The appearance of jaundice in a newborn baby is a very common problem associated with increased bilirubin levels... Every expectant mother should find out what kind of compound it is, why it appears in the blood of a newborn and causes yellow skin color, as determined in the child's body, and also what is being done when the indicators are increased.
What is bilirubin?
Bilirubin is a pigment, the formation of which in the human body occurs during the breakdown of hemoglobin. Normally, it binds to compounds produced in the liver and is excreted in the urine, as well as with feces. Such a pigment is always present in human blood in small amounts.
Types
Bilirubin is isolated:
- Indirect... This fraction is also called free or unbound. This bilirubin is insoluble in water and is quite toxic. It easily penetrates cells and disrupts their metabolic processes.
- Straight... Since this fraction of the pigment binds to glucuronic acid in the liver, it is also called bound. After binding, this bilirubin becomes water-soluble, making it easy to leave the body.
- General... This indicator shows the total amount of bound and free bilirubin.
How is the analysis done?
Immediately after birth, the umbilical cord blood is taken from the baby to determine the level of bilirubin and some other indicators. Also, blood taken from the heel can be examined in newborns. The infant is advised not to feed for four hours before blood collection. The blood is placed in a special test tube, and then examined, determining the level of total bilirubin, and, if necessary, its fractions.
The norm of bilirubin in newborns by day in the table
Why are the fluctuations in norms so strong?
These indicators are associated with increased education and slow elimination of bilirubin from the child's body. In the erythrocytes of the fetus in the womb, for better oxygen transfer, hemoglobin has a different structure than hemoglobin in adults and already born children. This hemoglobin is called fetal. As unnecessary after childbirth, its destruction begins with release into the blood, where it is converted into bilirubin. This causes a high concentration of bilirubin in the first weeks of life.
Reasons for the increased level
The appearance of an increased level of bilirubin is caused by:
- Premature baby.
- The development of diabetes mellitus in the expectant mother.
- Acute diseases of a pregnant woman.
- Hypoxia in an infant during gestation.
- Asphyxia during childbirth.
- Premature onset of labor.
- An increased amount of estrogen in breast milk.
- Incompatibility of the blood type of mother and baby.
- Rh-conflict during gestation.
- Refusal to breastfeed immediately after childbirth.
- Great weight loss in the baby in the first days after birth.
- Pathologies of intrauterine development.
- Infectious liver disease.
- Mechanical type of jaundice.
- Intestinal obstruction.
- The destruction of red blood cells due to genetic diseases.
- The use of medicines to stimulate labor.
- Hepatic dysfunction in an infant.
- Hormonal disruption in the toddler.
Types of jaundice according to the indicator
Most babies develop jaundice, which is called physiological jaundice. It manifests itself after the penetration of bilirubin into the superficial layers of the skin, which occurs when the level of this pigment is above 120 μmol / L in healthy term babies and above 85 μmol / L in premature infants.
When the level of bilirubin in a full-term newborn is more than 256 µmol / l, and in premature infants over 172 µmol / l, a diagnosis of pathological jaundice is made. The increase in the level of bilirubin in this state is more than 5 μmol / L per hour, while in physiological jaundice, such an increase does not exceed 3.4 μmol / L per hour.
The main symptoms of physiological jaundice and its differences from pathological are presented in the table:
Treatment: how to lower the rate?
The simplest, most affordable and harmless way of treating jaundice in newborns is phototherapy. A child with a risk of increasing bilirubin to toxic levels is placed for a certain time under special lamps, the light from which transforms indirect bilirubin into a non-toxic substance called lumirubin. Within 12 hours, bilirubin is excreted from the baby's body with feces and urine.
Phototherapy is performed intermittently for feeding. The baby should lie 20-40 cm from the lamp, and his genitals and eyes should be covered with a cloth that does not transmit light. Side effects of this treatment can include diarrhea, sunburn, fever, dehydration, and flaking of the skin. To eliminate them in the body of a newborn, it is important to maintain a constant water balance.
It is equally important to attach the baby to the breast as early as possible and feed often, as this stimulates the elimination of meconium, which contains large amounts of bilirubin, from the baby's intestines.
With pathological jaundice, such treatment is connected:
- Infusion therapy. The child is injected intravenously with special solutions, and if the baby's condition is difficult, then the baby is transfused with blood.
- Enterosorbents... The baby is given smecta, enterosgel and other drugs to prevent the reabsorption of bilirubin from the intestines.
- Specific treatment depending on the identified pathology.
What are the consequences of high bilirubin?
The main danger of an increased amount of bilirubin in the baby's blood is its negative effect on the nerve cells and other organ systems of the child. The result can be encephalopathy, enlarged spleen and liver, increased drowsiness, decreased blood pressure, seizures, developmental delays, hearing problems, and even paralysis.
Komarovsky's opinion
A renowned pediatrician confirms that physiological jaundice occurs in almost half of newborn babies and in most cases passes by 10-14 days of life without a trace.
Also, a popular doctor notes that many newborns have breastfeeding jaundice. With her, the baby's condition is not disturbed and the baby is gaining weight normally. This type of jaundice can be detected by stopping feeding for 1 day, as a result of which the bilirubin level immediately drops.
Prevention
- A woman should pay attention balanced nutrition and during the period of bearing a baby, and after childbirth.
- Immediately after the birth of a child, you need apply to mom's breast.
- Also, in an already born baby, they will help prevent the development of jaundice. sunbathing. Keep the baby in the sun for no longer than 10 minutes.
