Babies will face some small problems after birth, among which jaundice is a must-pass, which will cause parents to worry, is neonatal jaundice a disease? Next, let's take a look at the knowledge of neonatal jaundice.
Neonatal jaundice in newborns is manifested by elevated bilirubin levels and yellowing of the sclera and skin. The following situations are common:
A physiological jaundice
Physiological jaundice refers to the appearance of skin and eye yellowing in newborns 2 to 3 days after birth, reaching a peak in 4 to 6 days, resolving within two weeks in term newborns and resolving within 3 to 4 weeks in premature babies.
Mild jaundice can be confined to the face, neck and trunk, with a pale yellow color, and severe cases can spread throughout the body.
In addition to jaundice, newborns are generally in good condition, feeding, sleeping, and urinating and defecating are normal. This situation does not require any treatment and can be observed naturally.
II Inadequate intake of jaundice
In late preterm and term infants, there are some physiological jaundice caused by delayed breastfeeding, infrequent or insufficient infant sucking, and restriction of the infant's time on the breast, resulting in insufficient milk intake, called insufficient intake jaundice or starvation jaundice.
Mothers should breastfeed as soon as possible, encourage a small number of multiple breastfeeding, 10-12 times a day, to ensure adequate milk and energy intake, reduce the physiological weight loss. Pay attention to avoid feeding sugar water incorrectly, so that the number of breastfeeding is reduced, which is not conducive to the secretion of milk.
If serum bilirubin rises to the standard of phototherapy, intervention should be taken and breastfeeding may be continued, along with phototherapy.
3 Breast-milk jaundice
Breast-milk jaundice is hyperbilirubinemia that occurs in healthy, full-term, exclusively breastfed newborns with elevated unconjugated bilirubin. It is divided into early-onset and late-onset types.
Hyperbilirubinemia, which occurs 3-4 days after birth in healthy full-term breastfeeding infants, excludes hemolytic factors and other diseases, called early-onset breast-milk jaundice, and compared with physiological jaundice, the jaundice appears and peaks at similar times, but the peak of bilirubin and the duration of jaundice in breast milk jaundice exceed physiological jaundice.
Late-onset jaundice appears late, often followed by physiological jaundice, or worsened after physiological jaundice is reduced, i.e., bilirubin peaks often appear 7-10 days after birth, and jaundice persists for 2-3 weeks or even 2-3 months before subsiding. The baby is completely healthy except jaundice, breastfeeds well, urinates normally, and has satisfactory weight gain. If necessary, breast milk is stopped for 24-72 hours, and bilirubin rapidly decreases by about 50%. With re-breastfeeding, bilirubin may rise again, but not to its original level.
Jaundice is required when the jaundice value meets the intervention criteria. In the Expert Consensus on the Diagnosis and Treatment of Neonatal Hyperbilirubinemia published in 2014, the treatment of breast-milk jaundice recommended that breast milk could be suspended for 3 days when TSB 257 umoI/L (15 mg/dI) was changed to formula feeding. When TSB >342 umoI/L (20mg/dl), phototherapy is added. During light therapy, in order to ensure the nutrition of newborns and reduce the psychological burden of mothers, breast milk can still be fed, and the therapeutic effect can also be achieved.
Quad pathological jaundice
Jaundice occurs within 24 hours of birth in newborns and has an etiology, with bilirubin > 6 mg/dl within 24 h, or > 5 mg/dl per day or serum-conjugated bilirubin > 2 mg/dl.
Jaundice prolonged or physiological jaundice after the resolution of the recurrence, a progressive exacerbation, if accompanied by low-grade fever, vomiting, bloating, hepatosplenomegaly, yellow stool or blood, should consider neonatal hepatitis syndrome or biliary obstruction and infection, parents should pay attention to the observation and warmth of the baby's skin color, feeding as soon as possible, conducive to the normal establishment of intestinal flora, keep the stool unobstructed, cooperate with the doctor, and actively treat the primary disease.
This article is written by Yi Cuixia, Beijing New Century Women's and Children's Hospital
Disclaimer: Zhen Milk Network publishes all content and prohibits reprinting.
Resources:
[1] Ren Yuwen, Gao Haifeng, et al. Theory and Practice of Breastfeeding [M]. Beijing: People's Medical Publishing House, 2018; 135-139.
[2] Karen Wambach; translated by Gao Xuelian, Sun Yu, and Zhang Meihua. Breastfeeding and Human Lactology [M]. Beijing:People's Medical Publishing House,2021,3:288-290.]
[3] Practical Neonatology/Shao Xiaomei, Ye Hongmao, Qiu Xiaoshan, editors.-5th edition.-Beijing:People's Medical Publishing House,2018,455-456.