Causes of jaundice in premature newborns. Hyperbilirubinemia in endocrine diseases. Why does the crumb turn yellow

Physiological jaundice of newborns is a problem that thousands of young mothers have had to face. This pathology is visible to the naked eye, even to those people whose profession is not related to medicine. Parents almost immediately after the birth of the baby celebrate her presence. Unaccustomed to perception, dark, pouring usually raises a lot of questions. First of all, many are interested in the question of whether it passes on its own or requires treatment.

In addition to visual changes in the appearance of a newly born baby, he is able to declare the occurrence of an ailment clinical analysis blood.

A high level of bilirubin indicates that the child's liver has not yet reached functional maturity. This substance is present in the blood of a person of any age, but in infants it can be found in fairly large quantities.

Physiological jaundice is also caused by the rapid breakdown of red blood cells. These microscopic red cells, present in the blood, are a natural transporter of oxygen to organs and tissues in the baby's body during the prenatal period. As unnecessary after birth, they are gradually destroyed, while the bilirubin indicators are rapidly increasing.

The liver is responsible for removing such an insoluble substance from the body. necessary if voluntarily excess bilirubin is not eliminated.

Physiological and pathological jaundice in children

The peak manifestation of this condition is considered 3-4 days after the birth of the baby. Children's doctors classify the ailment, highlighting two of its types.

Pathological jaundice does not go away on its own. It is ascertained when the bilirubin level remains high for several weeks. largely affects the condition of the newborn. When further development the disease is expected to die of brain cells, in general, the prognosis for recovery is unfavorable.

In the second case, physiological jaundice appears. She does not cause any discomfort to the baby. As a rule, the ailment passes in a couple of weeks - this period is quite enough for bilirubin to completely leave the body. It is this type of pathology that is common among newborns.

How does jaundice develop in children without treatment?

Intensive breakdown of hemoglobin in the blood infant is the root cause of physiological jaundice. It is diagnosed on average in 8 out of 10 newborn babies.

In a normal course, it appears by the third day in newborns, at that time the level of bilirubin is off scale, but a short-lived pathology does not have negative impact on the general state child.

No negative consequences of the jaundice transferred in infancy threaten him, especially if additional treatment is undergone.

The unusual swarthy color of the baby's skin disappears approximately 7-8 days after birth, at the same time when the bulk of the bilirubin has time to leave the body along with meconium.

In addition, this process can go faster if the newborn is breastfed.

Signs of complication and need for therapy

The mother should sound the alarm and go for a consultation with a highly qualified pediatrician if the signs of physiological jaundice do not leave the child after two weeks at home. Drug treatment prescribed only when the severity of the condition of the small patient is high enough.

If the symptoms described below become noticeable, drug therapy cannot be avoided:

dark color urine;
colorless feces;
bruising on the body;
deterioration of the general condition of the child.

Doctors have long determined the deadline for self-elimination of the disease - two weeks. If there are no changes, the yellowness still does not go away, an urgent need to go to doctors for help.

In no case can you postpone the visit, since physiological jaundice will not go away on its own after two weeks of the baby's life.

Probable consequences of jaundice in newborns

By her own given form not dangerous, but it has the properties of being accompanied by complications, acquiring a more severe nature of the course of the disease.

Among the diseases that threaten incomplete treatment of jaundice, the most dangerous are:

Albuminemia. It develops due to a decrease in albumin in the blood due to high levels of bilirubin.
Penetration of a small amount of coloring pigment into the tissue. Yellowness skin can stay with a crumb for the rest of his life.
When bilirubin enters the brain, the disease can lead to deafness, mental retardation, and loss of motor control.

How to treat a baby?

With a prolonged form of physiological jaundice, as a rule, complex treatment... Many experts are inclined to believe that an increase in bilirubin in the blood is one of the symptoms of liver or biliary tract disease. Therapy of a symptom of the disease is unacceptable, the source of the symptomatology must be treated.

With physiological jaundice, which goes away on its own, no external intervention is required, the baby's condition will return to normal in the near future.

In other cases, the following treatment is used:

Light therapy (phototherapy). This method consists in active exposure ultraviolet rays on the skin, which allows bilirubin to pass into a water-soluble form and leave the newborn's body through the urinary and biliary tract.
Infusion treatment, the main measures of which are to restore water balance or prevent its disturbances in the body. Basically, the child is prescribed a glucose solution.
Reception of enterosorbents. A group of medications will contribute to the early elimination of bilirubin, preventing it from circulating in the intestinal-hepatic system.
Blood transfusion. IN severe cases when conservative therapeutic methods do not bring any results, use given treatment... The main indication for its appointment is considered a high risk of complications.
Sunbathing helps to reduce the level of bilirubin produced, having an overall beneficial effect on the baby's well-being.

Jaundice in children due to breastfeeding

Physiological jaundice, the cause of which is associated with breastfeeding newborn baby.

It turns out that there may be substances in breast milk that interfere with the binding and excretion of crumbs of bilirubin from the body.
Immaturity of the liver affects no less: it is not able to cope with so much of the substance, so it accumulates in the blood.
The high amount of yellow pigment causes major changes in the color of the skin and the whites of the eyes.

When the jaundice does not disappear for more than 2 weeks, the search for the cause often leads doctors to the peculiarities of the composition of the mother's breast milk in a particular clinical case... With such a disease, there are also no symptoms, the newborn develops in accordance with normal indicators, gains weight and has a good healthy appetite. It is distinguished from other healthy children by a slightly golden hue of the skin.

After the little man was born, the only concern of the parents is his health, which at this very moment is so vulnerable and fragile. Unfortunately, jaundice in newborns is something that almost 80% of young families have to deal with.

Someone refers to this phenomenon calmly, knowing that this is the norm. Some go crazy, considering this symptom dangerous and requiring hospitalization and treatment. Both are wrong. In this matter, the golden mean is very important: you cannot treat it too lightly, but you should not panic either. Let's see why.

The newborn's skin turns yellow due to bilirubin, a breakdown product of hemoglobin. In the womb, fetal red blood cells are saturated a certain kind hemoglobin, which after birth with pulmonary respiration begins to actively disintegrate. Great amount the resulting bilirubin (indirect and very toxic) enters the liver so that it converts it into an indirect one and removes it from the body. But the liver does not always cope with such a load.

Doctors call the following reasons jaundice in newborns:

pathogens that affect the liver;
disturbances in the structure or work of the gallbladder and bile ducts;
natural restructuring of the body as a result of its adaptation to a new environment;
a large amount of carotene in the diet of a nursing mother;
premature birth: jaundice in premature newborns occurs in 80%, since the liver is not yet sufficiently formed;
diabetes mellitus in the mother;
genetics;
diseases of the circulatory system;
asphyxia;
hormonal disorders (the child will be treated by an endocrinologist);
incompatibility: I blood group in the mother, II or III - in the child;
intrauterine infection;
stomach problems, when bilirubin will be constantly absorbed back into the body - in such situations, only surgery can save;

These are the main causes of jaundice in newborns. Each of them has its own characteristics. In some cases, bilirubin is still gradually excreted by the body without consequences. But there are forms of the disease that require immediate health care... Depending on the factors that trigger the development of jaundice, doctors call risk groups.

Medical terminology. The concept of "bilirubin" goes back to the Latin words bilis, which means bile, and ruber - in translation red.

At-risk groups

Even during pregnancy, the doctor includes in the risk group special categories of women, whose children at birth have a high chance of having jaundice. These include:

age less than 18 and more than 40 years;
early abortions, miscarriages;
previously occurred premature birth;
smoking, alcoholism, drug addiction during pregnancy;
negative rhesus factor;
intrauterine infections;
jaundice in previous children.

Women in the risk group are under the vigilant supervision of a doctor throughout their pregnancy and undergo additional tests. And yet, it is impossible to 100% prevent jaundice in a newborn, even if you constantly take care of the prevention of the disease. It is very important to recognize it in time by characteristic features to help distinguish one type of jaundice from another.

A common truth. If during pregnancy a woman leads healthy image life, she reduces the risk of jaundice in her baby.

Types of jaundice

Doctors diagnose different types jaundice in newborns, which, under normal conditions, without laboratory research, difficult to establish. This is very important point, since it is the type of disease that will determine the need further treatment and the risk of possible complications.

Physiological

Physiological jaundice is the norm for newborns, it occurs due to the natural restructuring of the body as a result of its adaptation to the new environment. It manifests itself in the first month of a baby's life, but not immediately after birth. Represented by the following types.

Carotene

Carotene postpartum jaundice occurs due to the large amount of carotene in the diet of a nursing mother. There is a lot of this substance in orange products: pumpkin, carrots, oranges.

Breast milk jaundice

This postpartum jaundice occurs when a mother has a lot of estrogen in her breast milk. The liver removes it first and only then - bilirubin. The baby remains yellow for about 3 months. But at the same time, he develops according to the norms of his age. This condition is not dangerous and does not require canceling lactation.

Neonatal

Neonatal jaundice is the most common type. Does not apply to pathologies, does not require treatment. It passes by itself, does not cause complications.

Pathological

Associated with serious medical conditions internal organs baby. It manifests itself within a few days after birth. Represented by different types.

Hemolytic

It is caused by problems with the circulatory system: due to the Rh conflict between mother and baby, mismatch in blood groups, incompatibility in antigens. It occurs only in 1% of cases. This is generic jaundice in newborns, as it is recognized instantly, in the first days and even hours after birth.

Mechanical

Bile is not separated from the liver due to disturbances in the structure or work of the bile bladder and bile ducts. Most often, birth trauma or. It appears only 2-3 weeks after birth.

Nuclear

IN circulatory system there is a special barrier that prevents toxic substances from reaching the brain, filtering them out. But if too high level bilirubin, it may not cope with the load. In this case, destruction is possible. nerve cells... Symptoms are lethargy, refusal to eat, monotonous screaming, head tipping back.

Conjugation

Caused by poor liver function. Enzymes do not bind bilirubin and do not remove it from the blood.

Hepatic

It is diagnosed after damage to liver cells by bacteria or viruses.

In no way dangerous and by itself passing physiological jaundice of newborns should not frighten parents. Everything is much worse if it is dictated by serious pathologies inside the body. To suspect something was wrong and to consult a doctor in a timely manner, the symptoms of the disease allow.

Educational program for parents. Why is conjugation jaundice? This word is derived from the Latin "conjugation", which means "conjugate." That is, this disease is associated with liver pathology.

Symptoms

Depending on the type of disease, the symptoms of jaundice can vary. If they do not go beyond the norm and indicate only the physiological form of the disease, there is no need to sound the alarm. After 3 weeks, everything will end happily. But if they add warning signs more serious pathology, it is necessary to inform the doctor about it - and as soon as possible.

Signs of physiological jaundice

The skin and whites of the eyes become yellow, almost orange;
minor stool disorders.

Symptoms pathological jaundice

More intense yellow skin color;
pinpoint hemorrhages, bruises;
undulating course of the disease: skin color is periodically restored to pink, and then returns to icteric;
the child is inhibited and lethargic, refuses to eat;
increased muscle tone of the muscles;
monotonous or strong, high-pitched crying;
dark urine;
discolored feces;
convulsions;
slow heart rate;
stupor or coma.

The clinical picture of specific pathologies

Lethargy, refusal to eat, monotonous screaming, throwing the head back, convulsions, attenuation of the sucking reflex - symptoms of nuclear jaundice;
persistence of yellowness of the skin after 3 weeks, dark urine and discolored feces indicate serious pathologies of the bile ducts;
if the skin and sclera turn yellow immediately after birth, the child is lethargic and sleepy, and when diagnosed, an enlarged spleen and liver are found - this is hemolytic jaundice;
skin acquires yellow tint with a greenish tint 2-3 weeks after childbirth, the stool is abnormally light, the liver is compacted, the spleen is enlarged - symptoms of a mechanical type of disease.

The faster parents recognize dangerous guy jaundice in a newborn, so faster doctors prescribe treatment and be able to help. Very often precious time is lost, and complications that affect the entire subsequent life of the child cannot be avoided. To prevent this from happening, a mandatory diagnosis of the disease is needed.

Distinguish jaundice from hepatitis! With hepatitis, a newborn's temperature rises, and the skin turns yellow sharply and unexpectedly.

Diagnostics

Only laboratory indicators can accurately determine which jaundice in a newborn is harmless physiological or dangerous pathological. To obtain them, the following studies can be carried out:

blood test: general and bilirubin;
Coombs' test for hemolysis;
Ultrasound abdominal cavity;
consultations of an endocrinologist, surgeon and other specialists.

Table of the norm of bilirubin in newborns

Table normal performance direct and indirect bilirubin

According to the norms, direct bilirubin should be no more than 25% of overall indicator, indirect - not less than 75%. Depending on the results obtained, an accurate diagnosis will be made (not only jaundice, but also the disease that provoked it) and treatment will be prescribed.

Helpful information. The Coombs' test is performed immediately after childbirth, using blood after cutting the umbilical cord.

Treatment

All parents are concerned about how to treat jaundice so that it goes away as quickly as possible. Such children are under constant medical supervision, but if this is a physiological disease and proceeds within normal limits, therapy is not required. If a pathology is found, treatment can take on different directions: antiviral, antibacterial, choleretic, detoxification or immune.

Medicines

If bilirubin readings go off scale, appoint special drugs from jaundice.

Ursofalk is an anti-jaundice medicine for newborns in the form of a suspension aimed at protecting and maintaining normal work liver. It is prescribed for lingering jaundice. The dosage is 10 mg per 1 kg of body weight.
Hofitol is another effective medicine from jaundice in the form of a solution based on natural artichoke extract, which activates the outflow of bile and simplifies the work of the liver. Assign 1 to 3 drops 3 times a day.
Infusion therapy for phototherapy to restore water balance: glucose solutions, electrolytes, soda, membrane stabilizers, cardiotrophics. Prolonged jaundice necessarily requires such treatment.
To normalize the liver, Zixorin, Phenobarbital, Benzonal can be prescribed.
When absorbing bilirubin by the intestines, sorbents are used: Enterosgel, Polyphepan, Smecta, Activated carbon.
Fat-soluble vitamins: cholecalciferol (D3), retinol (A), tocopherol (E), phylloquinone (K).
Trace elements: phosphorus, zinc sulfate, calcium.

Interesting fact. The basis of the drug from Urosofalk jaundice is ursodeoxycholic acid, which is contained in bear bile. To date, they have learned to produce it in laboratory conditions.

Treatments and phototherapy

With this disease, a decision can be made on the following procedures:

blood transfusion in the diagnosis of nuclear jaundice;
liver transplant for cirrhosis.

Also, with jaundice, the child needs the sun's rays, but in this small age they can be dangerous, therefore, a lamp treatment is prescribed - phototherapy. Under the influence of bright light, harmful bilirubin is actively excreted. This procedure is absolutely safe. The baby is placed under it for several hours a day, if there are no complications. When severe course illness, he will be under it for almost the whole day.

Phototherapy apparatus for the treatment of jaundice in a newborn

Parents should understand that jaundice in a newborn does not always require therapy. Therefore, there is no need to be surprised and indignant if the child turns yellow, and he and his mother are discharged from the hospital. But this is also possible only in cases where the blood tests are in order, the bilirubin content in the body does not go off scale and no internal pathologies the doctors did not find it. Accordingly, the baby does not need to be healed at home.

Folk remedies

Self-treatment at home with jaundice in a newborn is carried out only with the permission of a doctor. Even the most harmless, at first glance, remedy advised by a neighbor or mother, can be very dangerous for a small organism, many of whose systems are just adapting to a new environment. Among the most recommended drugs approved by pediatricians are the following:

dandelion root tincture: 3 drops 4 times a day;
a good remedy for jaundice is alfalfa tincture: 2 drops 4 times a day;
activated carbon solution: dilute 10 g of powdered coal in 50 ml of boiled warm water, give the baby 1 pipette every 2 hours;
rosehip broth;
infusion of corn stigmas;
after feeding, apply a bandage soaked in a solution of magnesia to the newborn from the liver;
tea "Collection for a nursing mother": drink 1 liter daily.

You cannot use several funds at once from of this list, because many of them are mutually exclusive, or their combination will be too powerful for a small organism. Proper care will be of much greater benefit to a newborn with jaundice.

Herbal medicine secrets. Lucerne - medicinal plant, rich in vitamin K, which improves liver function.

Care

It was not possible to avoid jaundice, they were discharged home with such an unpleasant diagnosis - what should the worried parents do in such a situation? Correct care for a newborn will ease his condition and speed up recovery. Here are the items it includes.

For a few minutes a day, lay the undressed child under the sun.
Frequent feeding and plentiful drink normalize liver function.
In case of galactosemia, feed the child with formulas without lactose and galactose: Nutramigen, Preregimil, lactose-free NAN.
With tyrosinemia, a diet is required: mixtures without phenylalanine, methionine, tyrosine (XP Analog, Afenilak, Lofenolac).
Adequate breastfeeding.
Mom's diet: exclusion of yellow foods, spices, peppercorns and salty foods from the diet.
Daily walks in the fresh air.
Phototherapy at home.

If any of the points of care for an icteric newborn is in doubt, it is better to consult a doctor, but do not do anything on your own and do not experiment. Especially carefully you need to deal with the treatment of sun rays, which in summer are fraught with burns. With the right approach to this issue, you can speed up recovery and avoid complications.

You should know it. Galactosemia - hereditary genetic disease, lactose intolerance.

Complications

Parents are worried about the danger of jaundice in newborns, how this disease can end in the end, except for recovery. The physiological form is rarely fraught with complications. But the pathological one can entail the following consequences:

Sometimes lingering jaundice in newborns can cause complications that further affect the nervous system, since indirect bilirubin has toxic effect on the central nervous system.
Phototherapy with an incorrectly selected treatment regimen can lead to burns, dehydration, hemolysis, lactose intolerance,.
The consequences of nuclear jaundice are deafness, complete or partial paralysis, mental retardation.
Toxic poisoning and intoxication.
Albuminemia is a decrease in albumin protein.
Bilirubin encephalopathy is a brain damage.

Knowing how dangerous jaundice is in newborns, parents will be able to assess the full degree of risk and take appropriate measures so that nothing terrible happens. It is much easier to prevent a disease than to cure it - if, even during pregnancy, constantly think about prevention, the baby will be able to avoid problems with bilirubin after his birth.

Forecasts for the future. The modern level of medicine will even cure bilirubin encephalopathy. True, with timely diagnosis and compliance with all medical requirements.

Prophylaxis

Prevention of jaundice future mom should be engaged even during the gestation of the baby and after his birth. To do this, it is enough to observe the following rules.

Adequate nutrition for the mother during pregnancy.
Her rejection of bad habits.
Prevention and treatment of any disease.
Refusal to inject a newborn with vitamin K, which is practiced in maternity hospitals.
Sunbathing.
Frequent breastfeeding.
Drinking plenty of fluids for a nursing mother.
Cutting the umbilical cord in the second hour after childbirth, when the pulsation at the base of the navel stops. This will help normalize blood circulation.

Being engaged in the prevention of jaundice, you can prevent the disease so that the first days of the baby are not overshadowed by anything. If you have any additional questions about this phenomenon, it is better to ask your pediatrician for all the information in advance.

Controversial issue. Doctors still argue about how the time of cutting the umbilical cord affects the manifestations of jaundice. On the direct relationship of these two facts scientific evidence not.

Frequently asked Questions

When should the jaundice go away in newborns?

The answer to the question of how much jaundice goes through in newborns depends on the type of disease and the individual characteristics of the organism. Normally, physiological jaundice resolves in 2-3 weeks.

What lamp is used to treat jaundice in newborns?

These are special lamps that emit bright ultraviolet light, the spectrum of its rays accelerates the decay of bilirubin.

Is jaundice contagious in newborns?

Unlike the hepatitis virus, jaundice in newborns is not contagious.

Can jaundice return in newborns?

Yes maybe. But with repeated manifestations of the disease, an urgent doctor's consultation is required to exclude complications.

On what day does a newborn have jaundice?

It can start 4-5 days after birth.

Whythe newborn does not have jaundice 1or even2 months?

There can be several reasons for lingering jaundice:

the bilirubin elimination cycle failed;
liver dysfunction due to birth defect or hepatitis;
stagnation of bile due to disturbances in the work of the biliary tract and gallbladder;
the formation of more and more bilirubin due to blood diseases.

In any case, lingering jaundice requires diagnosis of the causes and immediate treatment.

If a newborn is ill with jaundice, parents should closely monitor his condition. If he feels good, that's physiology and nothing more. The best medicine in this case is breast milk. If he is lethargic, often cries, this is already a pathology that requires a doctor's consultation, tests and treatment.

The beautiful and long-awaited baby, who was born, suddenly turned yellow. On the third day after giving birth, just in time for the discharge, which the whole family was waiting for, the baby acquired an unusual orange blossom, once and for all crossed out the mother's dreams of a beautiful photo session with the newborn. Anxiety has replaced joyful thoughts - what kind of jaundice is this and how is it dangerous? These questions are answered by the well-known pediatrician, TV presenter and author of books and articles on children's health, respected by millions of mothers, Yevgeny Komarovsky.

What happened?

Jaundice in newborns is a fairly common phenomenon, it is observed in 50-60% of full-term babies and 80% of premature babies. Treat it as a disease is not worth it. The child's skin turns yellow completely physiological reasons... The fetal hemoglobin in the baby's blood (which was natural for him during pregnancy) changes to normal human hemoglobin A. The baby adapts to the environment. Its enzyme system is immature, as is the liver. It is this organ that is responsible for the excretion of bilirubin, which is formed in all people during the breakdown of erythrocytes. These blood cells are constantly renewing, hence the need to "utilize" aging cells.

Have crumbs in postpartum period When hemoglobin is replaced with normal hemoglobin, erythrocytes, which are aging, also disintegrate, but a poorly functioning liver cannot yet remove bilirubin. This bile pigment, which remains in the body, causes skin coloration in yellow... Such a metamorphosis usually occurs with a newborn on the third day after birth.

The enzyme system is improving pretty quickly. As the liver is getting the necessary enzymes, begins to work in full force, bilirubin begins to leave the body, the skin brightens, first acquiring a peach shade, and then returning to its normal color. Usually, this process is completely completed by 7-10 days of life, thus, after discharge in 4-5 days, less often in a week, the jaundice should completely disappear. Prolonged neonatal jaundice can be observed in premature babies, but doctors try to carry out their treatment and observation in a hospital environment.

Another type of harmless jaundice is breastfeeding jaundice. According to Komarovsky, there are special substances in breast milk that slow down the binding of bilirubin in the liver. This situation is normal, requiring no treatment, and even more so, the abolition of breastfeeding and the transfer of the baby to nutrition with adapted formulas.

How to treat?

Since the process is natural, Evgeny Komarovsky advises mothers to calm down and not bother with questions about the treatment of neonatal jaundice. Modern medicine does not use special medications for these purposes. It is believed that the most effective method to slightly speed up the process of normalizing the color of the child's skin - phototherapy. To do this, use a "blue" lamp, which illuminates the skin of the child. As a result, the pigment bilirubin, under the influence of rays, breaks down into substances that the newborn's body is quite capable of excreting with urine and feces.

Komarovsky advises using ordinary "white" lamps at home, if there are no LED ones, since any bright light neutralizes the toxicity of bilirubin.

Another effective cure for jaundice is created by nature itself - mother's breast milk. It contains natural substances to enhance the immune defenses of the child. Therefore, the sooner the baby is attached to the breast, the more often he will be fed. breast milk, the faster and easier his body will cope with physiological jaundice. Feeding such children is a special story. As a rule, crumbs with increased bilirubin differ increased sleepiness and may skip feeding. It is important to make sure that the baby eats on time, wake him up if necessary, but in no case overfeed.

Healing effect walks with such a baby will also enjoy. It needs to be taken outside more often so that the child has contact with indirect sunlight. If the weather and season permits, a child with jaundice should spend in total on the street most day.

Pathological situations

An abnormal condition is considered in which a child, after birth, begins a massive disintegration of red blood cells, not only aging and in need of replacement, but also quite healthy. The level of bilirubin in this case is very high, and we are no longer talking about functional jaundice. Doctors talk about hemolytic disease of the newborn (HDN). This pathology can develop in children whose blood type and Rh factor are different from those of the mother. If an immunological conflict occurs, the mother's immunity develops specific antibodies against the fetal blood cells.

Such jaundice develops already in the first hours after the baby is born. As a result, severe anemia is observed in the newborn, his liver, central nervous system, and brain suffer. Doctors monitor bilirubin levels closely. When certain critical levels of this pigment in the blood are reached, a replacement blood transfusion is prescribed. Sometimes, several such procedures are required to reduce the toxic effect of bilirubin on the body and all its systems. In the case of a rapid and severe hemolytic disease, death can occur.

Another pathological jaundice inherent in children is associated with atresia of the biliary tract. it congenital pathology, in which these paths are not formed or formed incorrectly due to some genetic error. Such a disease is very rare; according to official medical statistics, one in 15 thousand children born into the world is susceptible to it. This condition is eliminated surgically, the operation is very complex, high-tech, but it gives the child a chance for a further normal life.

There are other reasons for the appearance of jaundice, which is abnormal for a newborn:

An overdose of vitamin K. The drug "Vikasol" (a synthetic analogue of vitamin K) is used during childbirth to prevent or eliminate heavy bleeding from a woman. If there is an error in dosing or an urgent need for a large amount of the drug for a woman, an overdose may occur in the baby.
Diabetic fetopathy. A condition in which the baby's liver and its enzyme system are underdeveloped due to the fact that the fetus suffered during pregnancy against the background of mom's diabetes.
Genetic (hereditary) liver malformations. These are some types of genetic syndromes in which structural genetic errors have occurred at the level of organ laying in the fetus.
Intrauterine infections... Some infectious diseases, which the mother suffered during pregnancy, can cause pathologies in the development of the fetal liver.

At the moment of birth, the baby, getting into a new habitat, experiences severe stress. In a fragile child's body, minor malfunctions can occur, which leads to such a phenomenon as jaundice in newborns. What is it, and should parents give in to panic?

Why does jaundice appear

Causes of jaundice in newborns

Most often, pathological jaundice suffers from children whose mothers had a hard time tolerating pregnancy, for example, they had a threat of miscarriage, had early or late toxicosis.

What, besides this, can still serve as the causes of the disease?

Hemolytic disease, which caused the incompatibility of the blood of the baby and the mother for the Rh factor.
Heredity.
Infection of a child's liver with a virus in the womb.
Underdevelopment of liver cells.
Reduced function thyroid gland- hypothyroidism.
Deviations from the norm in the bile ducts.
Premature birth in women with diabetes mellitus, including those that only appear during pregnancy (gestational diabetes).
The introduction of oxytocin into the body of a woman in labor.
Administering antibiotics such as cefazolin or ampicillin to the child.

How does the disease manifest? Tests for jaundice

In infants, additional manifestations of jaundice may be added to the change in the skin. The baby's urine becomes dark in color, and the feces, on the contrary, become discolored. On the body of the crumbs, bruises can appear for no reason. The general well-being of the child worsens, while the liver and spleen increase.

If the skin of the crumbs does not acquire a normal shade 2-3 weeks after birth, you need to consult a doctor for laboratory tests.

Before starting treatment, an analysis is prescribed to determine the amount of bilirubin in the blood. In full-term babies, the critical indicator is 324 µmol / l, and in premature babies only 150-200 µmol / l.

Since this value depends on several reasons, the doctor will prescribe treatment based on the general condition of the baby. In addition, an ultrasound scan of the abdominal cavity is performed in order to determine the condition of the internal organs, and samples are taken for hemolysis.

How to treat jaundice in a newborn

If a child has a physiological form of jaundice, then we are not talking about treatment, but only about helping the little man.

What should be done so that the child can quickly cope with the problem that has arisen?

You should start breastfeeding as early as possible. to help improve metabolic processes in the baby's body.
So that the crumbs do not have digestive problems , mom should stick to a diet.
The kid needs to be outdoors more often. , and if possible - take sunbathing.

Methods for treating jaundice in newborns

If pathological jaundice is detected, the treatment of the baby should be started immediately.

A lamp against jaundice in a baby

This is a treatment based on the effect of ultraviolet rays on the skin of the baby. When light is irradiated under the skin of a child at a depth of 2-3 mm, chemical reactions occur that convert indirect fat-soluble bilirubin into its water-soluble form - lumirubin. It dissolves freely in the blood of a newborn and is excreted in the urine.

Phototherapy is carried out in a hospital under the supervision of a doctor and following certain rules ...

The baby's eyes are closed special glasses or a bandage.
The duration of the treatment session is strictly regulated; for this, the lamp is equipped with a timer.
The procedure can cause peeling of the skin and dehydration of the body, therefore it is carried out under the constant supervision of a healthcare professional.

After the phototherapy sessions, the child's stool color and character may change. This is normal because excess bilirubin is excreted in the baby's feces.

Together with phototherapy, the doctor may prescribe infusion therapy. It will be required in order to restore water balance... It can be a glucose solution, membrane stabilizers, electrolytes and drugs that improve microcirculation.

Medicines to help with treatment

One of the drugs is Hofitol - a preparation containing an extract from the leaves of a field artichoke. It improves liver function, promotes rapid excretion of bile and a significant decrease in the level of bilirubin in the body of the baby. Ursofalk has a similar effect on the body. Small crumbs are prescribed a medicine in the form of a suspension.
Enterosorbents are prescribed as auxiliary agents, such as Polyphepan, Smecta or Enterosgel ... The drugs limit the circulation of bilirubin between the liver and intestines.
To stimulate metabolic processes and strengthen immunity, babies are prescribed Elkar - a remedy consisting of carnitine. The drug breaks down fatty acid, helping to generate additional energy in the baby's body.

When is blood transfusion necessary?

Blood transfusion is used for severe forms pathological jaundice. If the indices of indirect bilirubin increase rapidly and significantly exceed the norm, then exchange transfusion is indispensable. Most often, the procedure is carried out when a Rh-conflict occurs.

Exchange transfusion involves replacing a small amount of the child's blood with donor blood. This helps to flush out the bilirubin from the baby's body.

Folk remedies in the treatment of jaundice

In no case should you risk the health of a newborn and self-medicate! Folk remedies can be used only as an adjunct to treatment, which will be prescribed by the attending doctor and only with his approval.

To improve the general condition of the newborn, you can resort to a strengthening agent, the role of which can be played by a weak rosehip decoction. As an absorbent can be given to a child Activated carbon by dissolving in water the amount of powder corresponding to its weight.

You should not give the baby any medicinal fees as a diuretic and choleretic... No one can say for sure how they will react to them. children's organism.

Why is jaundice dangerous - the consequences of the disease

If the physiological jaundice quickly passes without leaving a trace in the body of the little man, then the pathological form of the disease can cause serious consequences.

With nuclear jaundice the nervous system of the child is affected, which leads to serious neurological abnormalities. In addition, the child may experience hearing and vision impairment, and in the most severe cases, cerebral palsy may develop. In rare cases, the disease can lead to paralysis of the sick baby.

If the jaundice color of the baby's skin does not subside in due time, immediately consult a doctor. If the crumbs have jaundice manifested in a pathological form, it must be treated immediately.

Video about jaundice, Komarovsky:

The baby was born. And three days later, a happy mother, who had just recovered from the "euphoria", suddenly notices that something is wrong with her child. He is somehow not like everyone else: his skin and eye whites acquired a yellowish tint. What to do? Doctors say that this is not dangerous, because jaundice in newborns is a very common phenomenon. And then, without explaining anything, they prescribe some medicines to the minipusik, carry out procedures, and all your questions are answered so indistinctly that anxiety grows more and more. Familiar situation?

Mom, don't panic! If your child turns yellow, it's okay!

And it happens that the newborn turns yellow at home. At the same time, the condition of the mother is even worse: there is no one to ask for advice, and she does not know what to do. A heap of assumptions (by no means optimistic) come to mind before the arrival of the pediatrician. A mother's awareness is the first step to her mental balance, and therefore to the calmness of the child. After all, he reads all the information from you and behaves restlessly if something bothers you.

Why does the baby turn yellow and how dangerous it is

Coloring of the skin after birth (on the 2-3rd day) is the norm. That is why baby jaundice is called physiological. It's just that for some, this process goes almost imperceptibly, and for some it is a whole problem. It all depends on the rate of bilirubin formation and the body's ability to neutralize and remove it.

Premature babies are most prone to yellowness on the skin.

Bilirubin is a breakdown product of blood cells. It has a yellow color and is present in every person, participating in metabolic processes. If some kind of malfunction occurs, then the level of pigment rises, and the skin and sclera are colored. And since bilirubin is a toxic substance, exceeding its critical parameters in the blood can lead to serious consequences: intoxication of the body, damage nervous system and the brain, disability (retardation in mental development, deafness) and even death. That is why prolonged jaundice is dangerous and should be treated as soon as possible.

but increased bilirubin in the body of newborns - a natural phenomenon. It is caused by the change of embryonic hemoglobin received through the placenta for hemoglobin received through inhalation of oxygen with air. As a result of this process, many "outdated" blood cells that have lost their function are destroyed, releasing bilirubin, which the children's liver cannot cope with due to its immaturity. These are the mechanisms of physiological jaundice that occurs 2-3 days after the baby is born and passes on its own, as soon as all the man's blood is renewed and his filtering organ rebuilds (matures).

After a few weeks, your baby's skin will take on a healthy pinkish tint.

The line between norm and pathology

What is the danger of jaundice, we have considered. Surely you are wondering how to distinguish its pathological form from the natural one. For this, there are the following criteria:

objective: a blood test for bilirubin and a comparison of indicators with the norm, as well as a comparison of indicators in dynamics;
subjective: the time of the onset of jaundice, the behavior of the child.

Bilirubin rate- a relative concept. It differs in adults and newborns, as well as in babies born at term and premature babies. Fluctuations in toxin levels are also a phenomenon associated with the rate of breakdown of red blood cells and the subsequent excretion of products of this process. As you can imagine, this cannot happen the same way all the time.

For a visual assessment of the level of bilirubin in the blood, the Kramer scale is used. According to her, the child's skin is colored not evenly, but in sections, depending on the change biochemical parameters blood. First the face and neck turn yellow, then the body, upper limbs, then the hands, lower limbs and feet. If you take an analysis from a child with yellowness of the hands and feet, it is very likely that his bilirubin level will exceed allowable values... According to Kramer, when the yellowness of the skin passes, the blood counts return to normal.

As soon as the yellowness of the child's legs passes, you can be sure that the crisis is over!

When laboratory assessment the level of toxin is measured by the amount of direct, indirect and total bilirubin... Doctors agree that direct bilirubin should not exceed 1/4 of the total. After all, it is he who is most dangerous for the body, since it has not yet been neutralized by internal chemical reactions and not ready to hatch.

The yellowness of the skin is not yet a reason for panic. It is much more important to pay attention to when it appeared (for example, if the skin becomes stained a few hours after birth, then this is an incentive for examining the child for the presence of serious illnesses) and on the behavior and well-being of the baby.

Even Dr. Komarovsky pointed out the need to consider the "disease" in its dynamics. If the baby's jaundice persists, but he is cheerful during wakefulness, sleeps well, actively sucks, then you should not worry.

If you observe following symptoms(in addition to yellowness), to medical care should be resorted to immediately:

shrill cry, it is difficult to calm the child;
limbs are compressed, trembling (convulsions);
eyes are wide open, pupils are enlarged;
hypertonicity of the cervical muscles (inability to tilt the baby's head).

All these signs indicate a serious intoxication of the infant's body, the consequences of which we have already considered.

Why does bilirubin rise?

Why the skin of a newborn turns yellow, we found out. Now highlight the reasons for the increase in the level of bilirubin.

Blood conflicts between mother and child (different rhesus, different group). Rh-positive children born to a Rh-negative mother are especially affected.
Immaturity of the child's liver, imperfection of the bile ducts.
Intrauterine infections.
An increase in the level of estrogen in breast milk (this hormone inhibits the enzymatic activity of the liver to neutralize the toxic effect of bilirubin) or simply improperly organized hepatitis B, in which the baby does not receive enough food.
Recent studies indicate that jaundice most often occurs in children whose mothers have had abortions or have undergone planned childbirth. It is these facts that have presumably influenced the increase in the number of newborns with icteric skin symptoms in the past few decades.

Mom, breastfeeding is very important for the health of the little man! Take care of yourself!

Methods for the treatment of pathological jaundice

"How to treat a baby if he has jaundice?" - a question that worries all mothers who are faced with its manifestations in their baby. Indeed, because he is so small, how can you poison his tender clean organism medicines? Treatment is not aimed at eliminating the symptom (that is, yellowness), but at helping the body fight the disease that caused it. Medication and non-medication are used.

Drug treatment

The child is prescribed drugs that help neutralize the toxin, accelerating its removal (diuretic, choleretic and hepatoprotective). Of these, the most common: Hofitol in liquid form, Ursofalk, Phenobarbital and Magnesia. However, if you read the instructions for these drugs, then in many of them you will not find a mention of jaundice. But surely pay attention to the sea of contraindications on the part of the nervous system, gastrointestinal tract and others. In addition, it will be very difficult for an immature liver and intestines to cope with such a medication load.

A child's body cannot cope with such serious medications!

Some doctors suggest giving the crumbs a rosehip broth to drink. It calms mom down, because you can't swallow pills, after all natural product... In such a position there is something from the Soviet times, when the child was given juices and decoctions to drink almost after birth. Well, the body of a newborn is not adapted to digest anything except mother's milk or its analog!

In severe cases of hemolytic disease, accompanied by jaundice, the baby may need a blood transfusion. But, fortunately, this happens very rarely.

Treatment without medication

In the world practice of treating jaundice in newborns, there has already been a revision and a departure from drug methods... Instead, the mother is taught breastfeeding (correct attachment to the breast), the mother and baby wards practice (to attach the baby to the breast as soon as possible, feed him on demand), use special lamps to treat jaundice and conduct phototherapy.

In some of our maternity hospitals, they still practice latching on to the breast only on the third day (especially in the presence of a blood conflict), feeding by the clock and using lamps only in extreme cases.

The idea to use a lamp to treat jaundice came about when they noticed that under influence sunlight in babies, the general condition improves and the color of the skin is normalized. So maybe you shouldn't "irradiate" the child and just take him outside more often? But it is advisable to do this only in summer time... The weather should be warm, sunny, calm. The baby should only be in a diaper and socks. At the same time, in the morning hours, he has an increased risk of hypothermia, and in a sultry noon - to get a burn.

Here it is - effective and safe way, which will help to quickly cope with all skin defects!

The lamp has no such disadvantages. It does not depend on the time of year and day, you can stay under it for a long time (only with breaks for feeding), there is no possibility of hypothermia or overheating. Recovery under it occurs much faster due to the emission of light of a certain spectrum, under the influence of which dangerous bilirubin is transformed into a compound that is easily excreted in urine and feces.

Is it worth it to be scared if the fontanel of a newborn is pulsating? How to calculate the average norm for the size of a child's crown? How soon should the fontanelle overgrow? What are the functions of the fontanelle? He will tell the answers to these and other questions.

Do you often travel by car? Then you just need to be right. To make a bargain purchase, you need to know the classification of the seats, how to install them in the car, as well as find out which brand is the best product.

If your baby turns yellow after birth, the doctor decides whether to treat it. If the doctor prescribes medications, after which the baby's body will require recovery, this is a signal that the doctor is not qualified enough. Consider looking for a new doctor!