Approximately on the third day after birth jaundice in newborns whites of their eyes, cheeks, or entire body of the baby turns yellow. It is not a disease, and diagnostic phenomenon. In most cases, it is perfectly normal and occurs in approximately 60% of newborns.
Jaundice, as already found staining in yellow skin, mucous membranes, and eye sclera. Her reason for following in utero in fetal blood the number of erythrocytes is much greater than in an adult. This is due to oxygen exchange between mother and fetus.
After birth, the extra red blood cells disintegrate. In the process of decay releases the pigment bilirubin, which is in the normal state is processed by liver enzymes and excreted in the feces and urine. However, often the liver can not cope with the amount of bilirubin, it is accumulated in the blood into the tissue and stains them a characteristic yellow color.
Jaundice in newborns is divided into physiological and pathological. Physiological goes away (usually 7-14 days) treatment is not needed (the doctor will only recommend walking, sunbathing, frequent breastfeeding). Pathological jaundice is caused by diseases that require diagnosis, treatment, and sometimes long-term medical surveillance. You need to consider the types of jaundice read more.
The most common form of jaundice in newborns diagnosed at 3-4 days after birth in approximately 60-70% of children. The condition is not dangerous and with time itself passes. The reason for this jaundice immaturity of the body systems of the child are not able to process a large amount of bilirubin. In this case, other signs of jaundice in newborns are rare drowsiness, lazy sucking and vomiting is only possible when very large quantities of bilirubin in the blood.
How severe physiological jaundice should be determined by the pediatrician. The fact that the intensity of the appearance of yellow is not an indicator. Need analysis at the level of direct bilirubin in the blood. The maximum concentration observed on day 3 of life. Usually the child’s body gradually cope with the bilirubin, linking it to albumin (it prevents the toxic effects).
If a lot of bilirubin, albumin is not able to neutralize its toxicity fully, causing the bilirubin penetrates the nervous system. This is a dangerous condition so as not to be excluded a toxic effect on the brain. This condition is called nuclear jaundice or encephalopathy bilirubinemia. Such postnatal jaundice in newborns is identified by symptoms of drowsiness, convulsions, impaired grasping reflex. Late symptoms are paralysis, deafness, mental retardation.
Previously, if you increase the level of free bilirubin used intravenous infusion of glucose solution, ascorbic acid, cholagogue, phenobarbital. However, modern professionals are increasingly refuse from such therapy a number of studies around the world confirmed its inefficiency. However, some domestic experts still use these tools.
General characteristics of physiological jaundice
- appears 2-3 days after birth
- buildup occurs 3-4 days
- extinction is observed in 7-10 days, complete disappearance in 14-21 days
- yellow orange with orange tint
- the General condition of the newborn is not broken
- the liver and spleen are not enlarged
- the color of the feces and urine is not changed.
Pathological jaundice in newborns in most cases manifests in the first 24 hours after birth. Often there is enlargement of the liver and spleen, discoloration of feces, dark urine, sometimes spontaneous appearance of bruises and petechiae. The analysis of the blood detected by enhanced hemolysis (breakdown of red blood cells) and anemia.
If there is incompatibility between mother and baby RH factor or blood group, there is enhanced hemolysis. Severe jaundice is common, if the mother blood type AB and the child the second or third. Each subsequent pregnancy may increase the risk of such complications. That’s why women with negative RH-factor is extremely dangerous to do abortions.
Types of jaundice in newborns
- conjugational occurs because of enzyme deficiency of the liver
- hemolytic associated with problems of blood to example, a change in the structure of red blood cells or hemoglobin
- liver occurs when different diseases of liver
- obstructive (mechanical) is caused by a disturbance of the natural flow of bile.
Conjugational jaundice develops when for any reason the liver enzymes are not active bind and metabolize bilirubin to the cells. Constitutional hepatic dysfunction (it is called Gilbert’s syndrome-Meulengracht) hereditary disease, very similar to physiological jaundice of the newborn. Occurs often enough. Failure of bilirubin level in this case is associated with impaired processing due to hereditary inferiority of the enzyme system of the liver. The newborn in this condition need to be treated and long-term follow up from a gastroenterologist.
Hemolytic jaundice develops when the deficiency of enzyme systems of erythrocytes, disorders of hemoglobin structure. The destruction of red blood cells is associated with a number of genetically determined disorders, for example, mikrosferocitoza (anemia Minkowski-a’s), violations of the structural part of hemoglobin (e.g. sickle cell anemia), changes in the structure and shape of the erythrocyte, etc. For the treatment of conditions that are accompanied by destruction of red blood cells, very often resort to exchange blood transfusion this allows you to remove the bilirubin and antibodies causing hemolysis.
Parenchymatous (hepatic) jaundice in newborns develops with the defeat of the liver tissue by bacteria, viruses, toxins. When hepatitis b and C, sepsis, cytomegalovirus infection, the accumulation in the blood of bilirubin staining of the skin and mucous membranes yellow with a greenish tint, enlargement of the liver and spleen. The stool becomes whitish, and the urine darkens.
The treatment of jaundice in newborns is carried out comprehensively, in a mandatory manner by providing the effect on the cause of the disease. Naturally, the first thing to neutralize the infectious process. Now, however, not all types of infections you can pick up effective methods of treatment. This is another factor why you need to responsibly prepare for pregnancy (especially if the expectant mother has an infectious disease).
Mechanical (obstructive) jaundice in newborns occurs when the violation of the outflow of bile. The main reason for the decrease in patency of the bile ducts due to hypoplasia (atresia), anomalies of development, neoplasms (including neoplasms of other organs). In some cases, changing the structure of the bile it becomes viscous and thick, thus accumulating in the bile ducts. Due to overcrowding the bile into the blood and triggers the symptoms of jaundice. To treat this jaundice without surgery in most cases impossible.
Treatment of jaundice in newborns
If the baby physiological jaundice in newborns, treatment at home is acceptable for walks, sunbathing, feeding mother’s milk. The most effective, safe and proven method of reducing the level of toxicity of bilirubin under physiological jaundice is phototherapy effect on skin UV light from special lamps.
Under the influence of such rays bilirubin is split into non-toxic derivatives, which within 12 hours excreted in the feces and urine. Serious side effects light therapy has the child can only experience drowsiness and diarrhea. At the end of the course, the jaundice disappears. However, doctors recommend often substitute the body of a child sunlight. Frequent breastfeeding is the best prevention in case of physiological jaundice. You need to feed according to a schedule (frequently and even Wake up a newborn, if his dream fell to feeding time) or on demand (if it is active and it wants to eat often).
Early mother’s milk acts as a laxative, due to which faster out of the original cal, bringing converted in the liver bilirubin. If there is a delay with the conclusion of the bilirubin can re-enter the bloodstream from the intestine, only increasing the level of jaundice.
Treatment of pathological jaundice the only task for physicians. Approaches to the treatment duration, the need for inpatient or home therapy it all depends on the cause of jaundice. In any case, it is impossible to delay treatment or attempt to take action independently, it threatens dangerous consequences.