In half of newborn babies (and in case of prematurity - in about 70-80% of babies), the skin turns yellow by 2-3 days of life. This condition is called neonatal jaundice.
What it is?
This is the name of the jaundice that occurs in the first days after childbirth, caused by hyperbilirubinemia in newborns. In most cases, this condition is physiological, so it soon goes away on its own, but in some babies, such jaundice becomes pathological (in about 10% of children).
You can learn more about neonatal jaundice of newborns in the following videos.
Causes
Jaundice of newborns is caused by:
- The rapid decay of fetal hemoglobin in the first days of life, resulting in the formation of a large amount of bilirubin circulating in the baby's blood.
- Immaturity of the liver, which does not function actively enough to bind the formed bilirubin.
- Reabsorption of bilirubin from feces in the intestine due to slow movement, which may be associated with rare attachments to the breast or lack of breastfeeding.
Under the influence of factors such as prematurity, hypoglycemia, hypoxia during childbirth, low weight and some other conditions, jaundice becomes pathological and can be complicated by bilirubin encephalopathy.
Symptoms
- With physiological jaundice, the color of the child's skin changes from top to bottom - first the face turns yellow, then the body and at the very end the limbs turn yellow, although in most cases the jaundice does not fall below the navel.
- The color of both feces and urine remains natural, the general condition of the toddler does not deteriorate, and the spleen and liver are not enlarged. By the end of the first week of life, the intensity of skin coloration begins to decrease in the opposite order. The limbs turn pale first, then the body and finally the face turns pale.
- If the jaundice is pathological, the baby's skin may become pale or greenish at the same time as the appearance of jaundice. The general condition of the crumbs worsens, the stool may become discolored, and the urine becomes dark in color.
- Encephalopathy due to toxic levels of bilirubin is manifested by drowsiness, lethargy, depressed sucking reflex, lethargy, which are then replaced by muscle hypertension, increased irritability, loud screaming, and sometimes fever. In the worst cases, the baby has seizures, stupor, apnea, and coma.
Bilirubin rate
Normally, the level of this pigment in the blood of a child on the third day of life does not exceed 205 μmol / l. In this case, jaundice becomes visible when the level of bilirubin in the blood of a premature infant exceeds 85 μmol / l. The skin of full-term babies turns yellow at a rate above 120 μmol / l.
Pathological jaundice is judged by the following indicators:
- In term babies, the bilirubin level exceeds 256 μmol / L.
- In premature infants, this indicator exceeds 172 μmol / l.
- The hourly increase in bilirubin exceeds 5 μmol / L.
Treatment
The most common and highly effective treatment for neonatal jaundice is phototherapy. The baby is kept under special lamps, the light of which converts toxic bilirubin into a harmless isomer that can be excreted with physiological excretions. In severe cases, the child is prescribed infusion therapy, including blood transfusion.
When does it pass?
Neonatal jaundice in most cases after the onset of 2-3 days and the increase in symptoms during the third or fourth day of life then begins to subside and by the end of the second week of life completely disappears. With prematurity, the duration of neonatal jaundice (physiological) often increases to three weeks.
Pathological jaundice can begin earlier than the second day of life or grow later than on the third or fourth day of life. Its duration often exceeds 3 weeks.
Tips
- For a faster decrease in the level of bilirubin, the baby should be often applied to the breast - at least 8-12 times a day, without interrupting feeding during a night's sleep. If the baby is not breastfeeding well, he is fed expressed milk.
- It is equally important to provide the newborn with daily walks, sun and air baths. At home, the baby should be left undressed on a diaper for up to 30 minutes, depending on the microclimate of the room and the time of year.
