When the baby’s skin turns yellow, they talk about the jaundice of newborns. This symptom, in some cases, may be a sign of a state as innocuous as the physiological jaundice of the newborn, in others it is a sign of quite serious diseases.
Let’s talk about the basic conditions and diseases of the neonatal period, which are manifested by jaundice.
This condition occurs in 100% of newborns, clinical manifestations occur in 60% of children.
For characteristics of physiological jaundice.: it appears not before 24 hours of life (usually 2-3 days of life), increases within 2-3 days, after which it begins to fade. The face and upper half of the body are more colored. This jaundice has an orange tint.
The liver, the spleen in this form does not enlarge, the anemia does not develop. The stools have a normal color (colored), the urine is light.
This is a transient physiological state. No special treatment is required.
It occurs as a result of the immaturity of the liver enzymes that are involved in the metabolism of bilirubin.
By conjugation of characteristic jaundice.:
- It appears in newborns older than 24 hours.
- It can increase within 5-6 days
- There is a more intense coloring of the skin. Painted face, torso, upper and lower extremities.
- It has a wavy flow. Icteric staining is expressed to a greater or lesser degree.
- The liver, the spleen in this form are not enlarged.
- No anemia
- It disappears at 3-6 weeks of life.
Conjunctural jaundice develops when the child’s body does not cope with physiological jaundice.
Treatment of jaundice of conjugation, As a general rule, conservative – most of the time it is phototherapy.
Jaundice of breastfeeding
The reason for this type of jaundice in a newborn is a large amount of prena-diol in breast milk (this substance inhibits the enzymes involved in the conjugation (binding) of bilirubin in the liver). A large amount of fatty acids in milk also plays an important role.
This jaundice, as described above, appears in newborns older than 24 hours of age. More often, it develops at 3-4 weeks of life. The intensity of skin staining can vary from light (only the yellow face and upper torso) to pronounced staining (staining of all parts of the body, including palms and soles).
It has an orange tint.
You should not forget this type of jaundice, especially if you notice prolonged jaundice in a newborn at 2 months.
This type of jaundice is characteristic., The fact that the baby receives only breast milk adds a good weight. There are no changes in the part of the internal organs, the liver and spleen are not enlarged.
There is no anemia.
For diagnosis Use a three-day test. For this, the child is weaned for 72 hours and observed. If jaundice is associated with breastfeeding, in 48 hours you can see that jaundice decreases.
After 72 hours, the baby can be applied to the breast and the jaundice has completely disappeared.
It is not paradoxical, but the prevention of this type of jaundice is the child’s frequent attachment to the breast (more than 8 times a day).
Jaundice in the hemolytic disease of the newborn.
The hemolytic disease of the newborn occurs when the blood groups of the mother and the child are incompatible. If it is not compatible with the Rh factor, they are talking about the Rh conflict, this happens when the mother has a Rh negative factor and the child has an Rh positive.
If there is no compatibility in the blood type, then this is a conflict in the ABO system, it occurs in the cases in which the mother has the group I (0) and the child has the II (A) III (B).
This type of jaundice is typical:
- It appears in the first 24 hours of life or from birth.
- Jaundice is very pronounced, all parts of the body are stained.
- The skin has a lemon tone.
- In this way, there is an increase in the liver, the spleen.
- There is anemia in the blood (reduction of the red blood cell count)
- For the diagnosis of special behaviors, serological reactions that allow you to identify the incompatibility of the blood.
This form always requires treatment. The doctor selects the treatment individually, depending on the severity, the clinical manifestations and the data of the tests.
Jaundice syndrome in the background of infectious diseases
The process of infection of any etiology always leads to hemolysis (death) of red blood cells. If a large number of red blood cells are broken down, then a large amount of bilirubin will enter the blood, which in turn leads to jaundice.
For jaundice in the context of infectious diseases, it is characteristic that it can appear on any day of the neonatal period. The degree of staining can be any, depending on the severity of the infectious process. A distinctive feature is the presence of signs of an infectious disease.
In this way, there may be an increase in the liver and spleen, and also in the blood – anemia.
The treatment is to eliminate the cause, that is, to fight the infection.
For all the previous states, an increase in the level of indirect bilirubin (unbound, insoluble in water) is characteristic.
The main methods of inactivation of indirect bilirubin are: phototherapy with the help of special legs and the replacement blood transfusion. Replacement blood transfusions are the most required for the hemolytic disease of the newborn.
Another type of jaundice is associated with an increase in direct bilirubin
If there is an increase in direct bilirubin, it is associated with pathology in the hepatobiliary system.
The pathology of the hepatobiliary system includes:
- Hepatitis, even against intrauterine infections
- Intrahepatic cholestasis of newborns
- Atresia of the biliary tract (obstructive jaundice).
For the treatment of the direct use of hyperbilirubinemia: hepatoprotectors, ursafalk, symptomatic therapy.
The treatment of jaundice in newborns is selected individually.
As you can see, jaundice is not always harmless for a child. The most important thing in time to recognize the cause and prescribe the treatment.
By following all of the doctor’s recommendations, you increase the chances of your baby’s rapid and complete recovery.