My friend called me: [Doctor Zhu, my family’s second treasure was born for 3 days. Today, the doctor made rounds and said that the baby had deep jaundice and would not be discharged from the hospital according to blue light. But my wife cried and shouted that she was not willing to do so, saying that Dabao had jaundice at the beginning. It would be good to nurse more. The old people in the family also said it was okay. Do you think it doesn’t matter? ]
Neonatal jaundice, whether it matters or not, whether to further treat, this is really not a word can be said clearly.
How to treat neonatal jaundice?
At present, the relatively recognized treatment methods for jaundice are blue light treatment and exchange blood treatment.
The former refers to putting newborns in a blue light environment with a certain light intensity, and through a series of complex photochemical reactions, bilirubin is discharged out of the body to reduce the level of serum bilirubin. Blue light therapy has very high safety and few adverse reactions to what.
The latter is to replace the whole body blood of the newborn with the blood with the appropriate normal bilirubin level. In order to reduce the level of serum bilirubin. This method sounds scary, and the operation is relatively complicated. Of course, there will be more adverse reactions. As a professional pediatrician, exchange blood therapy will not be adopted unless it is absolutely necessary. I also hope that parents will not [create practical opportunities] for us.
Sometimes, by strengthening feeding, promoting the baby’s stool excretion, or using some drugs can also help jaundice subside to some extent. In addition, for jaundice of certain specific causes, immunoglobulin or albumin and other methods will be used to treat jaundice.
How’s jaundice needs treatment?
Then the question arises, is jaundice as deep as what and needs treatment? In a nutshell: Listen to the doctor’s advice more and make less decisions.
In fact, jaundice at what level will cause harm to individual newborns. Affected by many factors such as body state and internal environment, it cannot be simply used as an intervention standard with a single index. In short, one cannot arbitrarily set a [normal value] or draw a stiff line: higher than this [important], must be treated, lower than this, then [it doesn’t matter], let it go.
One of the major characteristics of early neonatal jaundice is that it rises in a curve with time, so the [safe value] range is also changing at different time points.
Neonatal doctors will generally combine the baby’s gestational age, age, weight, health status, whether there are high-risk factors, whether effective follow-up and jaundice change curve reference range and other indicators to comprehensively judge whether further medical intervention is needed. This decision is professional, It is suggested that parents give this [difficult problem] to professional pediatricians.
Why is there jaundice?
Newborns will experience a yellow dyeing process visible to the naked eye from two or three days after birth, which we call jaundice.
From the perspective of professional medicine, this process is caused by changes in bilirubin in the blood. In fact, adult blood also has bilirubin, but because the value is very low, so the naked eye cannot observe skin jaundice. Newborns due to bilirubin production increases, bilirubin processing capacity is low, will appear short-term skin jaundice after birth.
In general, the most obvious jaundice of full-term infants is on the 4th to 5th days after birth, while that of premature infants is on the 5th to 7th days after birth. However, the time for jaundice to completely subside is generally not more than 2 weeks for full-term infants, and 3-4 weeks or even longer for premature infants.
The influence of jaundice can be large or small.
Each newborn has its own physiological and metabolic characteristics, so the jaundice degree and regression process of different newborns are also different.
1. Physiological jaundice is mostly irrelevant.
Usually, insufficient feeding, less stool after birth, neonatal diseases (such as infection, Hemolytic disease, premature delivery, low weight, etc.) can make neonatal jaundice deeper. Jaundice of most full-term newborns occurs 2-3 days after birth. Even when skin jaundice is most obvious, serum bilirubin does not exceed the normal level (12.9 mg/dL). This is generally [physiological jaundice], most [it doesn’t matter], and no intervention treatment is required. Generally, newborns can safely pass the jaundice period and gradually fade through methods such as strengthening feeding and helping defecation.
For jaundice of premature infants, although there is no completely unified intervention standard at present, the general treatment principle is more active than that of full-term infants. Therefore, if the baby is premature, parents are advised to pay more attention to jaundice of the baby and consult a professional doctor in time.
2. Pathological jaundice should be careful
However, some babies’ jaundice occurs within 24 hours after birth, or the degree of jaundice is very severe, which greatly exceeds the normal range of newborns, and the time of jaundice regression is obviously delayed. These are [important] [pathological jaundice].
For this kind of [important] jaundice, we suggest family members to check and treat it in time. Because if jaundice is allowed to continue to deepen, the consequences will be very serious, and the newborn may have [bilirubin encephalopathy], which is not only [important], but also [deadly].
Even if there is no death, there will be serious neurological sequelae such as mental retardation, permanent hearing impairment, dyskinesia, etc. In this way, the baby’s life will be destroyed.
In addition, jaundice accompanied by pale stool color and/or obvious yellow urine color is another [important] jaundice. This kind of jaundice often indicates that the baby’s hepatobiliary system has pathological changes and also needs early diagnosis and treatment. Therefore, jaundice can be large or small.
Can parents do some what?
Then the question arises again. Parents can do some what for their children. It’s the same sentence: listen to the doctor’s advice more and make less decisions.
Of course, as an ordinary parent who is far away from the medical industry, what is not unable to do it either. Let’s use one more sentence to summarize: listen to doctors in the hospital and comment on themselves when you get home. Don’t hesitate to have any problems.
At present, most healthy newborns in our country are discharged 72-96 hours after birth, and normal delivery may be advanced to 48-72 hours. The earlier they are discharged, the more cautious jaundice monitoring should be in a few days after returning home, and timely treatment should be given if there are problems.
1. Roughly estimate jaundice levels
Usually we can preliminarily evaluate the degree of baby jaundice by naked eyes. Jaundice usually appears in the head, face and eyes at the earliest. If only these places see yellow skin, bilirubin level is about 5-6 mg/dL at this time, and observation can continue.
Then it affects the trunk and limbs. Bilirubin is about 10 mg/dL at this time. If it is less than 3 days after birth, attention should also be paid to it.
Finally, the palms and soles of the feet, if to this extent, need professional doctors to judge through instruments.
2. Be alert to common high-risk factors
Newborns with the following conditions are more prone to hyperbilirubinemia and need more active response.
(1) High-risk factors for hemolysis: ABO hemolysis (maternal blood type O, paternal blood type non-O), Rh hemolysis (maternal Rh blood type negative), G6PD deficiency (family history of [broad bean disease], native place Guangdong, Guangxi, Hainan and other places are more common).
(2) Premature delivery, low weight (birth < 2500 grams), birth asphyxia, unstable body temperature, poor mental response, lethargy, etc.
3. Help your baby get rid of jaundice
(1) Strengthen feeding and promote defecation. Generally speaking, let the baby [eat more Dora]. This is especially useful in the early stage of newborn.
(2) Under the guidance of doctors, give adjuvant drugs such as intestinal probiotics.
Summary
1. Neonatal jaundice is mostly a physiological process, there is no need to [talk about yellowness]. Under the guidance of doctors, dynamic monitoring of jaundice changes, timely intervention when necessary, the baby can safely pass the jaundice period. However, full attention should also be paid to it, because [hyperbilirubinemia] can cause irreversible serious damage to the baby if it is not treated in time.
2. Jaundice assessment can be handed over to doctors during the hospitalization of the baby with its mother. Parents should pay full attention to jaundice changes about one week after returning home from hospital, and see a doctor in time if there is any situation, especially for those with high risk factors of hyperbilirubinemia.
3. The above content is aimed at the identification and treatment of jaundice of infants discharged early after birth. For breast milk jaundice (which usually occurs about one week after birth and the peak period is 2-3 weeks after birth), there is no need for excessive tension. The intervention threshold is also different and will be recounted later.