Jaundice in newborns: causes, treatment, consequences, reviews

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

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 of bilirubin in them - a bile pigment. The severity of the pathology depends on its concentration in the blood and a decision is made on the appropriate treatment. It must be understood that in most cases this condition is considered a physiological norm and does not require medical intervention. But there are times when a baby needs help.

The process of development of jaundice

Being in the womb, the baby received everything he needed through her circulatory system. After birth, hemoglobin breaks down, the cells of which are responsible for delivering oxygen from mother to fetus. As a result, excess bilirubin accumulates in the child's blood and the skin acquires a characteristic shade.

Doctors note indicators that are the norm. If on the 3-5th day after the birth of a full-term baby, the level of bilirubin is normally more than 172 - 206 µmol / l, then by one month it should fall to 3.4-22 µmol / l. If athis does not happen, then a pathological process is diagnosed that requires immediate treatment.

Classification of pathology

Jaundice in a newborn is classified into two varieties (depending on the flow process):

1. 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 the 3-5th day from the moment of birth and lasts no more than 10 days. The bilirubin index can rise to 223 µmol / l, but this does not affect the state of he alth, the baby feels good. The cause of this condition is the massive and rapid breakdown 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 afraid of it. Pathology passes naturally and does not entail any consequences. The process will be much shorter if the baby is breastfed.
2. Pathological. Jaundice in a newborn may have pathological causes. Fortunately, this type is quite rare and signals a serious problem in the baby's body.

Reasons for the development of the disease

Pathological jaundice in newborns is of particular concern and attention to doctors. The reasons for this phenomenon can be very different and are classified into congenital and acquired. Quite a complicated processis 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 of red blood cells in the blood 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 in newborns can be treated differently. The reasons for its appearance must be clarified in order to know what to look for when prescribing procedures.

Innate form

Increased concentration of pigment in the blood may be congenital. The appearance of pathological yellowness is associated with the following factors:

1. The membrane of erythrocytes is pathologically altered. In this case, there is not only a change in skin color, but also an enlarged spleen, liver.
2. Disturbances in the natural system of hemoglobin production. In this case, the first signs of the disease may be noticeable only after six months of the baby's life.
3. Disturbances in the structure of the biliary tract. Examinations 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 the enlarged liver) is usually protruded forward. The skin becomes greenish.
4. Lack of erythrocyte enzymes. The disease appears on the second day after birth. Yellowing is not only the skin,but the urine becomes much darker.
5. 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 ducts with mucus clots.

All congenital factors require examination and complex treatment.

Acquired form

Jaundice can manifest itself in different ways in newborns. Causes and consequences depend on the form of its manifestation. So, a baby can be born absolutely he althy, but under a number of unfavorable circumstances, get this disease:

1. Hemorrhages in the internal organs. As a result, red blood cells break down in the focus of inflammation, which causes yellowing of the skin.
2. Rhesus conflict between mother and baby can lead to the development of hemolytic disease. In this case, there is a change in the tone of the skin and mucous membranes.
3. Non-specific causes. Pathology can be caused by reflux of blood into the stomach during childbirth or an increased concentration of red blood cells in the blood.

It should be understood that jaundice in newborns is most often caused by natural causes. 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 take its course 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, so constantmedical supervision.

Main manifestations

Any doctor and observant mother will immediately notice the characteristic symptoms of jaundice. The main ones are as follows:

1. The skin takes on a persistent yellow tint. The color of the mucous membrane of the eyes also changes.
2. The consequences of jaundice in newborns can be different. If the physiological form is manifested, then there are no changes in the feces and urine. When pathological, they darken. The well-being of the baby also varies. With a natural process, the baby feels good and gains weight. In the case of pathology, the child looks depressed, his appetite and general he alth suffer.
3. With a physiological form, hemoglobin tests are normal. Otherwise, anemia rapidly develops.

Only the pathological form becomes a big problem. To the general symptoms is added an enlargement of the spleen, liver and persistent dilatation of the veins in the anterior abdominal wall.

When does jaundice go away in newborns?

All systems of a he althy child are gradually improving. Therefore, the problem usually goes away by itself on the 5-6th day after birth. The excretion of excess bilirubin will go even faster if the baby is receiving breast milk, and is not formula-fed. This process belongs 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 bother. When should this pathology pass?know to all new parents. The entire process of removing bilirubin should not take more than two weeks. If it drags on or the baby's condition worsens, then a doctor's consultation and additional examinations are required.

The condition may be severe and require hospital treatment. Doctors most often use "Hofitol" to pass jaundice in newborns. Reviews about its use, as well as general drug therapy, are mostly positive. Negative feedback about treatment is often found in those parents who turned to a specialist too late.

Required tests

How to treat jaundice in newborns? It depends on the form of its manifestation. Appropriate tests will help determine the cause. After all, the disease is manifested not only by the appearance of the skin. Urine also acquires a dark yellow tint, and stool becomes whitish. Bruises may form on the baby's body. If there is no improvement within two weeks, you should consult a doctor. You should not hope for an independent cure, because the consequences can affect all organs and systems of the child's body.

A pediatrician at the reception examines the baby and sends him for a blood test. It is necessary to determine the level of bilirubin. If the problem is more serious, then an abdominal ultrasound and tests for hereditary diseases will be required. Complex therapy is prescribed only after all examinations.

Necessary treatment

Jaundice can take on different forms in newborns. Treatment in this case may be required even if the pathology isphysiological character. Depending on the severity of the course and the general he alth of the baby, a preliminary forecast is made.

Methods for correcting bilirubin metabolism are selected taking into account the form of manifestation of jaundice. This does not always require taking 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 fractions of bilirubin and convert them into non-toxic compounds. If the baby has minor manifestations of yellowness, then treatment may not be required. However, in underweight preterm infants, this method is mandatory.

Light therapy is carried out under a special lamp that emits green or blue light. Usually the baby lies under it for up to 12 hours a day, so this method is used only in a maternity hospital or hospital. It is important to protect the genital area and eyes while doing this.

It should be understood that the procedure is safe if it is carried out by specially trained personnel. It is strictly forbidden to carry out such treatment on your own.

Blood transfusion

Indication for this procedure is:

• rapid and uncontrolled rise in bilirubin;
• decrease in hemoglobin to critical levels;
• complete lack of effect from other therapies.

Individual biological material is selected for each specific case. Transfusionwill 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 full control of medical professionals for 3-4 hours.

Medication use

The purpose of this technique is to bind to the excretion of excess bilirubin. For this, choleretic drugs are prescribed:

• magnesium sulfate;
• "Allohol;
• "Cholistyramine";
• "Agar-Agar";
• "Carbolene".

In addition, ATP and vitamin therapy are used.

Enterosorbents can also be prescribed. If jaundice is observed in newborns, home treatment involves taking "Smecta" or "Polypefan". Such 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 frightened by the possible side effects that are indicated in the instructions. Among them are:

• vomit;
• diarrhea;
• allergic manifestations.

But doctors say that not all children have such symptoms. Doctors often prescribe a drug because the intended benefit far outweighs the possibleside effects.

Jaundice is dangerous because it causes intoxication of the body. To avoid such problems, diffuse therapy is often prescribed, which consists of intravenous administration of glucose and sodium chloride.

Possible consequences

Despite the fact that the disease often goes away on its own, it should not be left to chance. 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. The pathological form, which signals from serious diseases, requires special attention. In this regard, the following complications may occur:

• Bilirubin breakdown products 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;
• albumin concentration decreases, so edema develops.

It can be seen that the consequences are quite serious, so medical assistance is necessary in any case.

Conclusion

Prognosis for this pathology always depends on the severity of the disease, the form of its manifestation and the state of he alth of the newborn. If the problem is noticed in time and all measures are taken to eliminate it, then negative consequences are usually not observed.

But if the bilirubin level is atcritical point, and parents do not pay attention to it, then brain damage and the problems associated with it are possible. The liver is more likely to suffer, convulsions develop, and in the future, "mental retardation" may be diagnosed.

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.