About 60% of newborn babies born on time, and 80% of premature babies, the skin within 1-2 weeks after birth has a yellowish tint. The reason is bilirubin. It is the high level of this pigment in the blood that gives the skin a yellow tint. For most children, this condition is not dangerous and does not require special intervention or serious medical treatment. But the situation should not be left to chance, since in some cases high bilirubin can be toxic to a growing organism. About what is dangerous jaundice in newborns, we will tell in our article. Be sure to dwell on the causes of this condition, possible consequences and treatment features.
Physiological and pathological jaundice
A condition in which the skin surface of the crumbs turns yellow is not considered a disease, but rather a physiological phenomenon. After birth, the baby's body begins to adapt to new conditions of existence. As a result of the splitting of red blood cells during the breakdown of fetal (fetal) hemoglobin, a bile pigment, bilirubin, is formed. The liver is responsible for its elimination, which in infants is immature, like the entire enzyme system. Accumulating, bilirubin becomes a toxin, which, spreading throughout the body, is able to infect brain cells. And this is only one of the reasons why jaundice is dangerous for newborns.
Staining of the skin yellow usually occurs on the third day. But when the jaundice in the newborn passes, it is impossible to accurately predict. It all depends on how quickly the liver will receive the necessary enzymes and begin to work in full force. Usually this happens on the 7th day after discharge from the hospital or on the 10th day from the birth of the baby if he was born full-term.
Physiological jaundice is natural for newborns. This condition should not cause anxiety in parents. Danger for the fragile body of a newborn is a pathological jaundice. It arises as a result of the massive breakdown of red blood cells, not only those that already need replacement, but also new ones.
Pathological jaundice occurs in the first hours after birth and is accompanied by severe anemia. The level of bilirubin at this moment is very high. Moreover, not only the liver, but also the central nervous system and the brain are affected. To prevent this condition, the baby needs constant monitoring of the level of bilirubin in the blood and timely treatment.
Causes of jaundice in newborns
Most often, the child turns yellow on the third day after birth. The main reason for physiological jaundice is associated with natural processes in the body, the result of which is the replacement of fetal hemoglobin by normal or living. This condition rarely requires special treatment, since it is considered normal for the body of a newborn. The growth of bilirubin in this case can cause starvation, hypothermia, accumulation of meconium. To quickly cope with a high level of bile pigment, it is recommended to put the baby to the chest more often. The first milk - colostrum - acts as a laxative, which contributes to the speedy departure of meconium. At the same time, bilirubin decreases much faster.
Pathological jaundice in newborns deserves closer attention. The causes, consequences and norms of such a state are perfect by others. It occurs in 65 children out of 1000. There can be several reasons for the development of pathological jaundice:
- rhesus conflict;
- incompatibility of blood groups of mother and fetus;
- infectious liver diseases;
- liver failure;
- low birth weight;
- premature birth;
- artificial feeding;
- diabetes in a woman;
- hormonal disorders in the body;
- mechanical damage to the liver or biliary tract;
- hereditary metabolic disorders.
Most of the above factors lead to a violation of the outflow of bile from the body. This condition requires constant monitoring by specialists.
Symptoms and diagnosis of pathology
The main sign of jaundice in newborns is the characteristic shade of its skin and sclera of the eyes. To assess the condition, the Cramer scale is used. Inspection is carried out in natural daylight, as artificial light distorts the results. To determine the jaundice of the skin of the child, it is necessary to completely undress. As a result of the inspection, it is possible to determine the approximate level of bile pigment in the body:
- Jaundice is limited to the head and neck - indirect bilirubin in the blood plasma is 100 mmol. This indicator is averaged and can be confirmed or refuted by a blood test.
- Yellowness of the head, neck and upper body - 150 μmol / L.
- Including the lower body - 200 μmol / L.
- Including arms and legs below the knees - 250 μmol / L.
- Including hands, palms and feet - more than 250 μmol / l.
Depending on the level of bilirubin in the blood, we can talk about when the jaundice should pass in newborns.
If the main symptom of the physiological state is a yellow tint of the skin, then the pathological phenomenon is accompanied by the following additional signs:
- occurs on the first day or a week after birth;
- the disease has a complex and undulating course;
- the growth of bilirubin exceeds 85 μmol / l per day;
- discoloration of the stool;
- staining of urine in a bright yellow color;
- a change in the normal state of the body (agitation or lethargy).
The pathological condition does not go away on its own and requires medical intervention.
The norm of bilirubin with jaundice in newborns
So that, if necessary, the baby was provided with timely help, it is necessary to control the level of bile pigment, which stains the skin in a characteristic color. Normally, the baby's bilirubin index is 8.5–20.5 mmol / L. This means that the child’s liver works well during the period of destruction of fetal hemoglobin and the appearance of living. The maximum level of bilirubin reaches the third day after birth. At this time, bile pigment is usually fixed at 205 μmol / L. Starting from the fourth day, the intensity of the icteric shade gradually decreases, and after about 10 days the skin integument returns to normal.
How long the jaundice in the newborn will last depends on bilirubin and the general condition of the body. If, by the third week of a baby’s life, the value of the bile pigment index does not decrease and amounts to 160 μmol / l and higher, the doctor makes a decision about hospitalization. If the child’s condition is not disturbed, yellowness of the skin is moderate and decreases, liver tests are normal, then treatment can be carried out at home.
Features of breast milk jaundice
Sometimes staining the skin of a child in a characteristic color is not associated either with physiology or with pathological disorders in the body. In this case, we are talking about another variety of jaundice, which occurs during breastfeeding. Despite the fact that in most cases, breast milk is a valuable source of nutrients, sometimes the substances contained in it can be harmful.
The cause of jaundice breastfeeding is a high level of hormones and fatty acids in milk. All this inhibits the normal functioning of the liver, as a result of which bilirubin begins to accumulate in the tissues. This condition occurs about 7 days from birth. But when the jaundice in the newborn passes, it depends on how quickly the correct diagnosis is made and adequate treatment is prescribed.
To reduce the level of bilirubin in the blood, the child is transferred to feeding with a mixture or expressed and breast milk expressed and pasteurized in a water bath for 3-4 days. In such a diet, estrogens and other hormones that affect liver enzymes are practically inactive. If after a specified time the level of bile pigment falls, then the baby really has icteric breast milk. With the restoration of natural feeding after a few days, the child's bilirubin will increase again.
When does jaundice in infants pass?
This question interests all, without exception, young mothers who first encountered a similar phenomenon. It is safe to say that the newborn passed jaundice when the level of bilirubin in the blood returned to normal. This usually occurs 10-14 days after birth, if the phenomenon is associated with physiology. If after a month the condition of the child has not improved, and the yellowness of the skin continues, you must immediately consult a doctor.
The treatment of pathological jaundice may take up to three months, subject to the treatment prescribed by the doctor. The level of bilirubin is determined by the delivery of venous blood in the laboratory.
What is the danger of jaundice in newborns?
In most children, the skin becomes yellowish for physiological reasons, which should not be a concern for parents. In just one or two weeks, the skin and sclera of the eyes will brighten. Jaundice caused by the presence of enzymes and fatty acids in breast milk can last for 2-3 months. However, all this time the baby is fully developing. Thus, physiological jaundice, like that associated with breastfeeding, cannot be dangerous for a newborn.
But the child may turn yellow for other reasons. For example, pathological jaundice is more dangerous for a newborn than physiological and breastfeeding, hundreds of times. Firstly, with this disease the condition of the child every day only worsens. Secondly, recovery without the help of doctors is impossible, since the consequences can be the most unpredictable:
- High bilirubin levels are toxic to the baby. In turn, this can lead to disturbances in the functioning of the central nervous system and brain.
- When bilirubin enters the brain, jaundice often develops. This condition is accompanied by muscle spasms and deviations in mental development. With nuclear jaundice , deafness often occurs.
- With prolonged jaundice, loss of control over the musculoskeletal system and partial paralysis are possible
The toxic effects of bilirubin on the nervous system have the most serious consequences.
Treatment for jaundice with light
If the yellowing of the skin is due to physiological reasons, then therapy in this case is not required. In this case, one should speak not about treatment, but about how to help a small body cope with this condition faster. All recommendations are given by the doctor. You should not stuff the child with any dubious medicines on the advice of friends. A newborn baby in this period of his life must provide:
- daily walks in the fresh air;
- sunbathing and air bathing;
- full breastfeeding.
In addition to the aforementioned, a mother must follow a diet, excluding from her diet those foods that create an additional burden on the liver. In general, the best prevention of jaundice in newborns is breastfeeding on demand from the first minute of the baby's life.
In some cases, the doctor recommends treating newborn jaundice under a lamp. This method of normalizing the level of bilirubin in the blood is called phototherapy. During treatment, the child is placed under the lamp, after covering his eyes with a bandage. Under the influence of light, the bile pigment in the blood is destroyed, and the substances formed during this process are easily excreted from the body along with urine and feces. It should be noted that phototherapy is advisable with a bilirubin level above 100 μmol / L. Further, liver enzymes will be able to break down and remove it on their own. And when the bilirubin index drops to 8.5-20.5 μmol / L, we can say that the jaundice in newborns has passed.
When the baby's skin turns yellow as a result of pathology, in addition to herbal medicine, medication is prescribed in a hospital setting. Depending on the reasons that caused the jaundice, even a blood transfusion (with Rh conflict) can be used.
Drug treatment
To bring the level of bilirubin with jaundice of newborns to normal, one of the following drugs is prescribed:
- Hofitol. One of the safest and most effective remedies for neonatal jaundice. The drug is a vegetable-based solution intended for oral administration. Its main action is to protect the liver. In addition, the drug provides normalization of metabolic processes, improved kidney function and choleretic effect.
- Galstena. This is a homeopathic herbal preparation, which is prescribed for jaundice in order to eliminate intoxication. For children, it is prescribed in the form of drops.
- "Ursofalk" from jaundice for newborns. Under the influence of this drug, liver cells begin to work more actively. They produce more enzymes that help to remove bilirubin from the body. The dosage of the medicine is determined by the doctor based on the level of bile pigment in the blood.
Dr. Komarovsky’s opinion on the problem
Neonatal jaundice is a physiological process. Dr. Komarovsky advises mothers to calm down and not to focus on this condition. For the treatment of physiological jaundice in modern medicine, the use of special medications is not recommended, unless it is protracted. However, a blue lamp can be used to speed up the process of normalizing the skin tone of the baby. With jaundice in a newborn, light therapy allows you to split bilirubin into substances that are easily excreted by the body with feces and urine.
At home, Evgeny Komarovsky in the absence of a blue lamp recommends using ordinary white. He explains this by the fact that her bright light also neutralizes the toxicity of bilirubin. About the same effect has diffused sunlight.
As for pathological jaundice, Dr. Komarovsky warns that the drug “Phenobarbital” may be prescribed for its treatment in our country. He categorically does not recommend moms to use this tool in relation to their children. This drug, despite its effectiveness in enhancing the work of certain enzymes in the liver, is banned for use worldwide because of side effects. “Phenobarbital” has a destructive effect on the child’s nervous system, leads to a decrease in intelligence and learning ability at school age. The doctor does not say exactly when the jaundice in newborns should pass. He notes only the protracted nature of the disease.
Dr. Komarovsky advises in case of jaundice to drink the child with water and not refuse to be vaccinated against hepatitis B, since in this case the risk of the disease increases significantly.