Increased yellowness of the skin and whites of the eyes occurs in 60% of term and 80% of preterm infants during the first weeks after birth. Typically, this jaundice is not associated with hepatitis, and in most cases do not require treatment. Usually it is due to age immaturity of the liver of the baby or, less frequently, an excess of hormones in the milk of the mother. However, in 0.3-0.7% of newborns yellowing of the skin can be attributed to a very dangerous hemolytic disease, which can lead to the death of a child.
Why a baby “yellow”?
Yellowing of the skin, mucous membranes and whites of the eyes of a baby is always explained by the high content in his blood, bile pigment bilirubin, which is the result of a natural process of the breakdown of hemoglobin in the blood. Released bilirubin is insoluble poison, and its removal from the body is difficult. Therefore, in the liver it is associated with glucuronic acid, becomes non-toxic, soluble and easily excreted in the urine. Jaundice occurs when the liver fails to bind the released bilirubin and its content in the blood exceeds 35 µmol/L. Then he penetrates the tissues, causing yellow skin, eye sclera, the lower surface of the tongue, the sky.
What is physiological jaundice (hepatitis) in the newborn?
In the vast majority of cases (60-80%) cause of jaundice in the newborn is the immaturity of enzyme systems of the liver. First of all it concerns premature infants. This is a natural condition in which the liver of the newborn baby does not have time to respond to the rapid process of disintegration of hemoglobin, because of the blood of this child at this time is undergoing a process of rapid change of hemoglobin, which provided the fetus of oxygen to the entire period of pregnancy, hemoglobin born and sadashivrao own person. As a result, in the blood of the baby may accumulate bilirubin, and his skin and eyeballs to turn yellow. It usually becomes noticeable on the second day after birth, peaks to the eighth and the tenth day of a child’s life, and goes to the third or fourth week. This condition does not require special treatment and does not cause the kid is a serious inconvenience, though, and is able to scare parents. This jaundice passes itself as soon as the liver of the child will get stronger and will be able to process all the accumulated bilirubin. However, if the bilirubin in the blood of the kid reaches high figures, doctors recommend special treatment.
Why do I get jaundice from breast milk?
This type of jaundice is physiological. He explained the surplus in the mother’s milk of female sex hormones – estrogens which are associated with glucuronic acid, “occupying” the place of bilirubin. This jaundice is not dangerous. It can take up to 1-3 months. Typically, the child feels no anxiety, he is active and normally putting on weight. Peak bilirubin level in such cases accounted for 10 to 21 days, and its level can vary from 150 to 500 µmol/L. If jaundice breast milk to interrupt breastfeeding for a short time, the level of bilirubin in the blood of the baby will be sharply reduced. However, doctors usually recommend to continue breastfeeding because breast milk jaundice usually does not pose a serious danger to the child.
What is hemolytic disease?
In rare cases (0,3-0,7%) jaundice may be due to hemolytic disease (GMB) due to rhesus-conflict of mother and child (92%), the incompatibility of the blood (7%) or other antigens (1%). In this case, the jaundice is more pronounced and appears in the first hours of life of the baby. It is accompanied by anemia, enlarged liver and spleen. The buildup of bilirubin toxicity takes place rapidly. While the child is noticeably worse: he becomes sluggish, drowsy, lose muscle tone. In the absence of medical intervention is to 3-4 days of the bilirubin level can reach the critical indicators. Unbound bilirubin can begin to be deposited in the basal nuclei of the brain of the baby. This so-called kernicterus, which can lead to disability and even death of the child. Its symptoms are rigidity of occipital muscles (the child is not able to tilt the head), seizures, wide-open eyes, the constant cry.
In addition, pathological jaundice may be caused by mechanical disturbances to the outflow of bile, infection, internal bleeding or birth injuries toddler etc. Such diseases require constant medical supervision and treatment in hospitals.
How is it treated jaundice (hepatitis a newborn in the hospital?
The treatment of pathological jaundice depends on the causes of this condition. When rhesus-the conflict of mother and child, as well as incompatibility of blood groups use exchange transfusion, in order to “wash” from the baby’s blood bilirubin. During one procedure transfusion child can replace up to 70% of the blood. If the bilirubin level will again rise, blood transfusion newborn to repeat 4-6 times. In severe anemia child pour in special drug blood erythrocyte mass.
Typically, the level of bilirubin try to control using different procedures that facilitate the binding and excretion of the substance from the body of the child. Use of hyperbaric oxygenation, i.e. in the pressure chamber with a child serves a specially humidified oxygen.
For the same purpose are often prescribed intravenous phenobarbital, which accelerates the binding of bilirubin, and additional fluid in the form of water with glucose. In this case, as a rule, assigned to a course of antibiotics to prevent infection of the baby’s body. As a result of such treatment increases the load on the liver of the newborn, and the introduction of additional fluid leads to a decrease feedings of breast milk.
Sometimes pediatricians recommend phototherapy (exposure to blue light), contributing to the breakdown of bilirubin in the skin.
However, such treatment is required only under high rates of bilirubin, which are commonly found in pathological types of jaundice. In most cases it is not necessary, because jaundice is physiological and heals itself. The use of glucose is inefficient – contrary to popular belief, it does not contribute to the output of bilirubin from the body.
How to cure jaundice (hepatitis) a child
The child should be put to the breast within the first few hours after birth, so that he could get the colostrum. It promotes discharge of meconium (the first intestinal secretions and prevents physiological jaundice. Further feedings should be frequent, at least 8-10 times per day, and unlimited time. This will result in frequent bowel movements and systematic withdrawal of excess bilirubin from the body naturally. For the newborn also useful indirect sunlight. This natural phototherapy helps to get rid of the bilirubin.
Do I need additional watering the child with jaundice?
Unbound bilirubin is dangerous for the child and has a toxic effect. It is insoluble in water, so drink plenty of water in this case is useless. If your baby will be drinking a lot of water, this can lead to weight loss: water will prevent him from getting the right amount of breast milk. The less the child will eat, the less will be leaving feces and urine, and therefore, the bilirubin is excreted from the body more slowly.
What to do if jaundice in the newborn does not pass?
If a newborn baby is actively nursing, receives the necessary amount of milk, he has no problems with urination and stool, if it is normally putting on weight and not worried for no reason, then most likely physiological jaundice runs it fine, just a little slower than usual. If the baby is lethargic, too sleepy, he does not chair, the mother should consult a doctor to determine the level of bilirubin in the blood and to exclude pathology.