Prolonged jaundice in newborns. Jaundice in newborns: treatment, symptoms, causes and photos; consequences of jaundice in newborns

Good day, dear mothers and everyone else interested in the health of babies.

My name is Lena Zhabinskaya, I am a mother twice, and I know first-hand what jaundice is in newborns. At one time, she made me quite worried and thoroughly understand the question of what it is, why some children have it and others don’t, whether it is dangerous, how to recognize it and how to treat it.

About all this in today's article!

Jaundice in newborns is not the name of a specific disease, but one of the symptoms of a disease.

There can be many reasons for jaundice, from quite harmless (for example, physiological jaundice newborns), to quite deadly ones (hepatitis B).

Therefore, if you suspect that your baby has yellowish skin and the whites of his eyes, you should immediately consult a specialist so that the doctor can determine what is causing this and prescribe tests and other measures.

Causes of jaundice and its types

The most common and absolutely not dangerous option. According to statistics, it occurs in 60-70% of healthy newborns and in 80-90% of premature babies, which allows us to conclude that if you are lucky enough to avoid it, then you are the exception rather than the rule.

The occurrence of physiological jaundice in newborns is explained by the following reasons.

After birth, the respiratory and circulatory systems crumbs. Now the baby eats and breathes on his own. In the body, as unnecessary, excess red blood cells disintegrate, inside of which there is a yellow pigment - bilirubin.

The body does not need excess bilirubin and should be neutralized. Who should do this? Of course, the liver, because it is this organ that is responsible for neutralizing everything harmful and unnecessary.

But in a child, especially a newborn, the liver is very, very immature, it still cannot do much, and this is not surprising. Just as hands cannot yet grasp a toy, and legs cannot walk, so the liver does not know how to quickly remove large amounts of harmful substances.

As a result, we get an increase in the level of bilirubin in the blood and a tanned skin color in the newborn.

Since this is the most common type of jaundice - up to 60% of all cases of jaundice in newborns - are physiological, not dangerous, and go away on their own, we will examine this type of jaundice in detail in the article.

Personally, I encountered physiological jaundice once - when Lev was born. About the third day after birth, he turned yellow, and we glowed under a special lamp right in the maternity hospital.

This problem did not arise with Eva - apparently, girls and their livers are better able to cope with difficulties from birth (just kidding). In general, this particular type of jaundice is very common, although harmless, which cannot be said about other types.

Breastfeeding jaundice

It occurs specifically in babies who eat mother’s milk and is due to the fact that breast milk contains substances that interfere with the functioning of the baby’s liver enzymes.

If the doctor suspects this particular type of jaundice, then a simple test is performed.

The mother is instructed to feed the baby formula for a couple of days and pump to preserve or.

Usually this time is enough to see how the baby has returned normal color skin, and bilirubin returned to normal.

After this, breastfeeding, as a rule, is allowed to resume, and the general condition of the baby and its tests continue to be monitored.

If the amount of bilirubin in the blood does not grow rapidly to alarming proportions (10-15 times more than normal), then the mother continues to breastfeed the baby.

Hemolytic jaundice

Not far anymore harmless condition which requires constant monitoring at the doctor.

It is most often caused by:

1. Rhesus conflict between mother and fetus that was not prevented in time.
2. Blood type incompatibility between mother and baby.

Unlike physiological jaundice and jaundice breastfeeding, with hemolytic disease, the skin and whites of the eyes turn yellow within the first hours after birth.

In addition, a competent specialist can easily identify, by palpating the baby’s tummy, an enlarged liver and spleen.

Obstructive jaundice

A dangerous and, fortunately, very rare pathology that can only be treated by specialists.

They bring her to her various disorders structure of the liver, biliary tract, gallbladder, how birth defects development of these organs, and those obtained as a result of birth trauma.

Unlike the forms of jaundice already discussed, this disease can appear both immediately and several weeks after birth.

In this case, the skin may acquire an unnatural greenish tint, urine becomes dark in color, and feces are almost colorless.

The doctor, palpating the tummy, will determine abnormalities in the density and size of the liver and spleen.

Viral jaundice

Called viral infections, for example, hepatitis A, B, C. The most dangerous is hepatitis B, it is with it that a severe complication occurs - cirrhosis of the liver - which requires a transplant of this organ, otherwise the patient’s death is possible.

You may ask, how can a newborn become infected with hepatitis B? It’s very simple, because the infection is transmitted, including:

1. In case of close household contacts (saliva, blood, other liquids) from relatives (possible carriers are mother and grandmother who do manicures in a salon, father who shaves in a barbershop).
2. For any medical interventions associated with skin disorders (blood transfusions, from which no one is immune, injections with unsterile needles).

Physiological jaundice of newborns

When does it start and how long does it last?

Jaundice in newborns usually begins on the 3rd day after the birth of the baby, and goes away on its own and without consequences on the 10-14th day.

However, answering the question of when the jaundice will go away in each individual case is not so simple.

Each newborn is individual, and if your baby’s “tan” has not disappeared two weeks after birth, this is not a reason to panic, but just a reason to monitor bilirubin levels with a doctor.

Norm of bilirubin

For ease of perception, I have clearly shown in the table the level of bilirubin in the child’s blood.

Meanwhile, pediatricians note that these limits of the norm are very conditional. In any case, cases where the bilirubin level exceeds the norm by 10-15 times are truly dangerous and require treatment.

An experienced doctor always looks at the level of yellow pigment over time. If the level is high, but there is a trend towards a slow but decrease, then most likely there is no need to worry - this happens when the jaundice gradually goes away. This suggests that the baby’s liver is successfully learning to neutralize the harmful substance, and it succeeds.

It’s another matter when bilirubin grows rapidly and rapidly. Such cases, of course, require medical intervention.

Treatment

Medicines

We have already said that postpartum jaundice in newborns is a natural condition, which, as a rule, goes away on its own and without consequences as the child’s liver “grows up”, on the 10-14th day after birth.

Therefore, in the absence of others, it is realistic health threatening baby, symptoms (except skin tone), drug treatment not shown.

In particular, modern pediatricians do not prescribe Ursosan, Ursofalk, and especially Phenobarbital, which a few years ago was considered a panacea for treating jaundice in newborns.

Numerous studies have now proven that, despite such a side effect as the ability to reduce bilirubin levels, influence is more dangerous this drug on the baby's nervous system.

If your doctor has prescribed you this drug, immediately consult with other specialists regarding the advisability of its use in a newborn.

Phototherapy or lamp

In the recent past, doctors discovered the following completely by accident. When light hits the skin, bilirubin becomes non-toxic.

This is how an effective and safe method phototherapy in the treatment of physiological jaundice in newborns, which involves exposing the baby’s skin to a special lamp.

This may look different depending on the type of lamp.

With some types of lamps, the baby is completely undressed down to the diaper, special glasses are put on his eyes, and the entire surface of the body is shone with a lamp, turning the baby over at certain intervals on his tummy and back.

Other types of lamps look like a flat, glowing rectangle wrapped around soft cloth, and are placed under the baby’s clothes close to the skin of the tummy and back alternately.

The duration of the procedures is determined by the doctor. In most cases, 96 hours are enough to receive noticeable decrease the level of bilirubin in the blood and the disappearance of yellowness of the skin.

If it’s summer and warm weather outside, then all these procedures can easily replace the usual ones. sunbathing. The only thing in this case is to carefully follow the rules of sun exposure: before 10:00 and after 16:00, and with the obligatory use of sunscreen.

Consequences and is it dangerous?

Physiological jaundice, as a rule, passes completely without consequences and is not dangerous for the newborn. If you want to understand this issue thoroughly, watch an additional video in which the famous pediatrician Dr. Komarovsky accessible language talks about jaundice.

This is a natural state of the body in which it learns to adapt to conditions environment, and the liver learns to work more efficiently and cope with greater loads.

IN as a last resort, if the level of yellow pigment exceeds normal limits and grows rapidly, the doctor will prescribe phototherapy - glow under a special photo lamp.

By the way, this can be done in a clinic or at home - fortunately, there are now services that provide such equipment for rent at home.

Now you know that you shouldn’t be afraid of physiological jaundice in newborns, and in order not to forget this, subscribe to blog updates and save the article to your wall on social networks so as not to lose it!

Raise healthy kids, and don’t get sick, Lena Zhabinskaya was with you, see you again!

Most newborns (about 60%) develop a yellow tint to the skin on the 2nd-3rd day of life.

What is this connected with and how to treat jaundice in newborns - these are perhaps the most FAQ new mothers facing this problem.

What causes jaundice in a newborn?

Skin coloring yellow(jaundice) occurs when the level of bilirubin in the blood increases, which is subsequently deposited in the skin and mucous membranes, which gives it its characteristic color.

A little about bilirubin: it is a pigment that is formed during the breakdown of erythrocytes (red blood cells). After breakdown, bilirubin is eliminated from the body with the help of enzymes produced in the liver. Normally, the body of every person undergoes regular renewal of blood cells, but this process is not accompanied by jaundice, since the level of bilirubin is not high and enzyme systems cope with its removal. And it is excreted in feces and urine.

There are two types of bilirubin - direct (enzyme-bound, water-soluble, non-toxic) and indirect (unbound, fat-soluble, toxic)

For a newborn baby, things are a little different. There are a number of physiological characteristics that lead to a child’s level of indirect bilirubin and rapid coloring of the skin occurs with the development of jaundice in the infant. These are features such as: increased breakdown of red blood cells after birth (fetal red blood cells change to normal ones), immaturity of the enzymatic systems of the liver (which slows down the removal of bilirubin from the body), reduced amount of blood protein (which is also needed for the removal of bilirubin), thinness of the skin in all layers . Therefore, physiological jaundice occurs in 100% of newborns, but clinical manifestations observed in only 60% of children.

How does jaundice appear?

Characteristics for physiological jaundice following features: it appears 2-4 days after the birth of the baby, an increase in jaundice is noted until the 5-6th day of life, then the jaundice subsides. This species is characterized by an orange tint to the skin. Completely disappears within 2-3 weeks. It should be noted that premature babies may experience a protracted and wave-like course of jaundice (up to a month, and sometimes longer). General state children do not suffer from physiological jaundice, it is not contagious, there is no anemia, the liver and spleen are not enlarged. This condition is physiological and, as a rule, does not require any treatment.

How to speed up the excretion of bilirubin?

You can only take measures to ensure that bilirubin is eliminated from the baby’s body faster. Thus, faster elimination is facilitated by: early breastfeeding (in the delivery room), breastfeeding on demand. Colostrum promotes faster passage of meconium, and with it bilirubin. Placing the child in the sun (during the warm season) also speeds up the removal of this substance from the body.

It happens that the child’s body cannot cope with the excretion of bilirubin, then its level in the blood increases to high values, in this case this is no longer a physiological condition, but a pathology that requires immediate treatment. The fact is that indirect bilirubin is a toxic substance, since it is water-insoluble (poorly excreted), but at the same time it is highly soluble in fats. It's dangerous because it's toxic substance begins to be deposited in organs and tissues that are rich in fat, and mainly in the brain. Which can lead to the development of “kernicterus,” that is, staining of the brain nuclei. The consequences after suffering from “kernicterus” are, as a rule, very serious and depend on the degree of its intensity and timely treatment. From minor manifestations of encephalopathy to severe brain damage with the development of blindness, deafness, paresis, paralysis and mental retardation.

Treatment of indirect hyperbilirubinemia

The main effective and safe (if all rules are followed) method of treating indirect hyperbilirubinemia (newborn jaundice) is phototherapy.

Phototherapy is carried out with a lamp that emits a certain spectrum of light waves, which help convert indirect bilirubin (toxic, water-insoluble) into direct (water-soluble, non-toxic), which is excreted in the child’s feces and urine. You should know that with intensive excretion of indirect bilirubin, the child experiences changes in the nature of his stool. Feces become dark green, semi-mushy, and in some cases even liquid.

Jaundice in newborns not only happens often, but happens almost always. Any mother will easily notice the first symptoms. The baby becomes unusually dark or appears to be filled with yellowness, and the whites of the eyes turn yellow. What is it - a disease or a feature? small child? This will become clear later, after several days of observations. Most often there is no reason for concern; this condition is caused by certain physiological characteristics body of a newborn child.

Why does jaundice appear?

Bilirubin is primarily to blame here. What is it and where does it come from? It's quite simple. A child who has not yet been born has special blood with special (fetal) hemoglobin. It carries oxygen through blood vessels baby. When a baby is born, he begins to breathe through his lungs. And then the composition of the blood changes: “live” hemoglobin appears in it, and fetal hemoglobin is destroyed. This is where bilirubin is formed. The child does not need it, and the little body begins to get rid of it.

This is a very difficult task for a child. You can't just remove bilirubin. First, it enters the liver and is mixed there with special enzymes, then dissolves in urine and is then easily excreted. If the liver cannot cope and there is a lot of bilirubin in the blood, jaundice will begin.

The causes of pathogenic jaundice are completely different. They are most often caused by a violation of the outflow of bile from the body due to the following conditions:

• blood group incompatibility;
• Rhesus conflict;
• viral liver damage;
• genetic disorders metabolism;
• hereditary diseases;
• hormonal disorders;
• mechanical damage to the biliary tract or liver.

VIDEO:

Norm of bilirubin

In the blood of a newborn baby, bilirubin should be from 8.5 to 20.5 µmol/l (micromoles per liter). The unit of measurement is quite complex, but you don’t have to delve into it. If you're really interested, a blood test is done molecular level. If the results of the analysis show that the bilirubin content is slightly higher than normal, the doctor understands: the baby’s body does not have time to cope with the load. True jaundice occurs when the bilirubin level exceeds 35 µmol/l.

And yet she is different...

Why jaundice appears is already clear. Why do you generally have difficulty removing bilirubin? Could this be a sign of pathology? Unfortunately yes. Doctors distinguish two groups of jaundice – physiological and pathological. Let's look at all types of jaundice from the rarest to the most common.

Pathological types of jaundice

They are rare, but require mandatory medical supervision and treatment. With pathological jaundice there is always additional symptoms. Some can be noticed by the mother or one of the relatives, others can only be recognized by a doctor.

Hemolytic disease

Among all babies who develop neonatal jaundice, less than 1% are affected hemolytic disease. Her reasons:

• Rh conflict between mother and baby (most often);
• blood type mismatch (very rare);
• antigen incompatibility (almost never occurs).

However, such jaundice is recognized quite quickly. The baby’s skin and sclera turn yellow not after a few days, but almost immediately after birth. The child looks lethargic and sleepy. The doctor, examining the baby, will feel an enlargement of the spleen and liver. All these signs show that the newborn urgently needs help, and then doctors begin immediate treatment. The most difficult case is kernicterus , in which bilirubin poisons the baby’s brain.

Obstructive jaundice

Rare, but still a pathology. There are several reasons for obstructive jaundice:

• gallbladder problems;
• obstruction of the biliary tract;
• liver problems.

Most often, obstructive jaundice is caused by genetic disorders or birth injuries baby. Manifestations of this disease become noticeable when the baby is two to three weeks old. The skin looks not just yellow, but with a greenish tint. The baby's stool becomes abnormally light, almost without color. The doctor will feel that the liver is thickening and the spleen is enlarged. If you suspect obstructive jaundice prescribe different additional examinations– for example, ultrasound. Treatment will depend on the type of pathology.

There are also borderline states when prolonged postpartum jaundice becomes pathological:

1. Conjugation jaundice associated with poor liver function. Liver enzymes do not bind bilirubin well and cannot remove it from the blood.
2. Kernicterus occurs when sharp increase bilirubin levels during postpartum jaundice. In this case, bilirubin penetrates the nervous system and exerts its toxic effect on it.
3. Hepatic jaundice appears when liver cells are damaged by viruses or bacteria.

Physiological jaundice

Now all doctors have recognized that this is not a disease, but one of the options normal condition newborn baby. However, even in this situation, the baby must be carefully monitored so as not to miss possible pathologies.

Breast milk jaundice

Another rare case. It occurs when the mother has a lot of estrogen in her milk (this is the female sex hormone). Then the baby’s liver first begins to excrete estrogen, and only then bilirubin. In this case, the baby remains icteric until three months . At the same time, the baby is developing perfectly - he has a good appetite, sleep and weight and height gain. This condition is not dangerous and goes away on its own.

If a child develops breast milk jaundice, mothers often ask: isn’t it better to wean the baby off the breast? There can be only one answer: no better! Yes, without breast milk the baby will stop turning yellow. But how much useful and important will he miss out on? So breastfeeding must continue.

Neonatal jaundice

And finally, the most common type. This is jaundice, which appears in most babies.. It is not a disease and does not require treatment. This type of jaundice in newborns goes away on its own and does not lead to complications. True, there is another view: if jaundice appears, then the baby’s liver is still overloaded. But the baby can be helped.

Symptoms

The main and indicative symptom of any type of jaundice is a change in the color of the skin and mucous membranes, and the whites of the eyes. They become bright yellow, almost lemon-colored.

When more than two weeks have passed and the baby’s skin has not acquired a normal color, you should consult a doctor. Before treating jaundice, a test will be performed to determine the level of bilirubin in the blood. The level of bilirubin depends on many factors and test results cannot be unambiguously interpreted. The doctor will draw conclusions about the child’s health status based on big picture health status.

Symptoms pathological types Jaundice manifests itself in changes in the color of the skin. The differences lie in the time of their appearance and some features of their manifestation:

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• changes in skin color appear immediately after birth;
• after three to four days the yellow color becomes brighter, all symptoms intensify;
• yellowness of the integument persists for more than one month;
• the appearance of symptoms of jaundice occurs in waves: it appears and then disappears;
• In addition to yellow, skin color can also acquire a green tint.

Plus, other symptoms are added to the change in skin color:

• stool is discolored;
• urine is dark in color;
• bruises appear spontaneously;
• enlargement of the liver and spleen is observed;
• the child’s general well-being deteriorates.

With kernicterus, extinction of the sucking reflex, severe drowsiness and the occurrence of convulsions are observed.

If we are talking about pathology, then any therapy is prescribed by a doctor. Most often, the baby and mother are admitted to the hospital, where everything is necessary procedures . For example, if a mother and child have a different Rh factor or other signs of blood incompatibility, then transfusions are most often prescribed. In one procedure, up to 70% of the baby’s total blood can be replaced. IN difficult cases transfusions are repeated several times.

These measures help get rid of pathological bilirubin, but can weaken the baby. Therefore it is often prescribed additional therapy: antibiotics, physiotherapy and so on.

Obstructive jaundice often requires surgical intervention. An informed decision is usually made by a whole commission of doctors who carefully examine the child and determine everything necessary measures. Such treatment and rehabilitation are also carried out in a hospital setting.

If the jaundice is physiological, then we are talking not about treatment, but about helping the baby. The child will cope with his condition faster if:

• put the newborn to the breast as early as possible (this stimulates metabolic processes);
• full breastfeeding;
• diet of a nursing mother so that the baby does not have digestive problems;
• sunbathing;
• walks in the open air.

Unfortunately, the last point cannot be fulfilled if it is cold outside. But in spring, summer or warm autumn, carrying the baby to Fresh air definitely necessary. In summer, in calm sunny weather, you can open children's arms and legs for a few minutes. This is especially useful in light shade - for example, under a tree, so that the child gets diffuse light. The main thing is that the baby does not freeze.

Such care for the newborn will perfectly help remove bilirubin from child's body. As a result, the baby’s jaundice will not only go away. The child will also become healthier and feel better.

The main way to treat and prevent neonatal jaundice is breast milk. That is why a newborn is put to the breast from the first minutes. Colostrum (the first portions of breast milk) has a pronounced laxative effect. It promotes the excretion of coloring matter (bilirubin) along with feces. Baby feeding - here best medicine from jaundice.

Sometimes in addition to breast milk Irradiation with a special lamp for the treatment of jaundice is prescribed - phototherapy. During the procedure, the child's eyes are covered with a bandage or goggles and placed under a lamp. The course is 96 hours.

lamp for the treatment of jaundice

Side effects may occur during phototherapy. The child may become drowsy, the skin may begin to peel, and bowel movements may occur.

Sunbathing has the same effect. When exposed to light, the baby’s body begins to actively produce vitamin D. It speeds up the process of removing bilirubin from the blood.

For severe jaundice, your doctor may prescribe glucose and activated carbon tablets. Glucose improves active work liver. Activated carbon absorbs like a sponge harmful substances, including bilirubin. Next, the charcoal along with bilirubin is excreted naturally with feces.

The doctor develops a treatment method for pathological types of jaundice depending on the diagnosis. All factors and circumstances of the child’s birth are taken into account. The course of labor and pregnancy, maternal illnesses, test results and ultrasound examination. Sometimes consultation is required narrow specialists; surgeon or endocrinologist.

Used in the treatment of jaundice different types therapy:

• Antiviral.
• Antibacterial.
• Choleretic.
• Detoxification.
• Immune.

They are used both individually and in combination under close supervision. medical supervision. It depends on the causes of jaundice.

Consequences and problems

At pathological conditions It is impossible to predict how quickly the baby will recover. First of all, it all depends on the causes of the disease and its severity.. This is why it is especially important to monitor your baby in the first days of life. What should you pay attention to?

1. Jaundice occurred a few hours after the baby was born (blood conflicts are possible).
2. The child is not developing well, he is sleepy and lethargic (significant excess of bilirubin in the blood, including in hemolytic disease).
3. Jaundice is accompanied by convulsions and constant screaming (this could be kernicterus). With this diagnosis, the child may develop hearing impairment, motor pathologies, and in the most severe cases, the baby may die.
4. The newborn had birth injuries.

As soon as the newborn begins to develop jaundice, careful monitoring is necessary to prevent the development of pathologies. If treatment is carried out on time, the baby will recover very soon and grow healthy.

Physiological jaundice does not cause any complications. It can last two to three weeks. Most babies get rid of jaundice when they are one month old. If the reason is in mother's milk, then the condition may drag on for another one or two months. After this, the baby’s skin and eyes are completely freed from the yellow tint. All this time the child is fully developing. The main thing for him is the care of his mother, family and doctors. And then the baby will grow up healthy and happy.

Physiological jaundice in healthy children does not harm the body and does not affect further development child. Pathological jaundice with age increases the risk of occurrence and development of cirrhosis or liver cancer. In 90% of children who were ill in infancy hepatitis, the consequences of jaundice remain for life. This results in weakened immunity and bad work liver.

The transferred kernicterus can subsequently lead to deafness, complete or partial paralysis, and mental retardation. Toxic effect high level bilirubin on the nervous system has the most severe consequences.

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Jaundice in a newborn is a condition characterized by yellowness of the skin and mucous membranes of recently born babies.

Pigmentation may be an option normal development child, and may indicate the presence of pathology. Doctors will help you distinguish one from the other, but there are some things that parents can also use to know.

Why does a baby develop jaundice?

In itself, coloring of a child’s skin is not a disease, but a symptom. The yellow color of a baby's skin is given by the pigment bilirubin, which is a breakdown product of red blood cells and is formed throughout life.

In adults, it enters the liver and is successfully excreted from the body. With a child the situation is more complicated.

In 70% of cases, jaundice occurs in newborns, the reasons for this prevalence are: the liver does not yet fully cope with its functions. At the same time, the level of bilirubin in the blood of babies is high, since in large quantities The red blood cells that supplied the baby with oxygen in the womb disintegrate.

Thus, three out of four newborns develop jaundice. In most cases, it goes away on its own. one month old child and does not require treatment. The causes of jaundice and high bilirubin levels in babies are:

• multiple pregnancy;
• smoking, drinking alcohol and certain medications during pregnancy;
• iodine deficiency in the expectant mother;
• other complications during the prenatal period;
• premature birth;
• drugs received to stimulate labor;
• Mommy's diabetes.

If the child has jaundice due to insufficient efficient work liver, then it will disappear on its own as soon as all the baby’s organs are sufficiently adapted to life outside the mother’s womb.

However, sometimes jaundice is a symptom severe pathologies in a child that requires immediate medical intervention. This condition is called pathological jaundice and can be caused by the following reasons:

• conflict between mother and baby based on blood types;
• incompatibility of mother and child according to the Rh factor;
• antibiotic therapy for the child;
• liver problems in the baby;
• certain genetic diseases;
• disturbances in hormone synthesis;
• blockage or damage bile ducts;
• pancreatic dysfunction.

With pathological jaundice, it is very important not only to reduce bilirubin in the child’s blood, but also to eliminate the cause that caused its increase.

Types of jaundice in newborns

The most important is the classification that distinguishes physiological and pathological jaundice.

How to distinguish physiological jaundice

Physiological jaundice in newborns is diagnosed quite simply; symptoms appear 2-5 days after the baby is born:

1. Bilirubin increases, the skin acquires a yellowish or dark tint on the face, the whites of the eyes turn yellow, then the pigmentation spreads to the child’s arms and chest.
2. The tummy, legs and feet of a baby with physiological jaundice are rarely stained.

At the baby's wellness, natural behavior. Feces and urine do not change color. Bilirubin does not exceed 256 µmol/l.

For examples of this type of “jaundice” in newborns, see the photo:

Signs of pathological jaundice

This dangerous condition develops in 70 babies out of 1000. Pathology should be suspected if:

• the baby “turns yellow” a few hours after birth ( neonatal jaundice in newborns);
• bilirubin exceeds 256 µmol/l; >>>
• the baby sleeps a lot, eats poorly, and is difficult to wake up;
• on the contrary, the child is in constant chaotic movement;
• change in color of discharge: urine darkens, feces lighten.

If measures are not taken at this stage, bilirubin enters the baby’s nervous system, poisoning it. Bilirubin encephalopathy begins, or kernicterus of newborns. Clinical picture accompanied by the following symptoms:

• monotonous scream on one note;
• convulsive syndrome;
• decrease in pressure;
• coma.

Kernicterus most often affects premature babies. The fact is that their brain cells have not yet fully formed, and have difficulty resisting toxic effect bilirubin.

Among the pathological forms, types of jaundice in newborns are distinguished according to the reason that caused the symptoms. Highlight:

1. Hemolytic(sometimes called suprahepatic). Hemolytic jaundice in newborns is associated with blood problems.
2. Mechanical- associated with problems of the child’s liver, gallbladder, bile ducts.

Obstructive jaundice, in turn, occurs

• hepatic,
• subhepatic,
• suprahepatic.

Hepatic jaundice is associated with disturbances in the functioning of this organ. If there are not enough enzymes to remove bilirubin from the child’s body, then this condition is called conjugation jaundice in newborns. The liver can also be damaged by toxins, viruses, and bacteria.

The causes of the so-called suprahepatic jaundice are problems with gallbladder, pancreas, bile ducts.

When does jaundice go away?

Physiological jaundice of newborns begins to subside when the baby is one week old. The signs of the disease completely disappear by the age of one month.

Pathological jaundice as a symptom can be eliminated quite quickly, within a few days. Today there are ways to quickly and safely remove bilirubin from the patient’s body.

It should be remembered that sometimes pathological jaundice and high bilirubin are symptoms of a serious illness, the duration of treatment of which depends on the situation and can be determined by a doctor.

What to do if jaundice persists

It happens that physiological jaundice does not go away by the age of one month. The reasons for this course of the disease are as follows:

• anemia in the baby (confirmed by a blood test);
• blockage (or fusion) of the bile ducts, stagnation of bile;
• galactosemia (this is one of those diseases that are screened for in the maternity hospital);
• deficiency of thyroid hormone (also checked in the maternity hospital);
• polycythemia (increased number of red blood cells, monitored by blood test);
• Breastfeeding jaundice.

If the baby is already a month old and the jaundice still does not go away, you need to consult a doctor. The doctor will be able to exclude serious diagnoses.

Deserves special mention breastfeeding jaundice, which occurs if mother's milk contains a lot of pregnanediol (a product of hormonal metabolism).

This substance inhibits the excretion of bilirubin. At the same time, the amount of pigment in the blood does not increase, but gradually decreases. The child is in good health.

In the medical community, you can find two opinions regarding breast milk jaundice:

1. Some doctors believe that increased level still provides bilirubin to the baby’s liver additional load, so breastfeeding must be stopped.
2. Representatives of the other camp do not see anything wrong with continuing feeding.

If you are afraid of harming your baby, but still want to continue natural feeding, the following method will suit you. You need to express the milk and heat it in a water bath to a temperature of 70°. >>>

Then cool it and give it to your child. When exposed to temperature, pregnanediol will disintegrate and will have no effect on the rate of bilirubin excretion.

If the baby is diagnosed with jaundice, the mother should find a pediatrician whom she completely trusts and follow all his instructions.

How is jaundice treated?

Most effective method Phototherapy is used to reduce bilirubin in the blood.

The baby is placed under special lamps that operate in the blue spectrum. When exposed to light, bilirubin is transformed into non-toxic lumirubin, which is quickly eliminated from the body.

Phototherapy of newborns with jaundice can be carried out both in the maternity hospital and in a children's hospital.

IN major cities You can rent a lamp for treating jaundice in a child. Therefore, if bilirubin does not go off scale and the baby’s condition does not cause concern, then therapy can be carried out at home.

At the same time, you should not forget to donate blood on time to determine the level of bilirubin.

The lamps are prescribed for 96 hours with breaks for feeding. To protect their eyes, babies are given special bandages or caps.

During phototherapy, the baby loses fluid, so when breastfeeding it is necessary to feed the baby on demand.

Side effects light treatment: skin peeling, frequent stools. These symptoms disappear as soon as treatment is completed. >>>

After the end of phototherapy, choleretic and diuretic drugs are sometimes prescribed to complete the treatment:

• Hofitol is given to newborns with jaundice in the form of drops, three times a day, mixed with water.
• Ursosan is given to newborns with jaundice once a day, diluting part of the capsule contents in a small amount of water. Read also: When can you give water to a newborn?>>>
• It is convenient to give Ursofalk to your baby; for newborn jaundice, it is better to purchase this drug in the form of a suspension.

Ursosan and ursofalk reduce bilirubin in the blood within a few days.

• From homeopathic medicines doctors can recommend Galsten. Galstena for jaundice in newborns is taken in the form of drops, 3 times a day. Before giving the medicine to the baby, the drops are diluted in breast milk.

During treatment severe forms For jaundice, blood transfusions are used. This helps replace most of the red blood cells in the blood and, thereby, reduce bilirubin by half in one procedure.

One transfusion replaces up to 80% of the baby's blood. Taking blood from the mother is not allowed, so another donor is found for the child.

Physiological jaundice goes away on its own and does not require treatment. special treatment. However, the mother can help the baby quickly get rid of excess bilirubin:

• The best method of prevention is breastfeeding. It is important to put your baby to the breast immediately after birth. Colostrum contains components that stimulate the baby's intestines. Together with meconium (the first stool), bilirubin is removed from the body. Mother's milk is the best remedy for fluid replenishment during phototherapy. >>>
• Sunbathing. In late spring, summer or warm autumn, you can move the stroller hood while walking so that the sun's rays fall on the baby's face. In winter, you can stand with the baby on the balcony, just make sure that the child does not freeze. Don't let the sun get into your baby's eyes. Vitamin D received by the baby helps remove bilirubin from the body.
• You should not give your baby glucose solution or rosehip decoction on your own; Only a doctor knows how glucose should be administered for jaundice in newborns.

What consequences can infant jaundice have?

Usually, breastfeeding jaundice and physiological jaundice in newborns have no consequences; when the yellowness of the skin disappears, nothing reminds of the disease.

Recently, neonatologists recognized these conditions as a variant of normal baby development.

Consequences pathological jaundice depend on the reasons that caused it.

If you start treatment on time and do not deviate from the doctor’s recommendations, then most likely the disease will be completely overcome and will not leave behind any additional diseases.

Untreated or untimely treated jaundice in newborns does not go away without a trace; the consequences can be as follows:

• greatly increased risk oncological diseases liver in the future;
• weak immunity in the baby;
• cirrhosis and other liver diseases.

If the baby has suffered bilirubin encephalopathy, and medical assistance was not provided to him, the consequences could be partial or complete hearing loss, developmental delays, and paralysis.

A child with signs of jaundice should be constantly monitored by a doctor so as not to miss the development of severe forms of the disease and to prevent dangerous consequences.

Health to you and your baby!

Young mothers, while still in the maternity hospital, notice that the skin of the newborn acquires a yellowish tint. Wherein pediatrician When examining the baby, he also pays attention to this factor. Jaundice in a newborn makes a new mother worry. But is this condition so dangerous? And is it worth sounding the alarm prematurely?

Why does the baby turn yellow?

Skin In a baby, they almost always become colored on the 2-3rd day. Such jaundice in a newborn (photo in the article) is the norm. It is also called physiological. For some babies, this process goes completely unnoticed. For others it may pose a threat. This depends entirely on the mechanism of bilirubin formation, as well as the ability of the small organism to neutralize and remove it.

So, why does a newborn develop jaundice? To answer the question, consider the mechanism of operation of a small organism.

Bilirubin is a product obtained from the breakdown of blood cells. His distinctive characteristic is yellow color. Bilirubin is found in every body and is involved in metabolic processes.

While the baby is in the mother's womb, many red blood cells carry hemoglobin. After birth, the need for so many blood cells disappears. That is why the process of their disintegration occurs. As a result, bilirubin is formed. It must enter the liver along with the blood and be excreted with the first feces and urine.

However, the child’s body is not yet perfect. Many systems are just getting ready to function correctly and are not yet able to fully cope with all responsibilities. That is why bilirubin, reaching the liver, is partially absorbed into the child’s blood. It stains the mucous membrane and skin.

Thus, jaundice in a newborn is physiological process, which occurs in a baby as a result of imperfect functioning of systems. There is no reason to worry in this case.

Signs of physiological jaundice

This condition usually occurs in babies on days 2-4. It is extremely important to remember when jaundice in newborns goes away. The skin should acquire a normal healthy color after 2-3 weeks in children born at term, and after 3-4 weeks in premature infants. This is one of the most important indicators physiological process.

We can say that jaundice in newborns is normal if this condition goes away in infants without medical intervention and does not cause any disturbances in the baby’s body. In this case, a decrease in shade should begin to be observed at the end of the 1st week of life.

So the signs physiological state the following:

• yellowish tint of the newborn’s face and mucous membranes;
• the appearance of coloring on average by the 4th day of life;
• the whites of the eyes are yellow;
• the coloring begins to gradually fade after the first week;
• the baby's condition is quite normal;
• feces and urine of natural color.

Except visual signs, jaundice in a newborn, a photo of which clearly demonstrates this condition, is controlled by the level of bilirubin in the blood.

Causes of physiological jaundice

Doctors identify a certain risk group. Jaundice in a newborn may occur if:

• the baby was born premature;
• the child's mother has diabetes;
• twins were born.

Modern experts, conducting research in this area, have identified several factors that can affect this condition in a baby. The causes of jaundice in newborns may lie in:

• woman's nutrition during pregnancy;
• bad habits of the expectant mother;
• deterioration of the pregnant woman's health;
• unfavorable environmental conditions;
• iodine deficiency during pregnancy;
• a woman taking certain medications.

All these factors can affect the underdevelopment of the baby in the womb. In addition, they can provoke premature birth. And in this case, the baby’s body does not have time to fully form in order to function perfectly.

As a result, the accumulated bilirubin does not reach the liver in a timely manner for excretion. The previously discussed process of skin coloring occurs.

Pathological jaundice

Physiological jaundice in a newborn, discussed above, is a completely natural and completely harmless condition. However, the second type can sometimes be observed. We are talking about pathological jaundice.

This condition is not so safe. In this case, some malfunction in the child’s body causes jaundice in newborns. The norm of bilirubin in such babies is exceeded. We must not forget about the toxicity of this pigment. Exceeding the critical indicator entails poisoning of the body.

Unfortunately, intoxication of the infant body can provoke quite disastrous consequences of jaundice in newborns:

• damage to the brain and nervous system;
• deafness;
• mental retardation.

Therefore, you should remember that prolonged yellowness of the skin can be very dangerous. Such a baby must be immediately diagnosed and adequately treated.

Symptoms of pathology

In most cases, physiological jaundice occurs in newborn babies. Pathologies are observed extremely rarely. And yet you should be very careful about the condition of the baby in the first days of life.

In order to recognize the disease in time or to make sure that your worries are groundless, you should know what symptoms jaundice manifests in a newborn in case of pathology:

• staining of the skin occurs on the first day;
• The child has long time(more than 3 weeks) the yellow tint of the skin remains;
• blood test shows high content bilirubin;
• the child is lethargic, drowsy, lethargic;
• the baby refuses to eat;
• a depressed sucking reflex is observed;
• the newborn screams monotonously;
• muscle hypertension is observed;
• presence of dark urine;
• the stool is almost discolored.

These are the main signs characterizing the presence of pathology. Parents can notice most of the above symptoms on their own, even without the help of a doctor.

If such a moment is missed and treatment is not started in a timely manner, the baby may develop new, more serious symptoms:

• bradycardia;
• convulsions;
• high-pitched scream;
• high lethargy - stupor;
• coma.

Causes of pathology

Once again, young parents should be reassured. Pathological jaundice in newborns is diagnosed quite rarely. According to statistics, this form occurs in 50-70 babies out of 1000.

The main indicator of pathology is the period of its occurrence. The mucous membranes and skin acquire an intense yellow tint almost in the first hours after birth. A blood test of such babies indicates high concentration bilirubin in the blood.

The main causes of pathological jaundice include the following:

1. Hemolytic disease caused by incompatibility of the Rh factors of the blood of the mother and baby.
2. Intrauterine infection of the baby's liver.
3. The presence of hereditary pathologies in the baby.
4. Abnormal development of the bile ducts in a child.
5. Immaturity of the baby's liver cells.
6. Pancreatic pathology.
7. Hypothyroidism is reduced functioning of the thyroid gland.
8. Administration of the drug "Oxytocin" to the mother during childbirth.
9. Premature birth of women diagnosed with diabetes mellitus.
10. Introducing antibiotics to the baby, such as Cefazolin, Ampicillin.

Children whose mothers had a difficult pregnancy are more susceptible to this pathology. Often these women experienced severe early and late toxicosis, and threats of miscarriage. Abortions and miscarriages significantly aggravate the condition. They can also become a source of development of such an unpleasant condition as pathological jaundice in newborns.

Norm of bilirubin

This concept is quite relative. Bilirubin levels are different for newborns and adults. They differ for babies born at term and premature.

The Cramer scale is used to visually assess bilirubin levels. It indicates that the skin of a newborn is colored unevenly. There is a certain pattern of yellowing of certain areas, depending on biochemical indicator in blood.

Initially, a newborn’s face and neck are painted. After this the body turns yellow. Then comes the turn upper limbs. Behind them, the hands become yellow. Then follow lower limbs, feet.

If you look at the blood test of a baby who has yellowness of the arms and legs, you can see that the bilirubin level significantly exceeds the critical value. This scale allows you to visually observe the dynamics of this condition. According to Kramer, when jaundice in newborns passes, the blood count will completely return to normal.

Bilirubin level is determined using biochemical analysis. If it exceeds 60 µmol/l, then yellowness becomes noticeable.

The following bilirubin norms for newborns exist:

• on the first day (baby is 24 hours old) - the indicator should not exceed 119 µmol/l;
• in the second (48 hours) - no more than 153 µmol/l;
• on the third day (72 hours) - does not exceed 187 µmol/l;
• by day 4-5 - 205 µmol/l.

With physiological jaundice, the bilirubin level never exceeds 205 µmol/l.

Diagnosis of jaundice

Don’t panic if your baby’s skin has become characteristic shade. About such a phenomenon as jaundice in a newborn, Komarovsky says the following: “You should pay attention to the accompanying symptoms.” The most important sign is, as previously noted, the period of skin coloring. If yellowness occurs several hours after the baby is born, this is a reason to examine the baby.

However, even if jaundice persists in a newborn, Komarovsky advises considering this condition in dynamics. If the baby is cheerful during the waking period, actively sucks the breast, and sleeps well, then there is no need to worry.

If you suspect a pathology, it is better to undergo diagnostics. To do this, the following research should be carried out:

• blood and urine tests (general);
• stool examination;
• test for bilirubin in blood, urine;
• test for antibodies to various infections and viral hepatitis;
• blood biochemistry (determination of liver enzymes, protein, cholesterol).

If necessary, the baby may be prescribed:

• Ultrasound of the liver, biliary tract;
• liver scan;
• Ultrasound of the spleen;
• tomography;
• duodenal intubation;

Treatment of jaundice

Physiological form special measures does not require intervention. This condition After a while, the baby goes away on its own. At the same time, some methods make it much faster and easier to overcome the phenomenon of jaundice in a newborn. Treatment depends entirely on the degree of its severity.

1. The very first and main cure for jaundice is mother’s colostrum. It acts as a laxative on the baby. Colostrum allows you to somewhat speed up and facilitate the process of passing meconium. And along with the original feces, as is known, bilirubin is also excreted from the child’s body.
2. Sunbathing can be an excellent treatment method. In warm weather, it is recommended to walk with the baby, exposing the legs and arms. In cold weather, it is advisable to move the child's bed closer to the window. Sun rays passing through the glass will still have a beneficial effect on the baby.
3. A special lamp for newborns for jaundice is often used. This therapy is prescribed to the baby very carefully, taking into account his full term. Under the influence of light radiation, the transformation of bilirubin begins. After 12 hours, in most cases it is excreted from the child’s body through urine and feces.
4. If more pronounced jaundice is observed in a newborn, more intensive treatment is required. Glucose and activated carbon are prescribed. Glucose promotes significant improvement liver functioning. Activated charcoal acts on bilirubin in the intestines, binding it and removing it from the body in feces.
5. For extremely severe jaundice, a transfusion is recommended for the baby. donated blood. This procedure very dangerous. And, unfortunately, it is not always possible. It is used in cases of severe pathologies to save a baby due to bilirubin intoxication.

Consequences of jaundice

In most cases this phenomenon- This is a normal physiological process of adaptation of the infant body to independent existence. Therefore, after 2-3 weeks, the jaundice goes away naturally. It does not provoke any complications or consequences. The baby is cheerful, cheerful and develops naturally.

But sometimes the picture is not so ideal. Complications may occur in the following cases:

• mother and baby have incompatible groups blood and Rh factors;
• The baby is diagnosed with genetic pathologies;
• While still in the mother’s womb, the child suffered liver damage from a virus;
• The baby's bile flow is impaired.

Such factors can lead to the pathological jaundice discussed above. It can last more than a month. The baby's skin turns greenish. The color of the baby's feces becomes light, and the urine, on the contrary, acquires a rich dark shade. At the same time, the liver and spleen may increase in size.

The baby's condition deteriorates significantly. In this case, you should immediately resort to medical care, since ignoring such a pathology can provoke extremely serious consequences:

• toxic brain poisoning, nervous system;
• albuminemia;
• deafness;
• mental retardation;
• increased frequency of seizures.

Conclusion

Jaundice in newborns is a fairly common occurrence. And it often goes away as quickly as it occurs. The most important thing is to be very attentive to your baby. Strength and patience to you to adequately cope with all the worries about the newborn.