Obstructive jaundice in newborns treatment. Treatment of jaundice in newborns. Causes of prolonged conjugation jaundice

Physiological jaundice is normal condition newborn during the period of adaptation to new environmental conditions. Yellow coloration of the skin and eye sclera is caused by the accumulation of a coloring pigment in the blood - bilirubin. The baby's liver and kidneys are not able to immediately remove all excess bilirubin from the body, so this state is considered normal and is not a reason for treatment.

But this applies only to physiological jaundice. If the pathology is caused by diseases of the liver, bile ducts or gallbladder, the child needs urgent health care. For example, with biliary atresia of the biliary tract, a Kasai operation is vital for an infant, which must be performed before the child reaches three months of age. So that in case of any deviations, the baby can receive timely necessary help, parents need to know when physiological jaundice in a newborn should go away.

During intrauterine development Certain types of proteins accumulate in the child’s blood: hemoglobin, myoglobin and cytochrome. Their structure differs from the proteins in the blood of an adult. While the child is passing through birth canal and within a few hours after birth, hemoglobin breaks down and is replaced by other types of proteins that have different properties and functions.

During the breakdown of hemoglobin, bilirubin is released, the main component of bile, which functions as a coloring pigment. The organ that processes bilirubin and is responsible for its removal from the body is the liver. In a newly born baby, the liver is not able to produce the required amount of enzymes that destroy bilirubin, so it begins to accumulate in the body and cause characteristic symptoms: yellowing of the eye sclera and skin.

Note! If a woman has hormonal problems associated with increased synthesis of steroid hormones belonging to the group of estrogens, the likelihood of developing jaundice in a child will be more than 85%. The fact is that estriol and estradiol can accumulate in breast milk and enter the baby’s body, which will get rid of them first. Thus, excess bilirubin will be retained in the blood, and jaundice will last several times longer compared to infants whose mothers did not suffer from endocrine disorders.

How long does it last?

Yellowing of the skin in most children occurs on the third day of life - it is during this period that the replacement of blood proteins and the process of releasing bilirubin ends. Nurse in the postpartum department, every day she measures the level of bilirubin using a special photo device that is applied to the frontal part. A slight excess of the norm is considered acceptable, but the child is taken under special control.

On days 3-4 after birth, signs of jaundice can be seen without any instruments. The child’s skin becomes bright yellow, the sclera turns yellow, and the nail plates may turn yellow (the child’s nails are thin, and you can see through them yellow skin under the nails). When pathological jaundice The baby's skin may take on an unnatural lemon tint. At the same time, the child may experience the following symptoms:

frequent, restless crying;
poor appetite;
weight loss significantly exceeding normal;
inhibition of reactions and weakness of innate reflexes;
constant drowsiness with short periods of sleep (the newborn often wakes up and screams without opening his eyes);
discrepancy between the size of the abdomen and the physiological norms and weight with which the child was born.

If jaundice has physiological reasons, it passes on the 5-7th day of the child’s life. During this time, the child will receive therapy using special photo lamps. Healthy children are usually discharged from maternity hospital on day 5. If the yellowness of the skin does not go away by this time, the mother and baby can be left in the maternity hospital for a period of 7-10 days. This period is considered optimal for eliminating physiological yellowing.

Important! In some maternity hospitals with a small number of available beds, the mother may be discharged alone, and the child may be left for further treatment for another 3-5 days. Of course, a woman has the right to take the child and refuse treatment, provided that she undergoes necessary procedures at your place of residence, but doctors do not advise doing this. In the presence of pathologies of the liver and gall bladder, timely diagnosis is very important, so it is better to leave the baby under the supervision of specialists (if the attending physician insists on this), who will be able to provide the necessary assistance in case of an emergency.

The child is discharged with jaundice

The situation when a baby is discharged from the maternity hospital with signs of jaundice is quite common. There is nothing wrong with this, since in some cases, yellowing of the skin can persist for up to 3 weeks. Great importance the woman follows a diet for nursing mothers (it is necessary to exclude any products containing a large number of coloring pigments), as well as following all doctor’s recommendations. The child may be prescribed physiotherapeutic treatment, which the mother can undergo at a local clinic, but pediatricians do not approve of this approach due to the high risk of infection of the child.

If the mother notices that the baby’s yellowness does not go away, but the baby is being prepared for discharge, there is no need to worry. Before discharging such a child to mandatory carry out:

biochemical examination of blood and urine;
ultrasound examination of the liver, gallbladder and bile ducts;
Liver tests are a blood test that helps to create a clinical picture of the condition of the liver and evaluate the functioning of liver enzymes.

ALT indicators (liver tests) in children of the first year of life

The doctor observing the child must evaluate the dynamics of changes in the level of bilirubin in the blood and draw a conclusion about the nature of jaundice. If there are no signs of a pathological course in the child, he is discharged from hospital. medical institution, and the mother is given recommendations on the regimen, care and treatment (if necessary).

Jaundice appeared after discharge from the hospital

If jaundice first appeared after the baby was discharged from the maternity hospital, this may be an alarming sign. There may be several reasons for this condition:

hormonal problems in women who are breastfeeding;
endocrine disorders in the baby’s body;
errors in the diet for nursing mothers;
impaired metabolism;
viral infections (for example, hepatitis).

In some cases, late jaundice may be associated with Rh conflict between mother and fetus, as well as blood type mismatch (very rare). Regardless of what reason caused the appearance of such symptoms, the child should be shown to a doctor and have a blood test. If necessary, the doctor will prescribe an ultrasound and other diagnostic measures, allowing you to accurately determine the cause of the pathology.

The baby is in his second month, but the jaundice does not go away

If the baby is already 1 month old and the skin still retains a yellowish tint, an examination will be required. IN exceptional cases Physiological jaundice can persist for up to 3 months, but it is necessary to exclude a pathological nature.

In most cases, jaundice in infants older than 1 month indicates a serious illness that requires examination and treatment in a hospital. It is possible that the child will require surgical treatment.

Such diseases include:

biliary atresia (obstruction of the biliary tract);
cirrhosis of the liver;
damage to the liver or bile ducts that is mechanical in nature;
gallbladder diseases;
stagnation of bile and bile acids.

Important! All these diseases have a high mortality rate in infancy, so the symptoms of pathological jaundice should never be ignored. If 3-4 weeks after birth the signs of jaundice in the baby have not disappeared, you should go to the hospital.

How to determine that jaundice is disappearing?

The first sign indicating the child’s recovery is the gradual disappearance of the yellow tint. First of all, the mucous membranes of the organs of vision usually turn pale, then the skin of the abdomen and extremities. Signs of yellowness may persist on the face for the longest time, but they do not completely disappear 2-3 days after the appearance of positive dynamics.

The child's well-being also improves. The baby becomes more active, his periods of wakefulness increase, and sleep becomes longer and more restful. Behavioral changes also become noticeable. The child becomes calmer, attacks of sudden crying appear less frequently. If you carefully observe the baby, you will notice that he tries to fix his gaze on objects and begins to respond to the voice of his mother or another person who is caring for him.

All these symptoms together indicate that blood counts are returning to normal, bilirubin levels are decreasing, and the functioning of the liver and gallbladder corresponds to physiological norms.

Is treatment required?

Most babies have jaundice and go away on their own on the 7-10th day of life (maximum 3-4 weeks). Drug correction is usually not prescribed, but if the amount of bilirubin in the blood significantly exceeds the permissible norms, phototherapy sessions are indicated for the child. The baby is placed under a special ultraviolet lamp, covering the eye area with protective glasses. The duration of the procedure is determined individually, as well as the duration of treatment.

At home, it is recommended for the child to sunbathe. In summer they can be done throughout the day, but it is better to choose periods when the sun is not particularly active: morning (before 11-12 o'clock in the afternoon) or evening (after 16-17 o'clock). In winter, on the contrary, it is better to arrange baths between 13:00 and 16:00, since this is the time ultra-violet rays are the most active and penetrate well through the atmospheric layer. The procedure is performed as follows:

the baby must be completely undressed (including the diaper);
on a hard surface on which it falls sunlight, lay a thick diaper (it is better to use flannel);
Place the baby on the diaper and leave for 10-12 minutes, periodically turning him from his tummy to his back and back.

During the procedure, it is necessary to distract the child, tell stories or sing songs. He does not yet understand the meaning of the words spoken, but he perfectly grasps the intonations of a familiar voice that will help him calm down. If the baby continues to cry, you can pet him or pick him up by going to the window.

Important! Parents must ensure that there are no drafts in the place where the child is. It is also worth remembering that sunbathing is contraindicated if the child has an elevated body temperature.

If the cause of jaundice is viral infection, a course may be prescribed antiviral drugs, as well as enzymes that restore liver cells and improve the functioning of the organ. For blood diseases, iron supplements, as well as cytostatic (antitumor) drugs, can be used - their choice and the need to take them depends on what kind of disease caused the accumulation of bilirubin.

Jaundice is a physiological condition of a newborn baby, which in most cases does not require drug treatment. Normally, jaundice disappears on the 10th day of a baby’s life, but protracted forms also occur (up to 3-4 weeks). If the skin retains a yellowish tint, and the child is already a month old, you need to go to the hospital - the cause may be severe pathologies of the liver and biliary tract, requiring emergency surgical care.

Video - Jaundice

Video - Newborn jaundice

Don't be scared! Despite the severity of the name, “jaundice in newborns” is by no means a disease, but just a physiological symptom of certain processes that occur in the baby’s body while he adapts to new living conditions. What to do with a “golden” child, how exactly physiological jaundice occurs in infants, is it possible Negative consequences We will look into this phenomenon and whether jaundice in newborns requires any treatment.

Jaundice in newborns: why did my baby turn yellow?

For the sake of your maternal peace of mind, let us repeat: the fact that your newborn baby suddenly turned orange on the second or third day of life should in no way make you nervous or 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 “moving” from the mother’s womb into the light of day.

In order to understand exactly how a newborn’s skin changes color from romantically pink to hysterically yellow, it makes sense to recall some paragraphs from a school anatomy course:

The mechanism of jaundice. In human blood there are special red blood cells - erythrocytes, whose task is to carry oxygen and carbon dioxide throughout the body. Every day, approximately 1% of all red blood cells that rush through our body die (the lifespan of each red blood cell is no more than 120 days). When these cells collapse, they release a substance contained inside red blood cells - bilirubin - a special yellow pigment that is actively involved in hemoglobin metabolism. Bilirubin itself is a rather dangerous and toxic substance. internal organs, therefore, normally, as soon as the blood brings it to the liver, it is immediately neutralized by special liver enzymes. In medical language, the process of neutralizing the harmful yellow pigment in the liver is called “bilirubin conjugation.” The neutralized bilirubin then passes through bile ducts and is eliminated from the body by the excretory system.

If any link in this chain of formation and excretion of bilirubin is disrupted, the level of this substance increases, the yellow pigment penetrates the skin, coloring 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 an obvious symptom of a serious disease (for example, liver disease like hepatitis, acute poisoning, intoxication, inflammation of the gallbladder, stagnation of the bile ducts, etc. .).

Physiological jaundice in newborns is within normal limits

But jaundice in newborns is most often physiological norm. The point is that a child, as soon as he is born, has a very high level hemoglobin, which begins to sharply decrease in the new living conditions of the baby. In addition, a newborn baby has a not yet fully formed “army” of liver enzymes. In other words, in the first days of life, the newly born baby is simply physically unable to cope with the high level of bilirubin in her blood. That is why the baby is rapidly turning yellow.

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 harm. In medicine there is even a term - physiological jaundice of newborns. Physiological means natural, normal, without pathology.

So, even if you are in this 60%, there is no reason to be afraid. And if it happens that the child was born premature (which means that he has even fewer capable liver enzymes than a healthy toddler), then you have an even greater chance of admiring his yellow color - 80-90% of all babies born prematurely , experience physiological jaundice of newborns.

Those at risk for jaundice in newborns include babies whose mothers have diabetes, as well as twins (twins, triplets, etc.)

Normally, jaundice in a newborn baby should go away within two to three weeks. But what to do in cases where the child turns yellow naturally, but doesn’t seem to be going back to pink, even after three weeks?

Why does a baby's jaundice not go away after 21 days?

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

1 As a result of any disease of the child, the destruction of the red blood cells of his blood occurs intensively and constantly (for example, with hemolytic disease, which often develops in children whose Rh factor differs from the maternal one). Accordingly, the level of bilirubin in the blood is constantly increased.
2 The liver’s function has not developed properly (for example, due to hereditary 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 disruption of the functioning of this particular organ. For example, a baby may have an obstruction biliary tract- in this case, jaundice is called mechanical.

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

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

Jaundice in newborns can last for over 21 days and for no reason at all. After all, every baby is individual and not a single child’s “aesculapian,” even the most outstanding medical genius, can predict the exact dates when he will learn to walk, when he will learn to speak, and when his liver will learn to process bilirubin.

As a caring and intelligent parent, you must understand that a newborn baby (as well as an older child) is in itself an excellent indicator of its physical condition. Simply put, if your baby has turned yellow and has continued to stay that sunny tone for over three weeks, but he is not showing any signs of distress - not crying, eating with appetite, gaining weight, regularly filling his diapers and sleeping soundly, then there is no reason You shouldn’t have to worry about prolonged jaundice.

The only thing you need to do is, with the help of an experienced and observant pediatrician, begin to regularly monitor the level of bilirubin in your baby’s blood.

Jaundice in newborns - consequences for everyone

During those couple of weeks, while the level of toxic bilirubin in the newborn’s blood was elevated and his skin had a “golden” tint, 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 has prolonged and gone beyond 21 days (which means the level of bilirubin in the body continues to remain high), it is imperative to contact a pediatrician and put the baby’s bilirubin “on the counter” - that is, it must be constantly measured and monitored. If the bilirubin level remains above normal, but does not tend to increase, there is no need to be alarmed; under the systematic supervision of a reasonable doctor, such jaundice does not threaten the child with any serious consequences.

Jaundice in newborns can pose 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 may be caused to the baby’s central nervous system, his liver, etc. But if you consulted a pediatrician in time, no responsible doctor would simply allow such a development.

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

Treatment methods for jaundice in newborns

It is not entirely correct to talk about the treatment of jaundice itself in the context of newborns - since this, as has already been said fifty times, is not a disease, but only a symptom.

If jaundice is a symptom (indicator or consequence) of some serious disease, then, naturally, it is not jaundice that is treated, but this very disease. But no disease can be cured overnight, and there are situations when, simultaneously with therapy, it is necessary to reduce the level of bilirubin in the blood, which is dangerously “creeping” to a critical level.

Even 15-20 years ago, in a situation where the level of bilirubin became alarmingly dangerous and could cause irreparable damage to the baby’s central nervous system, the child was given an exchange 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 fight against increased bilirubin- a bright lamp!

Phototherapy for jaundice: let there be light!

Scientists made this discovery by accident - during 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 common method of treating jaundice in newborns today was “born” - phototherapy.

The point is simple: if the baby’s bilirubin level is elevated and no positive dynamics are observed, he is laid out naked, but with protection over his eyes, under a bright lamp: sometimes for several hours a day, sometimes for several days (around the clock with breaks only for feeding and hygiene and massage).

The phototherapy method is good, safe and very common. He returned many children to their usual skin color, and their parents - peace of mind.

Breastfeeding jaundice: mother gilded

There is another type, fortunately, completely safe jaundice, which can be observed 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 are fed their mother's milk.

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

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

Moreover, this type of jaundice, as a rule, smoothly “takes over” from physiological jaundice and can last much longer than 21 days completely safely for the baby.

If you are scared and you want to make sure at all costs that your “orange” baby has safe jaundice breastfeeding, and not some kind of symptom dangerous disease- Stop breastfeeding for 1-2 days (give formula). If the yellow color of the skin noticeably brightens, 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, it is not you who should decide what to do with him if he turns yellow. And the health workers. And deal with it.

Find out whether your baby’s jaundice is dangerous (that is, is it a symptom of a serious illness?) or completely harmless, treat it or be patient and just wait, and if treated, then in what way - all these issues can only be resolved by pediatrician. Your task is to present your newborn to him for examination and tests.

Because in the case of jaundice in newborns, the probability of making a mistake is very high: a completely normal physiological state can be mistaken 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?

Every loving and attentive mother always notices even the most minor changes in her child’s body. What can we say about changing the color of the skin to an unusual color. But don’t be immediately alarmed when you notice a yellowish tint to your child’s skin and eyes. After all, we are not talking about a terrible and life-threatening disease, but about natural process in the body of a newborn – physiological jaundice.

First, let's figure out what are the causes of physiological jaundice in newborns and whether everything is really so scary. To understand the entire mechanism of occurrence (pathogenesis) of physiological jaundice in newborns, we will need to delve into biology and directly into anatomy in order to compare the functioning features of the liver of an adult and an infant.

Pathogenesis and norm of bilirubin in physiological jaundice in a newborn baby

The human body is supplied daily with oxygen and carbon dioxide, and this is done thanks to erythrocytes - red blood cells. Red cells are constantly renewed, and old red blood cells break down into molecules, releasing a special substance - bilirubin - a yellow pigment that is excreted by the liver. It is the cause of physiological jaundice. Since the liver of a newly born child is not yet functioning properly, it is not able to cope with such a high amount of bilirubin. This is why the baby's skin and eye sockets acquire such an unusual color. Indeed, any doctor will say that at a certain period physiological jaundice of newborns is considered normal.

An interesting fact is that physiological jaundice can be observed in 60-70% of healthy full-term newborns. After some time it passes without a trace and does not pose any further danger. If a child was born premature, then the opportunity to observe such a “colorful” baby is 80-90%. Twins and children whose mothers are sick have the same chances.

At the same time, the norm of bilirubin for physiological jaundice for a full-term newborn at 14-21 days is 90-120 µmol/l, for a premature one – 65-90 µmol/l.

Date of appearance and when physiological jaundice disappears in full-term and premature newborns

The timing of the appearance of physiological jaundice differs: in full-term infants it appears already on the second or third day after birth, in premature infants - on the fifth or seventh.

The signs of physiological jaundice are specific, so let’s look at what exactly in the child’s condition indicates this process:

Coloration of the skin and mucous membranes in an orange tint.
The extinction of the process occurs on the 7-10th day of life.
Disappearance of symptoms at 2-3 weeks of life in full-term infants, at 3-4 weeks in premature infants.
Absence of disturbances in the general condition of the child.
Hemoglobin and red blood cell readings are normal.

First of all, the face is painted yellow, then the neck, torso and limbs. A decrease in bilirubin levels is characterized by a change in the color of the legs first, then the torso, limbs, and lastly the face and neck. Taking into account the symptoms, we can say that it is quite simple to diagnose physiological jaundice.

The duration of physiological jaundice in newborns may vary. For example, breastfed children have an advantage; for them the process will take less time. Naturally, any parent wants to know when physiological jaundice in newborns goes away. At approximately 6-7 days, the skin already takes on its normal appearance; after a maximum of 14-21 days, not a trace of the yellow color of the integument is visible.

Treatment of physiological jaundice in newborns at home

Another frequently asked question is what treatment is prescribed for physiological jaundice. In fact, no drug intervention is needed. Since it is natural and absolutely normal process, then none medical assistance is not required, and all symptoms will disappear on their own. But given the full term and weight of the child, treatment of physiological jaundice of newborns is sometimes used. In rare cases, light and phototherapy is prescribed, but only when the indicators are dangerous, according to doctors. Modern specialists have practically abandoned therapy this phenomenon Therefore, parents treat physiological jaundice of newborns at home. Firstly, they increase the duration of the baby’s stay at fresh air and try to walk with him longer. Secondly, of course, breastfeeding is used. Breast milk increases the baby's immunity and gives him the strength to improve the body's functioning.

It’s a completely different matter if after 21 days the symptoms have not disappeared and no changes are observed. Here we are talking about prolonged physiological jaundice in children of the first year of life

This term defines the preservation of this disease in a child older than 1 month and does not apply to newborns (up to 28 days of life). Normally, by about 2-3 weeks, the jaundice of the first days of life “goes away”, the baby’s skin and mucous membranes acquire a normal color. In some healthy children this does not happen, and jaundice of the skin and/or mucous membranes can last up to 1-3 months of life. In most cases, this course is not a pathology.

In short, the cause of prolonged jaundice in a healthy child is the functional immaturity of liver enzymes that “process” bilirubin, which in turn is subsequently excreted with bile through the intestines. As you already understand, the causes and consequences of physiological jaundice in newborns is a broad topic of discussion.

Causes of prolonged conjugation jaundice

In children in the first month of life there are different types of this disease. One of them is conjugation. With this type of disease, the accumulation of bilirubin in the body is associated with a violation of the conversion of its indirect fraction into a direct one. Usually this type of this pathology appears on the third day of life. In this case, no enlargement of the spleen or liver is observed. Stool and urine are also colored Orange color. If your child continues to have icteric skin discoloration and unusual behavior: lethargy, drowsiness, breast refusal, poor weight gain, parents should contact their local pediatrician.

Long-term persistence of icteric skin discoloration in a newborn requires mandatory examination. It must certainly consist of a general blood test, determination of the level of total bilirubin and its fractions in the blood serum, liver function indicators, a general blood test, a hemolysis test (Coombs test), ultrasound examination organs abdominal cavity, and, if necessary, consultation with specialists to clarify the diagnosis and timely treatment.

In case of prolonged conjugation jaundice, the child should be carefully examined. The causes can be either improper feeding or infection.

The neonatal form is one of the types of conjugation pathology. For the most part, this is a physiological manifestation, but there are also pathological cases. Exist various reasons occurrence of this condition:

heredity;
birth injury;
asphyxia;
presence of diabetes mellitus in the mother;
, or ;
sepsis, etc.

As a rule, physiological neonatal jaundice in a child goes away on its own in the third week of the newborn’s life. If we are talking about pathological prolonged neonatal jaundice, then the clinical picture will look slightly different:

It appears already on the first day of the baby’s life and lasts more than 3 weeks.
The level of bilirubin in the blood is very high.
The liver and spleen often become enlarged, stool may become discolored, and urine may become dark in color.
Sometimes bruises and pinpoint hemorrhages spontaneously appear on the skin of a newborn.

Clinical manifestations of prolonged jaundice:

Body weight loss and gain per month is less than 500 g.
Unusually "big belly".
Frequent heavy regurgitation that appeared at 3-4 weeks, especially accompanied by weight loss.
Unusual skin color or shade against a background of jaundice.
Changes in the child’s consciousness, either acute or increasing: drowsiness, lethargy of the child.
Prematurity or immaturity.
The appearance of jaundice in a bottle-fed baby.
The appearance of jaundice after several weeks of its absence.
Predominance in biochemical analysis blood direct fraction of bilirubin or an equal ratio of direct and indirect fractions.
Any diseases that are identified during the examination.
, especially with a high level of reticulocytes.

Treatment and consequences of prolonged neonatal jaundice

To understand what treatment to prescribe for prolonged neonatal jaundice, it is necessary to conduct a number of studies to determine the cause of the disease. Appointed general analysis blood and urine, x-ray of the abdominal organs, consultation with a surgeon and gastroenterologist, blood test for hormones, as well as serological diagnostic methods. Only after receiving the results can the pediatrician prescribe appropriate therapy.

Oddly enough, due to the naturalness of its phenomenon, physiological jaundice in newborns does not cause any consequences. It passes after some time without any changes in the body. But in some cases, negative phenomena also occur. Pathological prolonged jaundice in newborns can even cause the following serious complications:

Toxic poisoning of the brain and nervous system.
The emergence of a nuclear disease state.
Involuntary muscle contractions (in later stages).

All these consequences depend primarily on the cause of prolonged jaundice, the correct established diagnosis, treatment and whether the pathology was diagnosed on time. Don't miss out!

Infants with prolonged jaundice can be examined on an outpatient or inpatient basis. Such children should be hospitalized in the pediatric department. Mandatory inpatient examination (round the clock) is required only for children with significant underweight, severe jaundice (according to a blood test, a high level of bilirubin) and identified diseases.

If a child has insufficient weight gain, the first thing to do is improve nutrition. Most often, after achieving optimal gains, jaundice goes away on its own, if it is not associated with any disease. Positive weight gain can be achieved by correcting the organization of breastfeeding (more frequent feedings, correct attachment, etc.). If this cannot be done, then it is necessary to supplement the baby with expressed breast milk or adapted formulas. If insufficient gains are associated with some disease, then the latter should be treated against the background of nutritional correction.

Methods for treating prolonged jaundice are varied: both ordinary maternal tricks (a bottle of sweet water) and procedures prescribed by a doctor are used. The most important thing is breastfeeding at least 8-10 times a day. This promotes cleansing digestive system from excess bilirubin naturally. And breastfeeding in the first hours of a child’s life generally serves to prevent the occurrence of of this disease. After all, colostrum helps remove the first natural secretions. And it is not at all necessary to move to a hospital room for phototherapy; you can use a photooptical bilirubin blanket at home. The most important thing is not to panic or be nervous, because the parents’ mood is transmitted to the child.

This article has been read 7,816 times.

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

Some people take this phenomenon calmly, knowing that this is the norm. Some people go crazy, considering this symptom dangerous and requiring hospitalization and treatment. Both are wrong. In this matter, the golden mean is very important: you can’t take it too lightly, but you shouldn’t panic either. Let's figure out why.

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

Doctors call following reasons jaundice in newborns:

pathogens that attack the liver;
disturbances in the structure or functioning of the bile bladder 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 at the mother's;
genetics;
diseases of the circulatory system;
asphyxia;
hormonal disorders (the child will be treated by an endocrinologist);
incompatibility: blood group I in the mother, blood group II or III in the child;
intrauterine infection;
stomach problems, when bilirubin is constantly absorbed back into the body - in such situations, only surgery can save you;

These are the main causes of jaundice in newborns. Each of them has its own characteristics. In some cases, bilirubin is gradually eliminated by the body without consequences. But there are forms of the disease that require immediate medical attention. Depending on the factors that provoke the development of jaundice, doctors name risk groups.

Medical terminology. The concept of “bilirubin” goes back to the Latin words bilis, which means bile, and ruber, which means red.

At-risk groups

Even during pregnancy, doctors include 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;
previous premature birth;
smoking, alcoholism, drug addiction during pregnancy;
negative Rh factor;
intrauterine infections;
jaundice in previous children.

Women who are at risk are under the constant 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 to prevent the disease. It is very important to recognize it in time by characteristic features, which will help distinguish one type of jaundice from another.

The truism. 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 of jaundice in newborns who, under normal conditions, without laboratory research, difficult to install. This is very important point, since the need for further treatment and the risk of possible complications will depend on the type of disease.

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 appears in the first month of the baby’s life, but not immediately after birth. Represented by the following types.

Carotene

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

Breast milk jaundice

This postpartum jaundice occurs when the 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 cancellation of lactation.

Neonatal

Neonatal jaundice is the most common type. It is not a pathology and does not require treatment. It goes away on its own and does not cause complications.

Pathological

Associated with serious diseases of the baby’s internal organs. It appears within a few days after birth. Presented in different types.

Hemolytic

Caused by problems with the circulatory system: due to Rh conflict between mother and baby, mismatch in blood groups, incompatibility in antigens. Occurs only in 1% of cases. This is birth 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 function of the bile bladder and bile ducts. Most often the cause is birth trauma or. It appears only 2-3 weeks after birth.

Nuclear

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

Conjugative

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

Hepatic

Diagnosed after liver cells are damaged by bacteria or viruses.

The physiological jaundice of newborns, which is not dangerous and goes away on its own, should not frighten parents. Everything is much worse if it is dictated by serious pathologies inside the body. Symptoms of the disease allow you to suspect something is wrong and promptly consult a doctor.

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

Symptoms

Depending on the type of disease, the symptoms of jaundice may 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 are added warning signs more serious pathology, this must be reported to the doctor - and as quickly as possible.

Signs of physiological jaundice

The skin and whites of the eyes acquire a yellow, almost orange tint;
minor stool disturbances.

Symptoms of pathological jaundice

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

Clinical picture of specific pathologies

Lethargy, refusal to eat, monotonous cry, throwing back the head, convulsions, attenuation of the sucking reflex - symptoms of kernicterus;
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 diagnosis reveals an enlarged spleen and liver - this is hemolytic jaundice;
the skin acquires a yellow tint with a greenish tint 2-3 weeks after birth, the stool is abnormally light, the liver is compacted, the spleen is enlarged - symptoms of a mechanical type of disease.

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

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

Diagnostics

Only laboratory indicators can accurately determine which jaundice a newborn has - 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 of the abdominal cavity;
consultations with an endocrinologist, surgeon and other specialists.

Table of bilirubin norms in newborns

Table of normal indicators of direct and indirect bilirubin

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

Helpful information. The Coombs test is performed immediately after birth using blood from 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, no therapy is required. If pathology is detected, treatment can take on different directions: antiviral, antibacterial, choleretic, detoxification or immune.

Medications

If bilirubin levels are off the charts, prescribe special drugs from jaundice.

Ursofalk is a medicine for jaundice for newborns in the form of a suspension aimed at protecting and maintaining normal operation liver. Prescribed for prolonged jaundice. Dosage - 10 mg per 1 kg of weight.
Hofitol is another effective cure for jaundice in the form of a solution based on natural artichoke extract, which activates the flow of bile and simplifies the functioning of the liver. Prescribe 1 to 3 drops 3 times a day.
Infusion therapy with phototherapy for recovery water balance: glucose solutions, electrolytes, soda, membrane stabilizers, cardiotrophics. Protracted jaundice necessarily requires such treatment.
To normalize liver function, Zixorin, Phenobarbital, and Benzonal may be prescribed.
When bilirubin is absorbed by the intestine, sorbents are used: Enterosgel, Polyphepan, Smecta, Activated carbon.
Fat-soluble vitamins: cholecalciferol (D3), retinol (A), tocopherol (E), phylloquinone (K).
Microelements: phosphorus, zinc sulfate, calcium.

Interesting fact. The drug for jaundice Urosofalka is based on ursodeoxycholic acid, which is found in bear bile. Today they have learned to produce it in laboratory conditions.

Procedures and phototherapy

For this disease, a decision may be made on the following procedures:

blood transfusion in the diagnosis of kernicterus;
liver transplantation for cirrhosis.

Also, with jaundice, the child needs sunlight, but in this at a young age they can be dangerous, so treatment with a lamp is prescribed - phototherapy. When exposed to bright light, harmful bilirubin is actively eliminated. This procedure is absolutely safe. The baby is placed under it for several hours a day if there are no complications. If the disease is severe, he will be under it for almost the whole day.

Phototherapy device 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 maternity hospital. But this is only possible in cases where blood tests are in order, the bilirubin content in the body does not go off scale and there are no internal pathologies doctors didn't find it. Accordingly, the baby does not need to be healed at home.

Folk remedies

Self-treatment at home for jaundice in a newborn is carried out only with the permission of a doctor. Even the most harmless, at first glance, remedy recommended by a neighbor or mother can be very dangerous for a small organism, many of whose systems are still adapting to the 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 grams of powdered carbon in 50 ml of boiled water warm water, give the baby 1 pipette every 2 hours;
rosehip decoction;
infusion of corn silk;
after feeding, apply a bandage soaked in a magnesium solution to the newborn on the liver side;
tea “Collection for a nursing mother”: drink 1 liter daily.

You cannot use several remedies from this list at once, because many of them are mutually exclusive or their combination will have too powerful an effect on a small organism. A newborn suffering from jaundice will benefit greatly from proper care.

Secrets of herbal medicine. 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 worried parents do in such a situation? Proper care for a newborn will ease his condition and speed up recovery. Here are the points it includes.

For a few minutes a day, place the undressed child in the sun's rays.
Frequent feeding and drinking plenty of fluids normalize liver function.
For galactosemia, feed the child with formulas without lactose and galactose: Nutramigen, Pregistimil, lactose-free NAN.
For tyrosinemia, a diet is required: mixtures without phenylalanine, methionine, tyrosine (HR Analog, Afenilak, Lofenolac).
Complete breastfeeding.
Mom's diet: exclusion of yellow foods, spices, pepper and salty foods from the diet.
Daily walks in the fresh air.
Phototherapy at home.

If any of the points of care for a jaundiced newborn are in doubt, it is better to consult a doctor, but do not do anything on your own or experiment. You need to be especially careful when treating with sunlight, which can cause burns in summer. With the right approach to this issue, you can speed up recovery and avoid complications.

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

Complications

Parents are worried about the danger of jaundice in newborns, and how this disease can end in the end, other than recovery. The physiological form is rarely fraught with complications. But pathology can lead to the following consequences:

Sometimes prolonged jaundice in newborns can cause complications that subsequently affect the nervous system, since indirect bilirubin has a toxic effect on the central nervous system.
Phototherapy with an incorrectly chosen treatment regimen can lead to burns, dehydration, hemolysis, lactose intolerance, etc.
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 lesion.

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

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

Prevention

The expectant mother should be involved in the prevention of jaundice even while carrying the baby and after his birth. To do this, it is enough to follow the following rules.

Adequate nutrition for the mother during pregnancy.
Her refusal of bad habits.
Prevention and treatment of any diseases.
Refusal of vitamin K injections to newborns, which are practiced in maternity hospitals.
Sunbathing.
Frequent breastfeeding.
Drinking plenty of fluids for a nursing mother.
Cutting the umbilical cord in the second hour after birth, when the pulsation at the base of the navel stops. This will allow blood circulation to normalize.

By preventing jaundice, you can prevent the disease so that nothing overshadows the baby’s first days. If you have any additional questions about this phenomenon, it is better to find out all the information from your pediatrician in advance.

Controversial issue. Doctors are still arguing about how the timing of cord cutting affects the manifestations of jaundice. About the direct dependence of these two facts scientific evidence No.

FAQ

When should jaundice go away in newborns?

The answer to the question of how long it takes for jaundice to last in newborns depends on the type of disease and the individual characteristics of the body. Normally, physiological jaundice disappears after 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 breakdown 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 if the disease recurs, an urgent consultation with a doctor is required to rule out complications.

On what day does jaundice appear in a newborn?

It can begin 4-5 days after birth.

Whynewborn's jaundice does not go away 1or even2 months?

There may be several reasons for lingering jaundice:

the bilirubin excretion cycle has failed;
liver dysfunction due to a birth defect or hepatitis;
stagnation of bile due to disturbances in the functioning of the biliary tract and gallbladder;
the formation of more and more new bilirubin due to blood diseases.

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

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

Often, while still in the maternity hospital, looking at the baby, we notice that the color of his skin has changed - it has acquired a yellowish tint. This phenomenon is called neonatal jaundice. The whites of the eyes and visible mucous membranes may acquire a yellowish tint. Experts distinguish 2 types of neonatal jaundice:

Physiological (conjugation).
Pathological (nuclear, hemolytic).

There is a certain risk group of babies who may develop neonatal jaundice:

premature babies;
children of mothers who have diabetes;
twins.

Neonatal jaundice: causes

While conducting research, modern specialists have proven that the appearance of jaundice on the baby’s skin is also affected by:

maternal nutrition during pregnancy;
deterioration of the pregnant woman's health;
bad habits of the expectant mother;
iodine deficiency in a pregnant woman;
unfavorable state of the environment;
conducting medicines into the body of a pregnant woman during childbirth or during breastfeeding.

All of the above factors influence the underdevelopment of the fetus in the womb and premature birth, when the baby’s organs are not yet fully formed to function well. And underdevelopment of the fetus negatively affects the body’s ability to transport the bilirubin accumulated in the baby’s blood after birth to the liver for removal from the body. And so, when the body cannot remove bilirubin completely and in a timely manner, then a jaundiced coloration of the child’s skin and mucous membranes occurs.

Physiological or conjugation jaundice: causes

Any yellowness of the skin is associated with increased level bilirubin in the blood of a person, even a newly born one. Bilirubin is a substance that is formed after the breakdown of red blood cells. In the womb, the baby has a large number of red blood cells that carry hemoglobin. After birth small man does not need so many of them, and therefore they are destroyed. Bilirubin, formed after their breakdown, must enter the liver with the blood and be excreted through the urine and first feces of the newborn.

While bilirubin “gets” to the liver, it can be partially absorbed into the baby’s blood and stain his skin and mucous membranes. Jaundice occurs due to underdevelopment in infants of the systems that are responsible for the exchange of bilirubin in the blood.

Physiological jaundice of newborns appears 2-4 days after birth. This type of jaundice disappears within a maximum of 2-3 weeks after birth in full-term babies (3-4 weeks in premature babies), without medical intervention or disruption of the general condition of the child. But fading, that is, less jaundice, should begin at the end of the first week of life.

Physiological jaundice: symptoms

baby's orange skin tone;
the general condition of the child is normal;
hemoglobin concentration is normal;
urine and feces are naturally colored.

Physiological (conjugation) jaundice: consequences

Physiological jaundice, which disappears within 2-3 weeks after birth without any complications, has no consequences for the vital functions of the child’s organs. If in the maternity hospital they tell you that the baby has jaundice, but they don’t do any tests, and you don’t observe capriciousness and refusal to breastfeed, then you have physiological jaundice.

Physiological (conjugative) jaundice: treatment

Such jaundice does not require medical intervention if there are no disturbances in the general condition of the baby. In the maternity hospital, the course of this disease is monitored daily by pediatricians who assess the degree of jaundice of the child every day and decide whether there is a need for a blood test to determine the amount of bilirubin contained in the blood.

After discharge, the parents monitor the baby at home, checking every day to see if the jaundice has become stronger. If it fades away, then you should not see a doctor. If you notice that the baby’s skin has become yellower than before, you should consult a doctor for advice.

Sometimes after discharge a 5% glucose solution is prescribed for jaundice, which after 1-1.5 should help relieve jaundice in non-pathological cases.

The sun's rays have a beneficial effect on the mood of mother and baby, and good medicine from physiological jaundice.

Pathological jaundice of newborns

As stated earlier, newborn jaundice can be of two types. One of them is discussed above (physiological), but the second type - pathological jaundice of newborns - is not as harmless as the first type.

If jaundice continues for more than a month, then you should start to worry. Most likely, you are faced with the pathology of jaundice. You cannot do without a blood test and consultation with an experienced doctor.

Types of pathological jaundice:

Nuclear.
Hemolytic.

Pathological jaundice of newborns: symptoms

Pathological jaundice of newborns occurs on the first day after birth, in contrast to physiological jaundice. Also, a distinctive indicator of the pathological course of this disease is the duration of the yellow color of the child’s skin (more than 3 weeks) and the high level of bilirubin in the blood.

Another symptom is lethargy, refusal to eat, or suppression of the sucking reflex. A child with yellow skin color may be lethargic and drowsy. Muscular hypertension and a baby's monotonous cry can also indicate a pathological course of newborn jaundice.

Along with a long-term course of jaundice (more than a month), the child may experience a constant yellow color of the skin and mucous membranes, darkening of urine and discoloration of feces - this is the main thing that even parents can notice at home.

If symptoms are not noticed in time, they may appear more severe symptoms: convulsions, bradycardia, high-pitched scream, stupor and coma.

Nuclear pathological jaundice of newborns: causes

Pathological jaundice of newborns occurs due to excess bilirubin in the baby’s blood. The main reason for the occurrence of excessive amounts of bilirubin in the blood of an infant is the lack of enzymes in the body that supply bilirubin to the liver. The absence of such enzymes is associated with:

prematurity;
massive hemorrhages on the child’s skin and head;
very pronounced jaundice in previous children, if they were in the family.

Most of all, of course, the likelihood of developing such a course of jaundice in a newborn is precisely in premature babies, since their organs are not ready for independent life without the participation of the mother’s body.

Nuclear pathological jaundice: consequences

Kernicterus received this name because, penetrating into the baby’s blood, it reaches the brain and affects the nuclei of its cells. Kernicterus of newborns in the absence of timely and proper treatment may lead to mental retardation and physical development, to cerebral palsy, deafness, decreased vision up to blindness. The activity of the entire nervous system is disrupted, and a very serious neurological defect occurs. In some cases, kernicterus leads to paralysis of the child.

Nuclear pathological jaundice: treatment

An excessive amount of bilirubin in the blood should be determined in the maternity hospital. Experienced doctors must eliminate the main reasons for the increase in the concentration of this substance in the baby’s blood.

The most common way to eliminate excess bilirubin from a baby’s blood is phototherapy. Phototherapy usually uses quartz lamps, which can break down the bilirubin accumulated in the newborn's skin. As long as indications exist, phototherapy sessions should be repeated regularly. The optimal phototherapy regimen for most newborns is sequential alternation of phototherapy sessions with breaks for feeding.

There is also the possibility, if not very heavy currents kernicterus, use droppers with special drugs that help remove excess bilirubin from the child’s body. Droppers with a 5% glucose solution are used.

In particularly severe cases, they resort to replacement blood transfusions in order to completely cleanse the small body of excess bilirubin cells that negatively affect its vital functions.

Hemolytic pathological jaundice: causes

It’s not for nothing that women who register with antenatal clinic for pregnancy, they take a whole group of tests at once. One of these tests is a blood test to determine the group and Rh factor. If a woman ends up with group 1 or a negative Rh factor, then they definitely require that the future father also be tested for the group and Rh factor.

This is done in order to prevent the subsequent occurrence of a “conflict” between the blood of the mother and the fetus. Such conflicts can lead either to pathologies of fetal development or to miscarriages.

Thus, another reason for the accumulation of bilirubin in the child’s blood may be a mismatch of the blood groups of the mother and child or a mismatch of Rh blood (the mother is negative and the child is positive).

Hemolytic pathological jaundice: consequences

Like the symptoms, the consequences of this jaundice are the same as those of kernicterus, since both of them interfere with the excretion of bilirubin from the body, leading to its absorption into the blood and affecting all vital organs.

All children who have suffered hemolytic jaundice are observed by a neurologist, ophthalmologist, or orthopedist monthly for a year. Such children are given a one-year exemption from vaccinations.

Hemolytic pathological jaundice: treatment

As for pathological kernicterus, both phototherapy and an IV can be used. But most in an effective way is an exchange blood transfusion, which instantly relieves the baby of excess bilirubin.

If the doctor thinks surgery impractical, then most often a course of droppers is carried out, since the lamp in this case can be a waste of time.

How can you tell how serious your newborn's jaundice is?

If yellowness of the baby’s skin and other symptoms of the pathological course of this disease appear in the maternity hospital, then it is considered necessary to take the baby’s blood for analysis. The analysis is taken from a vein on an empty stomach. According to the results of tests that show the level of bilirubin concentration in the blood, the doctor prescribes treatment or says that everything will go away on its own.

There is a norm for the concentration of bilirubin in the blood of a newborn - 255 µmol/l. If this norm is exceeded, conservative or surgical treatment(depending on the degree of excess of the norm). But even if the norm is met, but your baby is low weight, then the pediatrician may consider it necessary to carry out conservative treatment phototherapy or IVs.

Prevention of neonatal jaundice

The best way to prevent newborn jaundice is early and frequent breastfeeding. Colostrum is a natural laxative that causes more quick exit meconium in a baby, which also releases excess bilirubin.

Since children who have increased bilirubin are very sleepy, they should even be woken up for feeding: when the time is right, but the baby does not wake up. There are times when breastfeeding is the cause of jaundice (mother's diabetes), but even in this case, giving up breastfeeding is not encouraged.

Thus, jaundice of a newborn is the acquisition of a yellowish tint to the skin and visible mucous membranes of the baby due to excess bilirubin content in the baby’s blood. It may appear on the first day or after 2-3 days.

There are two types of jaundice: physiological - practically harmless and goes away on its own 2-3 weeks after birth; and pathological - a serious excess of the amount of bilirubin in the blood, which without medical intervention can lead to serious consequences: paralysis, deafness, blindness and mental and physical retardation. When jaundice manifests itself, the main thing is daily monitoring of the baby’s general condition and the degree of yellowness of the surfaces.

Replies