Jaundice is a special symptom that manifests itself in infants in the form of a change in skin color and sclera of the eyes. Yellow color is manifested depending on the intensity of the pathology. Jaundice in newborns does not require treatment at home in all cases. Quite often, the symptom decreases as the baby grows older. However, there are other types of disease (for example, intrauterine) that require the appointment of adequate therapy. Parents should be aware of the nature and causes of the pathology. A pediatrician will help to cure her, who prescribes a course based on the results of the patient's tests.
Today, phototherapy is most often prescribed, a special diet for a nursing mother. The use of sorbents and other drugs, bathing in a bath of herbs also has a positive effect. It is also recommended that you regularly drink a special solution of glucose along with a decoction of wild rose.
Causes of the appearance of pathology
Most often, jaundice in newborns manifests itself immediately after birth. The situation is considered normal, because it is caused by the following factors:
- In the skin, the process of decay of fetal hemoglobin continues.
- Bilirubin accumulates in the blood. This is a special substance that gives the skin a characteristic yellow color.
With jaundice in the baby’s body, the course of natural processes is disrupted:
- In the mother, a violation of the production of hormones is recorded. Estrogen has a direct effect on breast milk. To remove it from the body, it will be necessary to use additional resources of the gastrointestinal tract.
- A woman does not adhere to a special diet during lactation.
- The baby has not yet fully formed the liver and some organs of the biliary system.
For a newborn, the manifestation of jaundice is considered normal in the period from two weeks to a month. During this period, the color intensity may vary.
Bilirubin is a special substance that has the property of accumulating in blood serum. The process occurs only if the baby has not yet fully matured the liver. Against this background, an insufficient outflow of bile is recorded. Products are absorbed into the intestinal wall without prior disinfection.
If bilirubin accumulates in blood in large quantities, then the risk of intoxication increases in the child's body. The symptom is serious and can lead to complications in the human body. Toxic substances adversely affect the brain and its trunk, so a baby can develop a number of neurological diseases.
Children with jaundice should be under the constant supervision of a doctor. Dynamics is analyzed within two weeks. If there is no obvious improvement, then it is advisable to start a course of drug therapy.
There are neonatal types of pathology that pose a serious threat to the baby’s health:
- If hemoglobin breakdown was recorded inside the womb, then the baby develops a hemolytic disease.
- Liver cells were affected due to the presence of intrauterine infection in a woman.
- Anomalies are present in the digestive tract. In this case, obstructive jaundice is diagnosed.
In such cases, treating jaundice in newborns should be immediate. However, at the first stage, the causes and diagnosis are established. Next, the doctor needs to track the dynamics of changes in bilirubin. Only then can you choose between folk and drug methods. Additionally, a woman should adhere to a special diet. Products that lead to an exacerbation of pathology are completely excluded from the diet. In this case, it is possible to prevent infection of the liver and disturbances in the gastrointestinal tract.
What is jaundice in newborns?
Jaundice - yellow staining of the skin, sclera and mucous membranes due to the deposition of bile pigments in them. Fat-soluble bilirubin accumulates in the skin, which is formed during the breakdown of red blood cells.
The liver does not have time to neutralize the decay products. Therefore, an excessive amount of this pigment appears in the blood.
- unconjugated or indirect. It is fat soluble
- conjugated or direct. Such bilirubin is water soluble.
Therefore, direct bilirubin is freely excreted in the bile and urine, and indirect bilirubin is excreted as a result of a complex biochemical process in the liver.
Direct bilirubin does not have a neurotoxic effect. Its level is determined only for the purpose of making a diagnosis. Indirect bilirubin is neurotoxic.
This happens only at a very high level. In full-term infants, one level is above 342 µmol / L, in premature infants, from 220 µmol / L, in deeply premature third, from 170 µmol / L.
The threshold level of neurotoxicity also depends on the duration of exposure and a number of other circumstances. Jaundice in newborns is common enough. In 60% of full-term and 80% of premature infants.
Neonatal jaundice of newborns and its types
The physiological jaundice of newborns becomes noticeable on the second or third day, reaching a maximum on the second and fourth. Jaundice should pass when the child is 5 to 7 days old.
If neonatal jaundice is just such, then this is a classic physiological jaundice associated with insufficient conjugation of bilirubin in the liver. But she is considered such only after the exclusion of other causes of postpartum jaundice.
When are jaundices of newborns regarded as severe?
- Manifest on the first day of life.
- With viral and bacterial infections.
- In the presence of hemorrhage.
- In case of incompatibility between mother and child by Rhesus antigens and ген or by blood type.
- In case of prematurity or immaturity of the newborn.
- With insufficient nutrition.
- In the presence of jaundice in older children in the family.
Jaundice in a child begins with a face. The higher the level of bilirubin, the lower the body becomes colored (yellow).
Jaundice has a bright yellow, even orange color due to indirect bilirubin and greenish or olive due to direct bilirubin. The difference is clearly visible with severe jaundice.
Pathological jaundice happens:
- conjugation in case of enzymatic liver failure,
- hemolytic with a change in the normal structure of hemoglobin and red blood cells,
- hepatic in liver disease,
- obstructive, or mechanical, jaundice in violation of the normal outflow of bile.
With an increase in jaundice, symptoms of hemolysis, infections, a laboratory blood test is necessary. Determine total bilirubin, direct and indirect, blood type and Rh factor. Microscopy of a blood smear is performed to determine the percentage of reticulocytes and a Coombs sample. To determine the level of bilirubin, a non-invasive percutaneous determination of bilirubin is used.
This is the definition of pigment using a reflective photometer, which determines the level of bilirubin in the blood by the color of the skin.
Why does the baby develop jaundice?
In itself, staining the skin of a child is not a disease, but a symptom. The pigment bilirubin, which is a decay product of red blood cells and is formed throughout life, gives a yellow color to the skin of the baby.
In adults, it enters the liver and is successfully excreted. The situation is more complicated with the child.
In 70% of cases, jaundice occurs in newborns, the reasons for this prevalence: the liver still does not fully cope with its functions. At the same time, the level of bilirubin in the blood of babies is high, since the red blood cells that supply the baby with oxygen in the womb break down in large numbers.
Thus, three out of four newborns develop jaundice. In most cases, she passes by the age of one month and does not require treatment. The causes of jaundice and high bilirubin levels in babies are:
- multiple pregnancy
- smoking, drinking alcohol and certain drugs during pregnancy,
- future mom’s iodine deficiency,
- other complications in the antenatal period,
- premature birth
- drugs obtained to stimulate labor,
- diabetes in mom.
If jaundice in a child occurs due to insufficiently effective liver function, then it will disappear itself as soon as all the baby’s organs are sufficiently adapted to life outside the mother’s womb.
However, sometimes jaundice is a symptom of severe pathologies in a child that require immediate medical attention. This condition is called pathological jaundice and can be caused by the following reasons:
- conflict between mother and baby by blood type,
- Rh factor incompatibility of mother and child,
- antibiotic therapy for a child
- problems with the baby’s liver
- individual genetic diseases
- hormone synthesis disorders,
- blockage or damage to the bile ducts,
- pancreatic dysfunction.
With pathological jaundice, it is very important not only to lower bilirubin in the blood of a child, but also to eliminate the cause that caused its increase.
When does jaundice pass?
The physiological jaundice of newborns begins to weaken when the baby is a week old. The signs of the disease completely disappear by the age of one month.
Pathological jaundice as a symptom can be eliminated quite quickly, within a few days. Today, there are ways to quickly and safely remove bilirubin from the patient.
It should be remembered that sometimes pathological jaundice and high bilirubin are symptoms of a serious disease, the duration of treatment of which depends on the situation and can be determined by a doctor.
What to do if the jaundice is delayed
It happens that physiological jaundice does not pass by the age of a month. The reasons for this course of the disease are as follows:
- anemia in a baby (confirmed by a blood test),
- blockage (or infection) of the bile ducts, stagnation of bile,
- galactosemia (this is one of those diseases that are screened in the hospital),
- thyroid hormone deficiency (also tested in the hospital)
- polycythemia (an increase in the number of red blood cells, monitored by a blood test),
- breastfeeding jaundice.
If the baby is already a month old, and the jaundice still does not go away, you must consult a doctor. The doctor will be able to rule out difficult diagnoses.
Deserves special mention breastfeeding jaundice, which occurs when breast milk contains a lot of pregnandiol (a hormone metabolism product).
This substance inhibits the excretion of bilirubin. At the same time, the amount of pigment in the blood does not increase, but gradually decreases. The child feels well.
In the medical community, there are two opinions about jaundice of breast milk:
- Some doctors believe that an increased level of bilirubin nevertheless gives the baby's liver an additional load, so breastfeeding must be stopped.
- Representatives of another camp do not see anything terrible in continuing feeding.
If you are afraid of harming the baby, but still want to continue natural feeding, the following method is suitable for you. It is necessary to express the milk and warm it in a water bath to a temperature of 70 °. More on how to express breast milk correctly >>>
Then cool it and give to the child. From the effects of temperature, pregnanediol will decompose and will not have any effect on the rate of bilirubin excretion.
If the baby has jaundice, mom should find a pediatrician, whom she fully trusts, and follow all his instructions.
How to treat jaundice
The most effective method of lowering bilirubin in the blood is phototherapy.
The baby is placed under special lamps operating in the blue spectrum. Under the influence of light, bilirubin is transformed into non-toxic lumirubin, which is rapidly excreted from the body.
Phototherapy of newborns with jaundice can be carried out both in the hospital and in the children's medical institution.
In large cities, a lamp for treating jaundice in a child can be rented. Therefore, if bilirubin does not go off scale and the condition of the baby does not cause concern, then therapy can be carried out at home.
In this case, one should not forget to donate blood in time to determine the level of bilirubin.
Glow with lamps is prescribed for 96 hours with interruptions in feeding. To protect the eyes, the kids put on special dressings or pull on hats.
With phototherapy, the baby loses fluid, therefore, when breastfeeding, it is necessary to apply the baby on demand.
Side effects of light treatment: peeling of the skin, rapid stool. These symptoms disappear as soon as treatment is completed. Read more about how many times a chair should have a newborn >>>
After phototherapy is completed, choleretic, diuretic drugs are sometimes prescribed to complete the treatment:
- Hofitol for newborns with jaundice is given in the form of drops, three times a day, mixed with water.
- Ursosan is given to newborns with jaundice once a day, diluting part of the contents of the capsule in a small amount of water. See also: When can I give water to a newborn? >>>
- It is convenient to give the baby ursofalk, with jaundice of newborns, this drug is better to acquire in the form of a suspension.
Ursosan and ursofalk lower blood bilirubin in a few days.
- Of homeopathic medicines, doctors can recommend galsten. Galstena with jaundice in newborns is taken in the form of drops, 3 times a day. Before giving the medicine to the baby, the drops are diluted in breast milk.
In the treatment of severe forms of jaundice, a blood transfusion is used. This helps to replace most of the red blood cells in the blood, and thereby reduce bilirubin by half in one procedure.
For one transfusion, up to 80% of the baby's blood is replaced. Taking blood from the mother is not allowed, so the child is looking for another donor.
Physiological jaundice passes by itself and does not need special treatment. However, the mother can help the baby quickly get rid of excess bilirubin:
- The best method of prevention is breastfeeding. It is important to put the baby to the chest immediately after birth. Colostrum contains components that stimulate the work of the intestines of crumbs. Together with meconium (first feces), bilirubin is removed from the body. Mommy's milk is the best way to replenish fluid during phototherapy. Read more about HS and proper application >>>
- Sun baths. In late spring, summer or warm autumn, you can move the hood of the stroller while walking, so that the sun's rays fall on the face of the baby. In winter, you can stand crumbs on the balcony, just make sure that the child does not freeze. Do not allow the sun to fall into the eyes of the baby. Vitamin D, obtained by the baby, helps to remove bilirubin from the body.
- You should not give your baby a glucose solution or a rosehip decoction on your own, only a doctor knows how to administer glucose for jaundice in newborns.
What consequences can infant jaundice have?
Usually, jaundice of breastfeeding and physiological jaundice in newborns do not have consequences, when the yellowness of the skin passes, nothing reminds of a disease.
Recently, neonatologists have recognized these conditions as an option for the normal development of the baby.
The consequences of pathological jaundice depend on the causes that caused it.
If you start treatment on time and do not deviate from the doctor’s recommendations, then most likely the disease will be completely overcome and will not leave any additional diseases.
Untreated, or untimely cured jaundice in newborns does not pass without a trace, the consequences can be as follows:
- the risk of liver cancer in the future is greatly increased,
- weak immunity in the baby,
- cirrhosis and other liver diseases.
If the baby suffered bilirubin encephalopathy, and he did not receive medical attention, the consequences may be partial or complete hearing loss, developmental delays, and paralysis.
A child with signs of jaundice should be constantly monitored by a doctor so as not to miss the development of severe forms of the disease and prevent dangerous consequences.
The main symptoms of the disease
Most often, a change in skin color in a baby is recorded on the third day after its birth. The baby becomes much darker, and the skin becomes bright brown. In infants, jaundice is manifested in this way.
The final color of the skin depends on the level of bilirubin in the blood. Its amount can vary from 35 to 250 μmol / L. Serious consequences cannot be avoided if the indicator becomes maximum.
Physiological jaundice in newborns also manifests itself in the form of the following symptoms:
- great anxiety
- frequent regurgitation, which can turn into vomiting,
- general state of apathy and lethargy,
- characteristic discoloration of urine.
All these manifestations arise due to severe intoxication of the body. Parents are interested in the question of whether they are discharged from the hospital in this condition. The expediency of the process is evaluated by the doctor. Based on the tests and signs, he can prescribe treatment in a hospital setting. Here, the dynamics and intensity of changes in bilirubin are monitored.
Nuclear jaundice is characterized by the following symptoms:
- The lethargy and drowsiness of a child become more apparent every day.
- Occasionally, spontaneous regurgitation or vomiting may be noticed.
- The sucking reflex is getting smaller.
- Periodic appearance of spontaneous muscle twitches.
Treatment of jaundice in newborns at home cannot continue in this case. The situation should be analyzed by a doctor. In some manifestations, it is impossible to do without hospitalization.
Methods for treating jaundice
Parents have a logical question about how to treat jaundice in a newborn? When choosing a course, the pediatrician takes into account the following important criteria:
- The general condition of the baby.
- The presence of pathological processes in the past.
- Change in bilirubin in dynamics.
- Does the baby still have illnesses.
In this case, the parents of the house are recommended to use the following therapeutic measures:
- Phototherapy and regular sunbathing.
- A newborn should regularly be in the fresh air.
- Taking medications should only be done after consultation with your doctor.
- Alternative methods also help to eliminate symptoms. For this baby, they regularly bathe in chamomile broth. In addition, as a mother's drink, it is recommended to use a rosehip broth and glucose solution. These two drinks will help significantly improve liver function.
If it was decided to discharge the baby from the hospital, then in the future treatment of the pathology will be carried out at home. Mom should be attentive to each symptom. Additionally, the attending physician monitors the change in the physiological state. If no improvement is observed, then it is advisable to change the treatment tactics.
In the process of treating infants, only those funds that have been previously agreed with the attending physician can be used.
Quickly and effectively remove toxic substances allows a decoction of rose hips. For its preparation, it is necessary to use three dried berries, which are carefully chopped and poured with boiled water. Just a glass of liquid is enough. To obtain the maximum number of healing properties, the decoction should be infused for at least five hours. Getting rid of jaundice will allow taking one teaspoon each time before feeding. Parents should be extremely careful when using, if the child has already been allergic.
These herbs help improve blood circulation and eliminate inflammation. The process leads to the rapid removal of bilirubin from tissues and blood.
The broth can be made independently. For this, 200 grams of calendula and chamomile flowers are poured with one liter of water. Brewing should last at least 10 minutes. Insisting is necessary to spend three hours. It is advisable to add the tool every time while swimming.
In order to quickly remove bilirubin from the blood, a woman is not recommended to refuse breastfeeding. Milk contains protein, which quickly and effectively binds all toxic components. Due to this, the body's resistance to harmful effects increases several times. Breast milk normalizes the baby's stool and improves the functioning of his digestive system.
Lactation should be discarded only in case of immunological conflict. In this case, the milk contains antibodies that will only worsen the general situation. Such a clinical picture is rare, so most often, GV specialists recommend continuing breastfeeding.
If the baby was diagnosed with jaundice, then the woman will have to follow a special diet. Thanks to this, it will be possible to achieve recovery in a short time. To quickly remove bilirubin from the blood, a woman should exclude dishes from her diet that can lead to a breakdown in the digestive system:
- seasonings and fried foods,
- all types of smoked meats,
- dishes, which include dyes and preservatives in large quantities,
- possible allergens
- foods that can lead to excessive gas formation in the baby or mother,
- ingredients that adversely affect stool.
To improve overall well-being and health, it is recommended that you regularly visit the fresh air. Walking improves metabolic processes and helps restore detoxification naturally.
Features of phototherapy
Exposure to light or ultraviolet rays is used to quickly eliminate the symptoms of jaundice. The process involves the use of a special lamp, which may have a white or blue glow. In the warmer months, the instrument can be replaced with ordinary sun baths. However, with such an effect on the baby, he needs to close his eyes and body with a special blanket.
Thanks to ultraviolet, the decay process of bilirubin is significantly accelerated, and it is quickly excreted from the body. If the process of natural exposure was chosen, then in the open sun the baby should be no more than twenty minutes three times a day. The method has a positive effect on the immune system, as it is considered one of the options for hardening.
Treatment of jaundice with sorbents
Bilirubin is eliminated from the human body using sorbents. With the breakdown of hemoglobin, the color of feces changes dramatically.
- Sorbent helps the body to remove bilirubin from the intestine for a short time. To speed up the process, it is recommended to use Enterosgel or Smecta. It is allowed to use only those sorbents that have been approved by the attending physician. Otherwise, their action may cause constipation or diarrhea.
- It is allowed to give the child also activated or white coal. The daily dosage should not exceed a quarter of the tablets three times a day. Before use, they must be carefully diluted with boiled water.
During the intake of any drug, it is necessary to monitor the change in the state of the crumbs. If activated carbon is taken, then it is quite possible to see dark inclusions in the feces. In some patients, all bowel movements also change color.
Jaundice is a serious disease that can only be eliminated by a professional. Parents should receive his consultation on each of the treatment methods. It is also necessary to monitor changes in the general condition of the baby. If deterioration is recorded, then it is imperative to visit the pediatrician's office.
When can pathological jaundice in newborns be suspected?
- if the baby jaundice developed already at birth, or on the first day, then it requires increased attention.
It is necessary to exclude the following conditions in a child: hemolytic disease of newborns, infections (syphilis, toxoplasmosis, rubella), latent hemorrhages,
- on the fourth - seventh day, jaundice occurs more often with congenital infections,
- the cause of jaundice after the 1st week of life there are infections, hypothyroidism, hepatitis, atresia of the biliary tract, cystic fibrosis,
- with persistent jaundice during the first month of life, it is necessary to exclude infections, hereditary genetic pathologies,
- Among the causes of hemolytic disease of newborns there is a syndrome of thickening of bile, stagnation of bile, pyloric stenosis, atresia of the biliary tract and other pathologies.
Breast milk jaundice
Jaundice in newborns can develop after the 1st week of life. This is due to the beginning of breastfeeding. Elevated bilirubin levels in infants can last up to 10 weeks when breastfeeding.
If breastfeeding is canceled for 1 - 2 days, then the jaundice from breast milk will pass, and bilirubin levels in the blood will quickly decrease. When breastfeeding returns, hiberbilirubinemia, as a rule, does not return. The general condition of the child is usually normal.
Although such jaundice in infants is rarely accompanied by bilirubin encephalopathy, cases of its occurrence are described. Why this happens, medicine is not yet clear.
What is the danger of bilirubin encephalopathy, is it nuclear jaundice in newborns?
The risk of bilirubin encephalopathy is higher in immature infants. Bilirubin penetrates into the neurons of the brain and has a toxic effect on them.
Clinically, this is manifested:
- weakened sucking
- neck extension
The consequences of nuclear jaundice in newborns
- a child is more likely to develop motor retardation,
- after the first year of life - movement disorders, deafness,
- by three years - convulsive syndrome, oligophrenia, hearing loss, strabismus, motor disorders,
- with obvious neurological symptoms, the prognosis is poor, mortality reaches 75%.
But there are always risk factors:
- discharge from the hospital earlier than 3 days without follow-up for two days,
- lack of alertness and underestimation of the severity of jaundice.
How to treat jaundice in newborns?
Treatment of jaundice in newborns aims to reduce bilirubin levels to indicators that do not exceed the threshold of neurotoxicity (the ability to infect brain neurons).
There is no consensus at what level of bilirubin it is necessary to start phototherapy. But since 6-12 hours should pass for the visible result, phototherapy should begin with a safe level of bilirubin.
During phototherapy, indirect bilirubin turns into direct, “non-hazardous”, and is easily excreted from the body. Conventional phototherapy is carried out continuously.
The child is often turned to lighten the skin as much as possible. Conduct phototherapy until the level of bilirubin is reduced to the maximum safe.
Skin color is not always indicative, because under the influence of light, yellowness of the skin decreases, and the bilirubin content in the blood remains high.
During phototherapy, they protect the eyes of the child.
Complications of phototherapy - skin rashes, diarrhea. After completing a course of phototherapy, a “bronze child” syndrome may be noted - staining of the skin in a gray-brown color.
Long-term effects of phototherapy are not registered, however, it is not recommended to prescribe phototherapy without indications. In vitro scientific studies have shown the possible pathological effect of the applied light radiation on DNA.
- If phototherapy is ineffective, exchange blood transfusion is used. Treatment of jaundice in newborns in this way is a very unsafe procedure, associated with the risk of serious side effects. But if necessary, multiple blood transfusions are possible.
- Other methods of treatment include a single intramuscular injection of Tinmezoporfirin on the first day of life, which reduces the need for phototherapy. This method is practically not used due to little knowledge.
- Infusion therapy (intravenous administration of solutions) is used when necessary during phototherapy, when the child loses a lot of fluid. Indirect bilirubin is not excreted by intravenous administration of any solutions.
- The prescription of drugs that reduce the density of bile, it makes sense with the syndrome of thickening of bile.
- The effectiveness of the appointment of sorbents has not been proven.
Prevention of jaundice
It is carried out at the stage of bearing a child.
- A full examination of the pregnant.
- Prevention of the occurrence of risk factors in a pregnant woman.
- Early attachment to the chest.
It is also necessary to understand that even a harmless, at first glance, jaundice needs the advice of a neonatologist or pediatrician. It is possible to judge the safety of a child only after the exclusion of pathological conditions when monitoring the level of bilirubin.