathology goes unnoticed.Milk has a laxative effect. Meconium (original feces), together with bilirubin, quickly leave the child’s body.

Pathological jaundice

This ailment differs in that it manifests itself almost immediately after birth. The content of bilirubin in the blood rises sharply, reaching critical levels, which is accompanied by poisoning of the nervous system. Treatment requires a lot of time and serious drug therapy.

To prescribe a competent treatment, first of all, it is necessary to find out the reasons for the appearance of this condition.Usually, pathology develops when there is immaturity of the systems of internal organs. As a result, the baby’s body cannot cope with the large amount of bilirubin on its own.

If the doctor diagnoses “pathological jaundice”, the causes of its development in newborns can be caused by many diseases:

1. Incompatibility for the Rh factor or blood group.
2. Diseases of the liver parenchyma. The body cannot fully convert bilirubin and remove it into the intestines, which is reflected in the level of this substance in the body.
3. Pathology of the circulatory system. Usually we are talking about disorders at the genetic level. They entail pathologies of the erythrocyte walls, which is necessarily accompanied by their massive decay.
4. Diseases of the biliary tract is another reason why jaundice occurs in newborns.

Komarovsky in his lectures focuses on the fact that the ailments listed above are extremely rare in young patients. That is why, when they talk about jaundice, they usually mean the physiological form.A long course of one or another variant of pathology can lead to problems with the central nervous system, digestive tract and heart. Bilirubin has a negative effect on many body tissues, so treatment should be prompt and competent.

When should jaundice go away in a newborn?

The bilirubin release system is being gradually improved. Usually, the yellow color of the skin disappears after 6-7 days. If the baby is breastfed, the process of removing bilirubin is more intensive.The physiological variant of the pathology is not dangerous and does not pose a threat to the child’s life.

If symptoms of an illness appear after this condition has lasted for more than two weeks, it’s time to sound the alarm. Mom urgently needs to show the child to the doctor. Based on the severity of the condition, hospital treatment with medication may be required. In practice, “Hofitol” is usually used for newborns from jaundice. Reviews of the drug therapy used in most cases are positive.Negative opinions of parents, as a rule, are caused by a late visit to the doctor.

Doctor’s consultation: what tests are needed

In infants, this pathology is manifested not only by changes in the skin. Often the urine becomes dark in color, while the feces, on the contrary, become discolored. Bruises may appear on the body. The general well-being of the child gradually deteriorates. If the skin does not take on a normal shade after two weeks, you should seek the help of a doctor.You should not postpone the visit and wait for the newborn’s jaundice to go away on its own.

At the consultation, the pediatrician must examine the child and prescribe a blood test to determine the amount of bilirubin. Additionally, an ultrasound of the abdominal cavity, a test for hemolysis may be required. Based on the test results, the doctor prescribes the appropriate therapy.

How to treat jaundice in newborns

If a child has a physiological form of pathology, specific therapy is not required.Parents should make every effort to help the small body independently cope with such a problem as jaundice.

In newborns, home treatment offers several options. First of all, it is recommended to start breastfeeding as early as possible, because milk speeds up metabolic processes in a fragile body. So that the crumbs do not have digestive problems, the mother must adhere to a special diet. It is important for the kid to be more often in the fresh air, to take sun baths.

Such care for a child helps to strengthen the body. In this case, breast milk acts as an effective medicine, which the baby should receive on demand.

With pathological jaundice, serious drug treatment is required. He is appointed by the pediatrician after determining its stage, the presence of complications. In addition to it, you can use proven traditional medicine recipes.

Drug therapy

If a pathological form of an ailment is detected, treatment should be started immediately.Pediatricians usually recommend Hofitol for newborns from jaundice. Reviews about this drug are extremely positive. It contains an extract from the leaves of the field artichoke. The medication improves liver function, helps to reduce the level of bilirubin and the rapid elimination of bile from the body.

In addition, enterosorbents are prescribed (Smecta, Polyphepan). Their main purpose is to interrupt the circulation of bilirubin between the liver and the intestine itself.

Pediatricians recommend Ursosan for cholestasis.For newborns from jaundice, this is a very effective drug, which is available in capsule form. Many parents are afraid of the side effects of this medication. These include vomiting, allergic rashes, and diarrhea. However, such manifestations are not observed in all children. Pediatricians still prescribe “Ursosan” for newborns from jaundice, because this pathology is not always harmless.

Light therapy

Today, most doctors believe that the fight against this disease is impossible without the use of drugs.Many parents think differently and are worried about the health of a still fragile child’s body. In such a situation, light therapy comes to the rescue. It is a very effective method of treating an ailment such as jaundice in newborns.

Home treatment involves the use of a special lamp. Its light waves break down bilirubin into non-toxic components. After 10-12 hours of this, they are excreted from the body along with urine and feces. Treatment allows not to separate the baby from the mother, which gives an excellent opportunity not to give up breastfeeding.

In some cases, light therapy is carried out in a hospital under the supervision of a doctor. During the procedure, the child’s eyes must be covered with glasses. Her time is strictly regulated. Sometimes light therapy leads to peeling of the skin and dehydration of the body, so constant medical supervision is simply necessary.

In most cases, you do not have to wait long for the jaundice to pass in a newborn. The duration of treatment with this method is only 96 hours.However, already after the first session of phototherapy, positive dynamics are noticeable.

Consequences of pathology

The prognosis for this ailment depends on the causes and degree of its severity, the timeliness of confirmation of the diagnosis and the use of treatment. If the pathology was detected at an early stage, the negative consequences do not threaten the child’s life.

Otherwise, when the level of bilirubin reaches critical levels, and parents are in no hurry to seek help from a doctor, there is a high probability of brain damage.This, in turn, can lead to the appearance of seizures, the development of deafness, mental retardation.