Jaundice in a newborn is not a separate disease, but only signals a malfunction in the body. The skin becomes yellowish due to the accumulation in them of bilirubin - bile pigment. The severity of the pathology depends on its concentration in the blood and a decision is made on appropriate treatment. You must understand that in most cases this condition is considered a physiological norm and does not require medical intervention. But there are times when help is needed for the baby.
Jaundice development process
Being in the womb, the baby received everything necessary through her circulatory system. After birth, hemoglobin breaks down, the cells of which were responsible for the delivery of oxygen from mother to fetus. As a result, excess bilirubin accumulates in the child’s blood and acquires a characteristic shade in the skin.
Doctors report indicators that are the norm. If on 3-5 days after the birth of a full-term baby, the bilirubin level in the norm is more than 172 - 206 mmol / l, then by one month it should fall to the level of 3.4-22 mmol / l. If this does not happen, then a pathological process that requires immediate treatment is diagnosed.
Pathology classification
Jaundice in a newborn is classified into two varieties (depending on the course of the course):
- Physiological. It occurs in almost every newborn and requires only observation. The accumulation of bilirubin in tissues and blood is due to the functional immaturity of the child's body. A similar type occurs on 3-5 days from the moment of birth and lasts no more than 10 days. The bilirubin index can increase to 223 μmol / l, but this does not affect health, the baby feels good. The cause of this condition is the massive and rapid decay of red blood cells. As a result, the skin and mucous membranes become a characteristic yellow color. Pediatricians say that such a condition is natural and should not be scared. Pathology proceeds naturally and does not entail any consequences. The process will be much shorter if the baby is breastfed.
- Pathological. Jaundice in a newborn can have pathological causes. Fortunately, this type is quite rare and signals serious problems in the baby's body.
Causes of the development of the disease
Particular concern and attention of doctors is caused by pathological jaundice in newborns. The reasons for this phenomenon can be very different and are classified into congenital and acquired. A rather complex process is the exchange of bilirubin in the body. It is directly related to the work and functionality of the liver. The pathological form is detected immediately after birth. The content in the blood of red blood cells rises sharply, reaching critical levels. As a result, self-poisoning of the body occurs. Therefore, pathology requires immediate treatment and the use of various means.
But jaundice can be treated differently in newborns. The reasons for its appearance must be clarified in order to know what to look for when assigning procedures.
Congenital form
An increase in the concentration of pigment in the blood can be congenital. The appearance of pathological yellowness is associated with the following factors:
- The erythrocyte membrane is pathologically altered. In this case, not only a change in skin color is observed, but also the spleen and liver are enlarged.
- Violations in the natural hemoglobin production system. In this case, the first signs of the disease can be noticeable only after six months of the baby's life.
- Violations in the structure of the biliary tract. Surveys show partial or complete blockage. As a result, the natural outflow of bile is disrupted and excess bilirubin accumulates in the body. Pathology is usually noticeable immediately after birth. The abdominal wall (due to an enlarged liver) is usually protruded forward. The skin becomes greenish.
- Red blood cell enzyme deficiency. The disease appears on the second day after birth. Not only skin turns yellow, but urine also becomes much darker.
- Jaundice in a newborn may be associated with a hereditary disease. Most often, cystic fibrosis leads to the development of pathology. In this case, there is a complete blockage of the bile duct with clots of mucus.
All congenital factors require examination and comprehensive treatment.
Acquired Form
In different ways, jaundice may appear in newborns. Causes and consequences depend on the form of its manifestation. So, a baby can be born completely healthy, but under a number of adverse circumstances, get this disease:
- Hemorrhages in the internal organs. As a result, the erythrocytes decay in the focus of inflammation, which causes yellowing of the skin.
- Rhesus conflict of mother and baby can lead to the development of hemolytic disease. In this case, there is a change in the shade of the skin and mucous membranes.
- Non-specific reasons. Pathology can be caused by a drop of blood into the stomach during childbirth or an increased concentration of red blood cells in the blood.
It should be understood that most often natural causes are caused by jaundice in newborns. The causes, consequences and norm of bilirubin are always studied by specialists. But most often, the physiological type of jaundice is diagnosed, which usually does not require special treatment. However, it should be understood that letting the process go by gravity is also unacceptable. The consequences of jaundice in newborns are persistent disorders in the nervous system. In addition, an increased amount of bilirubin affects the work of many organs, therefore, constant monitoring by a doctor is necessary.
Main manifestations
Any doctor and observant mom will immediately notice the characteristic symptoms of jaundice. The main ones are the following:
- The skin acquires a persistent yellow tint. The color of the mucous membrane of the eyes also changes.
- The effects of jaundice in newborns may be different. If the physiological form is manifested, then in feces and urine there are no changes. When pathological, they darken. The well-being of the baby also varies. With the natural process, the baby feels good and is gaining weight. In the case of pathology, the child looks depressed, his appetite and general health suffer.
- With the physiological form, hemoglobin analyzes are normal. Otherwise, anemia develops rapidly.
The only problem is the pathological form. An increase in the spleen, liver and persistent expansion of veins in the anterior abdominal wall are added to the general symptoms.
When does jaundice pass in newborns?
All systems of a healthy child are gradually being improved. Therefore, the problem usually goes away on its own 5-6 days after birth. The excretion of excess bilirubin will go even faster if the baby receives breast milk, and is not breast-fed. This process refers to the physiological norm, does not harm the body and passes on its own.
But even after discharge from the hospital, jaundice in newborns may disturb . When this pathology should go, it is important to know all young parents. The entire process of removing bilirubin should not take more than two weeks. If it is delayed or the baby's condition worsens, then a doctor's consultation and additional examinations are required.
The condition may be severe and will require treatment in a hospital. Doctors most often use Hofitol so that jaundice in newborns passes. Reviews about its use, as well as general drug therapy, are mostly positive. Negative feedback about treatment often occurs with those parents who turned to a specialist too late.
Necessary analyzes
How to treat jaundice in newborns? It depends on the form of its manifestation. Find out the reason will help the appropriate tests. After all, the disease is manifested not only by the appearance of the skin. Urine also acquires a dark yellow hue, while feces become whitish. Bruises can form on the baby’s body. If no improvement is observed within two weeks, then you should consult a doctor. Do not hope for an independent cure, because the consequences can affect all organs and systems of the child's body.
The pediatrician at the reception examines the baby and sends for a blood test. It is necessary to identify the level of bilirubin. If the problem is more serious, then an abdominal ultrasound and tests for hereditary diseases will be required. Only after all examinations, complex therapy is prescribed.
Necessary treatment
Jaundice can acquire different forms in newborns. In this case, treatment may be required even if the pathology is physiological in nature. A preliminary forecast is made depending on the severity of the course and the general health of the infant.
Correction methods for bilirubin metabolism are selected taking into account the manifestation of jaundice. In this case, we will not always need to take medication.
Light therapy
In the treatment of physiological jaundice, light therapy is most often prescribed. This method is basic and is used everywhere. The rays of the lamp act on the bilirubin fractions and convert them into non-toxic compounds. If the baby has slight manifestations of yellowness, then treatment may not be required. However, in premature infants with a lack of weight, this method is mandatory.
Light therapy is carried out under a special lamp that emits green or blue. Usually the baby lies under it up to 12 hours a day, so this method is used only in the hospital or hospital. It is important to protect the genital area and eyes.
It should be understood that the procedure is safe if it is carried out by specially trained personnel. Conducting such treatment yourself is strictly prohibited.
Blood transfusion
Indication for this procedure is:
- rapid and uncontrolled growth of bilirubin;
- decrease in hemoglobin to critical levels;
- complete lack of effect from other methods of therapy.
For each specific case, individual biological material is selected. Transfusion will be carried out only after checking for full compatibility. However, it must be understood that such a technique is used in exceptional cases and may have a number of complications:
- violation of the cardiovascular system;
- anaphylactic shock;
- air embolism.
After the procedure, the baby is under the complete control of medical personnel for 3-4 hours.
The use of medicines
The purpose of this technique is to bind in the elimination of excess bilirubin. For this, choleretic drugs are prescribed:
- magnesium sulfate;
- "Allohol;
- "Holistyramine";
- "Agar-Agar";
- "Carbolen."
In addition, ATP and vitamin therapy are used.
Enterosorbents may also be prescribed. If jaundice is observed in newborns, treatment at home involves taking Smecta or Polypefan. Similar drugs disrupt the circulation of bilirubin between the liver and intestines.
If cholestasis is manifested, then Ursosan is recommended. The drug is available in the form of capsules and is quite effective against jaundice. However, parents are often scared of possible side effects, which are indicated in the instructions. Among them are:
- vomiting
- diarrhea;
- allergic manifestations.
But doctors say that not all children have such symptoms. Doctors often prescribe the drug, because the intended benefit significantly exceeds the possible side effects.
Jaundice is dangerous because it causes intoxication of the body. To avoid such problems, diffuse therapy is often prescribed, which consists in the intravenous administration of glucose and sodium chloride.
Possible consequences
Despite the fact that the ailment quite often passes on its own, it can not be allowed to drift. If doctors offer treatment, then you should not refuse. It must be understood that jaundice causes not only a change in skin color, but also affects the functioning of all internal organs. Particular attention is required to the pathological form, which signals from serious diseases. In this regard, the following complications may occur:
- decay products of bilirubin affect the central nervous system, which negatively affects the general condition of the body;
- motor function may be impaired;
- if bilirubin fractions penetrate the meninges, then this is fraught with the development of seizures, mental retardation or complete hearing loss;
- the concentration of albumin decreases, so edema develops.
It can be seen that the consequences are quite serious, so medical help is necessary in any case.
Conclusion
The prognosis for this pathology always depends on the severity of the disease, the form of its manifestation and the health status of the newborn. If a problem is noticed in time and all measures are taken to eliminate it, then negative consequences are usually not observed.
But if the level of bilirubin is at a critical level, and parents do not pay attention to it, then brain damage and problems associated with this are possible. The liver is more likely to suffer, convulsions develop, and the diagnosis of mental retardation may be made in the future.
Therefore, do not neglect this pathology. However, you should not be afraid of jaundice. Almost always, the disease is not dangerous and can be easily corrected.