Jaundice in newborns causes and consequences. Consequences of nuclear jaundice in newborns

jaundice skin is not independent disease, but only acts as a syndrome characteristic of some pathological or physiological conditions. The yellowness of the skin occurs due to the accumulation in them of the bile pigment - bilirubin. The higher its concentration in the blood, the more pronounced jaundice.

In 70% of newborns, this condition is considered a physiological norm that does not require close attention and fear.

What is neonatal jaundice

The accumulation of bilirubin in the body of a newborn child occurs due to the breakdown of fetal hemoglobin, which is responsible for the transfer of oxygen molecules from mother to fetus. The result of this process is yellowing of the skin of a newborn baby.

The physiological norm of pigment in newborns can be found in this table.

In the neonatal period, jaundice is classified into the following types:

1. Physiological type of jaundice. The percentage of occurrence of this condition in newborns is 90-95%. functional immaturity child's body causes the accumulation of the pigment-bilirubin in the blood and tissues. The physiological type of jaundice is characterized by the appearance from 3 to 5 days of a newborn's life. The duration of this state does not exceed 10 days. The well-being and general condition of the newborn remains unchanged. The increase in bilirubin reaches 223 µmol / l.
2. Pathological type of jaundice. This condition is very rare and is associated with diseases of the hepatobiliary system.

Yellowing of the skin is provoked by the accumulation of direct and indirect fractions of bilirubin.

Causes

In this case, the pathological type of jaundice in newborns deserves special attention. The exchange of bilirubin in the body is difficult process, the course of which depends on functional state liver.

An increase in the concentration of this pigment can be acquired and congenital.

The congenital form of pathological jaundice occurs for the following reasons:

• Pathological changes in the membrane of erythrocytes. This condition is characterized by a gradual yellowing of the baby's skin. There is an increase in the size of the spleen and liver.
• Failure in the hemoglobin production system. characteristic feature for this form of pathological jaundice is that the first symptoms make themselves felt by the first six months of the baby's life.
• Lack of erythrocyte enzymes. Development characteristic symptoms observed already on the 2nd day after the birth of the child. The baby's skin becomes yellow, and the urine becomes the color of dark beer.
• Developmental pathologies biliary tract. In this case, we are talking about a complete or partial blockage of their lumen. Violation of the outflow of bile provokes the accumulation of bilirubin in the blood. The skin of infants with this pathology acquires a greenish tint from the first days of life. Characterized by an increase in the size of the liver, as well as bulging of the veins of the anterior abdominal wall.
• Hereditary diseases (cystic fibrosis). With this disease, there is a mechanical blockage of the bile ducts with mucous clots.

The acquired form of pathological jaundice in newborns is caused by such reasons:

• Hemorrhages in the area internal organs, followed by the breakdown of erythrocytes from the pathological focus. The result of this process is the accumulation of bilirubin.
• Hemolytic disease in newborns. The reason for this condition is the Rh conflict between the blood of the mother and the fetus.
• Other reasons. Such reasons include an increase in the concentration of red blood cells in the blood, as well as the ingress of a portion of blood into gastrointestinal tract baby during the birth process.

Symptoms

The main symptoms of this condition are:

• Yellowish or yellow color of the skin, mucous membranes and eye sclera;
• With physiological jaundice, the feces and urine of a newborn do not change their color, and with pathological urine, it acquires a dark color;
• The physiological type of jaundice does not affect the general condition and behavior of the baby. With pathological jaundice, the child becomes lethargic, restless, loses appetite;
• With physiological jaundice, there is no change in the concentration of hemoglobin in the blood of an infant. If the jaundice is of the pathological type, then the child has anemia.

In addition, with the pathological type of jaundice, there is an increase in the size of the spleen and liver, as well as dilation of the veins of the anterior abdominal wall.

Treatment

Physiological given state in the neonatal period does not mean that help medical specialists need not. Depending on the cause of this condition, as well as on the severity of the process, the selection of methods for correcting the exchange of bilirubin in the body of the newborn is being carried out.

Phototherapy

This method is basic for the treatment of the physiological type of jaundice. Exposure to the baby's skin of rays, the length of which is 440-460 nm, turns the toxic fraction of bilirubin into non-toxic chemical compounds. In infants with low body weight, this technique is used even with a slight increase in the concentration of bilirubin.

Phototherapy is carried out using a special lamp that emits blue or green light. The duration of the child's stay under such a lamp is 12-13 hours a day. Pre-baby put on protection for the eyes and genitals. Carrying out phototherapy in conditions medical institution is a safe procedure, causing complications. Independent practice of phototherapy is strictly prohibited.

Blood transfusion

For the appointment of this procedure, there are special indications, which include a rapid increase in bilirubin, a decrease in hemoglobin, and the lack of effect from phototherapy. The material for transfusion is selected in individually for every baby in need.

Transfusion is performed after a preliminary determination of compatibility with donated blood. This technique has a number of complications, among which are:

• anaphylactic shock;
• air embolism:
• disorders of the cardiovascular system;
• getting an infection.

For 3-4 hours after the procedure, the newborn is under the close supervision of medical personnel.

Medical therapy

The goal of therapy is to normalize the binding and excretion of excess bilirubin. For this purpose, apply choleretic agents(Allochol, Magnesium sulfate), as well as drugs such as Cholestyramine, Karbolen and Agar-Agar. Additionally used vitamin complexes and ATP.

Infusion therapy

In order to detoxify the child's body, a drip of a solution of sodium chloride and glucose is used.

Consequences of jaundice

The physiological type of jaundice in newborns does not entail the development of complications. Complications of pathological jaundice include:

• toxic damage to the central nervous system by the breakdown products of bilirubin;
• impaired motor function;
• a decrease in the concentration of albumin protein, as a result of which edema develops;
• the penetration of bilirubin into the structures of the brain can result in the development of seizures, complete or partial hearing loss, as well as the formation of mental retardation.

Don't be scared! With all the severity of the name "jaundice in newborns" - this is by no means a disease, but just a physiological symptom of certain processes that occur in the baby's body while it adapts to new living conditions. What to do with the "golden" child, how exactly physiological jaundice occurs in infants, are there possible Negative consequences this phenomenon and whether jaundice in newborns requires any treatment - we will understand.

Jaundice in newborns: why did my baby turn yellow?

For the sake of your maternal peace of mind, let us repeat: the fact that your newborn baby suddenly turned orange on the second or third day of life should in no way make you nervous or frightened. Jaundice in newborns is not a disease! This is just an indicator (a kind of marker) of certain physiological processes that occur in the child's body due to his "moving" from the mother's womb into the light of day.

In order to understand exactly how the skin of a newborn changes color from romantic pink to hysterically yellow, it makes sense to recall some paragraphs of the school anatomy course:

Mechanism of jaundice. In the blood of a person there are special red blood cells - erythrocytes, the task of which is to carry oxygen and carbon dioxide throughout the body. Every day, approximately 1% of all red blood cells that rush through our body die (the lifespan of each red blood cell blood cell no more than 120 days). When destroyed, these cells release a substance contained inside red blood cells - bilirubin - a special yellow pigment that is actively involved in hemoglobin metabolism. By itself, bilirubin is a rather dangerous and toxic substance for internal organs, therefore, normally, as soon as the blood brings it to the liver, special liver enzymes immediately neutralize it there. In medical language, the process of neutralizing the harmful yellow pigment in the liver is called "bilirubin conjugation." The detoxified bilirubin then passes through bile ducts and is excreted from the body by the excretory system.

If any link in this chain of formation and excretion of bilirubin is broken, the level of this substance rises, the yellow pigment penetrates the skin, coloring the face and body in “autumn tones”. And if we weren’t talking about newborns, but about older people, then we should consider jaundice precisely as a clear symptom of a serious illness (for example, liver diseases like hepatitis, acute poisoning, intoxication, inflammation of the gallbladder, stagnation of the bile ducts, etc.).

Physiological jaundice in newborns - within the normal range

But jaundice in newborns is most often physiological norm. The bottom line is that a child, barely born, has a very high level of hemoglobin, which begins to decline sharply in the new conditions of the baby's life. In addition, a newborn baby has not yet fully formed "army" of liver enzymes. In other words, the newborn baby in the first days of life is simply physically unable to cope with the high level of bilirubin in its blood. That is why the baby is rapidly turning yellow.

At least 60% of absolutely healthy full-term newborn babies on the second or third day of life are “stained” in yellow. This is normal and does not threaten the child with any troubles. In medicine, there is even a term - physiological jaundice of newborns. Physiological means natural, normal, without pathology.

So, even if you are in these 60%, there is no reason to be afraid. And if it so happened that the child was born prematurely (which means that he has even less capable liver enzymes than a healthy toddler), then you have even more chances to admire him yellow - 80-90% of all babies born prematurely survive physiological neonatal jaundice.

The company at risk for jaundice in newborns are babies whose mothers have diabetes, as well as twins (twins, triplets, etc.)

Normally, in a newborn baby, jaundice should pass in two to three weeks. And what to do in cases where the child turned yellow naturally, but to turn pink again, even after three weeks, as if he is not going to?

Why does jaundice in a baby not go away after 21 days?

If the “golden” color of the baby’s skin has not disappeared in three weeks (which means that the process of neutralizing toxic bilirubin by liver enzymes has not improved), it is necessary to without fail consult a doctor who, with the help of analyzes and tests, will determine at what stage of the cycle of "existence" of bilirubin in the baby's body failures occur and why. The reasons can be, relatively speaking, dangerous. For example:

• 1 As a result of any disease of the child, the destruction of the erythrocytes of his blood occurs intensively and constantly (for example, with hemolytic disease, which often develops in children whose Rh factor differs from that of the mother). Accordingly, the level of bilirubin in the blood is constantly elevated.
• 2 Liver function never developed properly (for example, due to hereditary hepatitis). In this case, jaundice is rightly called hepatic.
• 3 Normally, after bilirubin is neutralized in the liver, it enters gallbladder and excreted from the body through the bile ducts. Often, jaundice in a newborn does not go away due to a malfunction of this particular organ. For example, a crumb may have an obstruction of the biliary tract - in this case, jaundice is called mechanical.

If the cause of jaundice in a newborn lies in one of these serious diseases, then with the help of special tests and tests, doctors will determine this and prescribe an adequate treatment, in which not the symptom itself, but the disease itself, will be treated.

Physiological (that is, absolutely normal, non-dangerous) jaundice in newborns can also last more than three weeks - in some babies, liver enzymes quickly "master their purpose", in others - more slowly.

Jaundice in newborns can last more than 21 days and for no reason at all. After all, each baby is individual and predict exact dates when he learns to walk, when - to speak, and when - his liver will learn to process bilirubin, not a single children's "esculapius" is able to, even if he is the most outstanding genius from medicine.

As a caring and sensible parent, you must understand that a newborn child (like an older child) is an excellent indicator of his own physical condition. Simply put, if your baby has turned yellow and continues to stick to this sunny tone for more than three weeks, but at the same time he does not show any signs of anxiety - does not cry, eats with appetite, gains weight, fills his diapers regularly and sleeps soundly, then there is no reason to worry about prolonged jaundice, you should not have.

The only thing that needs to be done is with the help of an experienced and observant pediatrician, start regularly monitoring the level of bilirubin in your baby's blood.

Jaundice in newborns - consequences for everyone

During those couple of weeks, while the level of toxic bilirubin in the blood of the newborn was elevated and his skin shone with “golden” hues, nothing bad could happen to the child. Although bilirubin is toxic, its quantity (even though it is elevated in the baby during this period) is still not enough to cause significant harm to the baby.

But if the jaundice has dragged on and gone beyond 21 days (which means that the level of bilirubin in the body continues to remain high), it is imperative to contact the pediatrician and put the baby's bilirubin "on the counter" - that is, it must be constantly measured and monitored. If the level of bilirubin is kept above the norm, but does not tend to increase, you should not be afraid, under the systematic supervision of a reasonable doctor, such jaundice does not threaten the child with any serious consequences.

Jaundice in newborns can threaten with real problems only in those situations in which the level of bilirubin in the blood rises 10 times higher than normal and has a progressive upward trend. In such cases, damage may be done to the baby's central nervous system, his liver, etc. But if you turned to the pediatrician in time, no responsible doctor will simply allow such a development of the event.

Critical indicators of bilirubin in the blood are for full-term and premature babies, respectively: 324 µmol/l and 250 µmol/l. You, the parents, do not need to know these numbers, the main thing is that the doctor who monitors the condition of the newborn remembers them.

Treatment methods for jaundice in newborns

It is not entirely correct to talk about the treatment of jaundice itself in the context of newborns - since, as has already been said fifty times, this is not a disease, but only a symptom.

If jaundice is a symptom (indicator or consequence) of some serious disease, then, of course, it is not jaundice that is being treated, but this disease itself. But not a single disease is treated overnight and there are situations when, simultaneously with therapy, it is necessary to reduce the level of bilirubin in the blood, which dangerously “creeps” to a critical level.

Even 15-20 years ago, in a situation where the level of bilirubin became threateningly dangerous and could cause irreparable damage to the baby's central nervous system, the child underwent an exchange blood transfusion.

Today, this method of treating jaundice in newborns is also used, but only in extreme cases. And in less severe situations recent decades practice another effective method of dealing with elevated bilirubin- a bright lamp!

Phototherapy for jaundice: let there be light!

Scientists made this discovery by chance - during medical research it was found that toxic bilirubin in human skin begins to actively break down under the action of bright light rays, turning into a non-toxic isomer. Thus, the most common method of treating jaundice in newborns today was “born” - phototherapy.

The bottom line is simple: if the baby's bilirubin level is elevated and there is no positive dynamics, he - naked, but with protection in front of his eyes - is laid out under a bright lamp: sometimes for several hours a day, sometimes for several days (around the clock with interrupted only for feeding, hygiene and massage).

The method of phototherapy is good, safe and very common. He returned to many kids their usual skin color, and their parents - peace of mind.

Breastfeeding jaundice: mom gilded

There is another kind of, fortunately, completely harmless jaundice, which can be observed in newborns and which can last more than three weeks. This is the so-called jaundice breastfeeding. As the name suggests, it only happens to babies who are breastfed.

The bottom line is this: in the mother's breast milk there is a substance that blocks the action of liver enzymes in the child.

Not a single “health specialist” has yet been able to find out why nature came up with this mechanism. Nevertheless, it works and is very active - many infants turn noticeably yellow in the first days of life precisely because the milk of their mothers "slows down" the activity of enzymes in the child's liver.

Moreover, this type of jaundice, as a rule, smoothly “takes a shift” from physiological jaundice and can last much longer than 21 days completely safely for the baby.

If you are scared and you want to make sure at all costs that your "orange" baby has safe breastfeeding jaundice, and not a symptom of some dangerous disease- Stop breastfeeding for 1-2 days (give formula). If the yellow color of the skin noticeably brightens - this is it, you can calm down and return your baby to his natural nutrition.

Jaundice in newborns: Epilogue

Despite the fact that the child is entirely yours, it is not you who should decide what to do with him if he turns yellow. And the health workers. And deal with it.

Find out if your baby’s jaundice is dangerous (that is, is it a symptom of a serious illness?) Or completely harmless, treat it or be patient and just wait, and if treated, then in what way - all these questions can only be resolved pediatrician. Your task is to present your newborn to him for examination and analysis.

Because in the case of jaundice in newborns, the probability of making a mistake is very high: you can mistake a completely normal physiological state for a symptom of a serious illness, and vice versa. Are you really ready to guess if the health of your beloved, “golden” in every sense of the word, baby is at stake?

Of course, almost all parents are very worried about the appearance of jaundice in their newborn baby. Is this process normal? Is it worth it to be afraid and should any measures be taken?

Jaundice is the coloring of the skin, visible mucous membranes and sclera of the eyes in yellow. This is a consequence and a visible manifestation of an increase in the level of bilirubin in the blood.

Jaundice develops when the level of bilirubin in the blood exceeds 35-50 µmol/l in full-term babies and 85 µmol/l in premature babies. The severity of jaundice is determined not only by the concentration of bilirubin in the blood, but also by the characteristics of the skin (initial color, depth, capillary tone, etc.) and therefore is not an objective indicator of the level of bilirubin. It is easiest to stain the eye sclera, the lower surface of the tongue, the sky, the skin of the face.

Babies in the first month of life may have different kinds jaundice: conjugative(i.e. associated with low liver binding capacity), hemolytic(due to increased destruction of red blood cells - hemolysis), parenchymal(associated with toxic or infectious lesion liver cells) and obstructive(due to a mechanical obstruction to the outflow of bile).

Physiological (transient) jaundice

This condition rightfully belongs to the so-called borderline conditions of newborns (this group includes conditions that are normal in most newborns, but require close monitoring, since in the event of an unfavorable development of events, many characteristics of body functions may go beyond normal). Transient jaundice occurs in 60-70% of all newborns. By nature this species jaundice refers to conjugation. This process is based on the restructuring of the hemoglobin system, which takes place after the birth of the baby. The fact is that fetal hemoglobin differs from that of an adult: during prenatal development hemoglobin F (HbF) predominates in the body (it binds oxygen better), compared to “normal”, adult hemoglobin A (HbA), due to which oxygen is transferred from maternal erythrocytes to fetal erythrocytes. Shortly after the baby is born, it the body begins to intensively destroy HbF in order to synthesize HbA. Naturally, the process of hemoglobin breakdown leads to the formation of indirect bilirubin. Since the binding capacity of the liver at this age is small, the concentration of bilirubin in the blood begins to gradually increase. Usually, the first manifestations of physiological jaundice can be observed by the end of the 2nd, and more often on the 3rd-4th day of life. The intensity of yellow staining may increase slightly until the 5-6th day. As a rule, the process has a benign course, and everything ends well: by the end of the 1st week of life, the activity of liver enzymes increases, the level of bilirubin begins to gradually decrease until it reaches the norm, and by the end of the 2nd week, the symptoms of jaundice disappear. But if there are “aggravating circumstances” (prematurity, immaturity of the fetus, previous hypoxia and / or asphyxia, hereditary defects in liver enzyme systems, the use of certain drugs that displace bilirubin from association with glucuronic acid - for example, vitamin K, non-steroidal anti-inflammatory drugs, sulfonamides , levomycetin, cephalosporins, oxytocin for newborns and mothers), the level of bilirubin in the blood can rise to dangerous numbers. In this case, jaundice physiological state becomes a threatening state. Accordingly, jaundice of premature babies, drug-induced jaundice, jaundice of children with asphyxia, etc. are distinguished.

What is bilirubin?
Bilirubin is a substance formed in the body during the breakdown of red blood cells - erythrocytes, or rather, the hemoglobin contained in them. Aged and outdated erythrocytes are destroyed mainly in the spleen, with the formation of bilirubin, called indirect, or unbound. It is insoluble in water (hence, it cannot be excreted by the kidneys) and therefore binds to albumin, a low molecular weight protein in blood plasma, for transport in the bloodstream. But most importantly, indirect bilirubin is a tissue poison, most of all it is dangerous for the central nervous system, in particular, the brain. Being associated with albumin, it reaches the liver, where it is transformed: it binds to the glucuronic acid residue and turns into direct (bound) bilirubin. In this new state, it is non-toxic to body cells and tissues, soluble in water, and can be excreted by the kidneys. It is also excreted in the bile and enters the intestines. In cases where the rate of erythrocyte decay outstrips the binding capacity of the liver, indirect bilirubin begins to accumulate in the bloodstream and causes the skin, mucous membranes and sclera of the eyes to turn yellow.

In term newborns critical level bilirubin in the blood - 324 μmol / l, in premature babies- 150-250 µmol / l. This difference is due to the fact that premature babies have increased permeability of the blood-brain barrier (a natural chemical and biological barrier between the lumen of blood vessels and brain tissue, due to which many of the substances present in blood plasma do not penetrate into brain cells), yes and immature brain cells are more sensitive to any kind of adverse effects. Toxic damage to the subcortical nuclei of the brain by indirect bilirubin is called nuclear jaundice, or bilirubin encephalopathy. Its symptoms are severe drowsiness or, on the contrary, a piercing cry, convulsions, a decrease in the sucking reflex, and sometimes stiffness (tension) of the occipital muscles.

That is why doctors in maternity hospitals carefully monitor the level of bilirubin in the blood of all newborns. When jaundice occurs, newborns should be given this test 2-3 times during their stay in the hospital to clarify whether there is an increase in the concentration of bilirubin in the blood. Mom may ask if such tests were taken from the child. For the treatment of hyperbilirubinemia (an increase in the level of bilirubin in the blood), intravenous transfusions of a 5% glucose solution (it is a precursor of glucuronic acid that binds bilirubin in the liver), ascorbic acid and phenobarbital (these drugs increase the activity of liver enzymes), choleretic agents ( they accelerate the excretion of bilirubin with bile), adsorbents (agar-agar, cholestyramine), which bind bilirubin in the intestine and prevent it from suction. However, today more and more researchers prefer phototherapy as the most physiological and effective method. During phototherapy, the baby's skin is irradiated with special lamps. When exposed to light of a certain wavelength, bilirubin passes into its photoisomer (it is called lumirubin), which is devoid of toxic properties and is highly soluble in water, due to which, without prior transformation in the liver, it is excreted in the urine and bile. Procedures are usually carried out in the hospital. The indication for the appointment of phototherapy is the concentration of bilirubin in the blood above 250 µmol / l for full-term newborns and above 85-200 µmol / l for premature babies (depending on the weight of the baby).

Transient jaundice occurs in 60-70% of all newborns.

The group of conjugation also includes jaundice in children fed with breast milk (Aries syndrome). Until now, the cause of the development of this condition remains poorly understood. Perhaps maternal estrogens (female sex hormones) present in milk are “guilty” of this, since they can displace bilirubin from its association with glucuronic acid. Perhaps the fact is that the sum of all calories received per day, with unsteady lactation, will be lower than with formula feeding (it is known that with relative malnutrition, bilirubin can be reabsorbed in the intestine and re-enter the bloodstream). Be that as it may, during the first week of life in children fed with breast milk (including donor milk), the development of transient jaundice is 3 times more likely than in their peers transferred for one reason or another to artificial nutrition. But you should not be afraid of these statistics: it has been proven that early breastfeeding and subsequent 8-time feeding in general reduce the incidence and degree of hyperbilirubinemia in newborns. Diagnostic criterion of this type of jaundice will be a decrease in bilirubin levels of 85 µmol / l or more when breastfeeding is stopped for 48-72 hours. More often, for this test, the child is not transferred to artificial nutrition even for these two or three days, it is enough to offer him expressed milk, preheated to a temperature of 55-60 ° C and cooled to body temperature - 36-37 ° C. With this treatment, the biological activity of estrogens and other substances mother's milk, which can compete for liver enzymes, is greatly reduced. This test is sometimes resorted to to exclude others. possible reasons jaundice. The course of this condition is benign, cases of bilirubin encephalopathy against the background of Aries syndrome have not been described, so treatment is usually not required, and children may well be breastfed. Hemolytic jaundice occurs with increased hemolysis (the breakdown of red blood cells). It may be one of the manifestations of hemolytic disease of the newborn (HDN), which develops in Rh-positive children with Rh negative blood mother. In such cases, antibodies against fetal red blood cells can be produced in the mother's body, which destroy them. AT clinical picture hemolytic disease - anemia (decrease in hemoglobin and red blood cells), hyperbilirubinemia, enlargement of the liver and spleen, in severe cases - tissue swelling, fluid accumulation in body cavities, a sharp decline muscle tone, inhibition of reflexes. Jaundice most often appears immediately after birth or on the first day of life, the level of bilirubin rapidly increases to threatening numbers. The most commonly used treatment for HDN operational methods. These include, first of all, exchange transfusion of blood (ZPK), sometimes hemosorption is also used. With PKC, blood is taken from the newborn, containing an increased level of bilirubin and a reduced number of formed elements (cells) of the blood, and the blood of a donor is transfused to him. In one procedure, up to 70% of the blood volume is replaced. Thus, it is possible to reduce the concentration of bilirubin and prevent brain damage, as well as restore required amount red blood cells that carry oxygen. Often, a second procedure is required if the level of bilirubin again begins to reach critical numbers. Hemosorption is the purification of blood from bilirubin, maternal antibodies and some other substances by precipitating them in a special installation. In non-severe HDN, the treatment methods used for transient jaundice can be used.

In addition, hemolytic jaundice can develop with hereditary diseases accompanied by defects in the structure of membranes, or erythrocyte enzymes, or hemoglobin molecules. Any of these causes leads to increased destruction of red blood cells and, as a result, to an increase in the level of bilirubin. Jaundice is noted from the first days of life. Associated symptoms are anemia, an enlarged spleen. Diagnosis is based on a combination of symptoms and a complete blood count, sometimes additional studies are required.

Parenchymal jaundice

It develops when liver cells are damaged by infectious or toxic agents, which leads to a decrease in their ability to bind bilirubin. In the first place in this series are intrauterine infections: cytomegalovirus (it is the cause of approximately 60% of all cases of prolonged jaundice in infants), toxoplasmosis, listeriosis, rubella, viral hepatitis. Typically, the idea of intrauterine infection occurs with the development of prolonged jaundice (when its duration exceeds 2-3 weeks in full-term newborns and 4-5 weeks in babies born prematurely), as well as in the presence of other symptoms (enlargement of the liver, spleen and peripheral lymph nodes, anemia (decrease in hemoglobin levels in blood), dark urine and discoloration of feces, signs of inflammation in general analysis blood (an increase in the number of leukocytes, an increase in ESR), an increase in the level of liver enzymes in biochemical analysis blood. To make a diagnosis, serological reactions are used (detection of antibodies to viruses or bacteria in the blood), detection of RNA or DNA of the pathogen by PCR (polymerase chain reaction - a method that allows you to "recreate" DNA or RNA by small fragments that are found in biological fluids or body tissues. After that, the resulting RNA or DNA is examined for species (i.e., the type of pathogen is determined).

Obstructive jaundice

It occurs in connection with gross violations of the outflow of bile, obstruction (blockage) of the biliary tract. This jaundice develops with malformations of the bile ducts (atresia, aplasia), intrahepatic hypoplasia, intrauterine cholelithiasis, compression of the bile ducts by a tumor, bile thickening syndromes, etc. characteristic feature This type of jaundice is a yellowish-greenish skin tone, enlargement and thickening of the liver, permanent or intermittent discoloration of the feces. Jaundice like clinical symptom appears on the 2-3rd week of life. Used for diagnostics radiological methods, biopsy (examination of a piece of tissue under a microscope, as well as using various biochemical methods). Treatment is most often surgical.

In this article, we have tried to cover some of the most common causes development of jaundice in newborns. We hope it will allow you to avoid unnecessary worries, and in cases where your fears are not unfounded, quickly navigate and show the baby to a specialist in time.

Dorofei Apaeva, pediatrician, Scientific Center for Children's Health, Russian Academy of Medical Sciences, Moscow

Discussion

Very valuable and detailed article. Useful material for pediatricians.

Comment on the article "Jaundice in newborns"

Ursofalk and newborn jaundice... ...I'm having a hard time choosing a section. A child from birth to one year. Care and upbringing of a child up to a year Ursofalk and jaundice of newborns.. girls, dd. us here without 2 days a month. today we had a pediatrician .. and said that we ourselves did not ...

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we were yellow by the month. they didn’t drink anything, but they lay in the hospital under a lamp. helped, but not much. A friend of mine recently had it lowered with droppers. there was a good effect. In general, you need to donate blood. and not only on bilirubin, look at the dynamics. and he decides from the rebirth of blood or from milk in general ... in general, he would go to a gastroenterologist, a hematologist ..

We also had jaundice for a month! And the eyes were yellow. Nothing was accepted. It all went away on its own after a month.

Chapter: medical questions(immortelle with jaundice in a 2-month-old baby). Jaundice!!! HELP!!! Our jaundice didn’t go away by a month either, we were in the hospital, treated with luminal (fenaborbital), drank for 5 days, and everything went away, bilirubin dropped from 230 to 70 ...

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Our jaundice didn’t go away by a month either, we were in the hospital, treated with luminal (fenaborbital), drank for 5 days, and everything went away, bilirubin dropped from 230 to 70, the little white baby became. But how many nerves this treatment cost me, when I found out that they give phenoborbital, I was simply shocked that such babies are treated with sleeping pills. But then my husband read on the Internet that everything is fine, this medicine is approved for use in jaundice.

My daughter had severe jaundice (at discharge, bilirubin 250, 150 per month), the increase per month was 400 grams. Vodichka-broth of wild rose-smecta did not help much. On the advice of the pediatrician, they switched to the mixture for 3 days (I have 1 g of blood, my daughter has 2, there was a suspicion that the antibodies in my milk were to blame). On the mixture, the daughter turned white right before her eyes, finally the yellowness subsided by 2 months, I decanted, everything was ok with GW.

Jaundice. If jaundice in a newborn lasts longer, the baby should be seen by a doctor. neonatal jaundice is a serious thing. Not only is drinking glucose for jaundice ineffective (although yes, it is still used), it can also be harmful to ...

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what nonsense. how many drugs smecta will continue constipation. glucose, by the way, too. We took Spascupreel when the child was too nervous and went into every cry. Well, fennel for colic. EFAVİT - it’s not at all clear why (some oils with vitamins, I barely found information about it). An enema is made one time 400 ml cool boiled water, and then microclyster 25 ml chamomile infusion 36-37C in the morning and evening for 3 days, otherwise frequent enemas can cause injury anus and kill the poop reflex. Hepatolac - laxative.Le Carnita No. 30 what is it? just wondering. Hipp Tea – Fennel alternated with chamomile is not a cure at all. In general, summing up, some drugs give constipation, others + enema relieve the stomach - a vicious circle. The only thing that will remove a little jaundice here is glucose, but again, constipation from it. I advise Hepel - 1/2 tablet a day - 30 days, and even better ursofalk 1.4 ml once at night for 14 days. analysis is best done once a month on an empty stomach and from a vein. And from constipation Nuksvomika Gomakkord 2 drops 2 r. per day 15 minutes before meals - 30 days + bifidum 2 p. per day - In the morning and at LUNCH - 14 days (it does not help immediately, do not be alarmed, somewhere on the 4-8th day) enema one-time (as I wrote above)

I don't think you're doing very well.
at your age, we were discharged from the hospital with a total bilirubin of 30 - that was good.,
we lay down with almost a hundred.,
and a month later it dropped to 12 with us.
It seemed to me that the lamp helped most of all,
it's summer now - you can take out more naked in the sun, but of course within reasonable limits

Jaundice in newborns - is it really so serious ??? I don’t know how to pour all this into him: (In general, I found my records from pregnant women Section: ... I find it difficult to choose a section (in which grass is it better to bathe a child if he has jaundice). Girls, tell me who has ...

Discussion

By the way, here are some tips for decoction of corn stigmas...
It is choleretic, not useful for all types of jaundice. Heel's drug is Hepel
http://www.arnebia.ru/
you probably don't need it...
About preparations for adults - I do not know what you had in mind.
In reality, with increased bilirubin (I don’t know about such small ones - I haven’t experimented), one helps homeopathic remedy, designed to alleviate menopausal manifestations in women and only because it contains a minimum dose of phenobarbital ...
Go see a doctor!

I am a mother of two jaundiced children.
Ask for a referral to the Filatov hospital. They have experts on childhood hepatitis of unknown cause.
You will be taken into account.
We were quietly observed there free of charge up to 3 years at all doctors. Even the urologist operated on us for free.
They will take all the tests, advise the treatment.
Do not listen to anyone, everyone has their own reason for jaundice, from prematurity to genetic diseases. There is an exotic in the form of intolerance to breast milk
But, in general, for your age, 10 times is not very much.
My eldest (21 years old) has 10-fold increased bilirubin ... This is scary.
Do not rely on the district clinic - they will feed you with phenobarbital.
Everything will be fine

Newborn jaundice is not jaundice / hepatitis in our usual sense, but in case of a strong excess of the norm, they put jaundice droppers. If jaundice in a newborn lasts longer, the baby should be seen by a doctor. Physiological jaundice does not go away.

Discussion

To begin with, take tests and look at the result. I would find another doctor. If you want I can give the contact of my doctor - a very competent specialist. Send me an email and I'll send you the coordinates.

Such a prolonged jaundice is fraught with damage to the central nervous system, unfortunately. and there is absolutely nothing good about it. Physiotherapy helps a lot (more precisely, a course of ultraviolet radiation in a children's clinic). GW on demand, some advise supplementing with water or glucose 5%. It is also desirable to pass blood-urine for direct and indirect bilirubin, determine the degree .. and then decide with medicines. Sometimes phenobarbital is prescribed literally for 2-3 days to induce microsomal liver enzymes, with a good effect. But this must be weighed very carefully, preferably together with a pediatrician and a neurologist to decide.

Often, while still in the hospital, looking at the baby, we notice that the color of his skin has changed - it has acquired a yellowish tint. This phenomenon is called neonatal jaundice. The whites of the eyes and visible mucous membranes can acquire a yellowish tint. Specialists distinguish 2 types of neonatal jaundice:

1. Physiological (conjugation).
2. Pathological (nuclear, hemolytic).

There is a certain risk group for babies who may experience neonatal jaundice:

• premature babies;
• children of mothers who have diabetes;
• Twins.

Neonatal jaundice: causes

Conducting research, modern experts have proven that the manifestation of jaundice on the skin of the baby is also affected by:

• maternal nutrition during pregnancy;
• deterioration in the health of the pregnant woman;
• bad habits of the expectant mother;
• iodine deficiency in a pregnant woman;
• unfavorable state of the environment;
• conducting medicines in the body of a pregnant woman during childbirth or breastfeeding.

All of the above factors affect the underdevelopment of the fetus in the womb and premature birth when the baby's organs are not yet fully formed to function well. And the underdevelopment of the fetus negatively affects the body's ability to transport the bilirubin accumulated after birth in the baby's blood to the liver for removal from the body. And so, when the body cannot completely and timely remove bilirubin, then an icteric color of the skin and mucous membrane of the child occurs.

Physiological or conjugative jaundice: causes

Any yellowness of the skin is associated with increased level bilirubin in the blood of a person, even a newly born. Bilirubin is a substance that is formed after the breakdown of red blood cells. In the mother's womb, the child has a large number of erythrocytes that carry hemoglobin. After birth small man does not need so many of them, and therefore they are destroyed. Bilirubin, formed after their decay, must enter the liver with blood and be excreted through the urine and first feces of the newborn.

While bilirubin “gets” to the liver, it can partially be absorbed into the baby’s blood and stain its skin and mucous membranes. Jaundice is manifested due to the underdevelopment in infants of the systems that are responsible for the exchange of bilirubin in the blood.

Physiological jaundice of newborns appears 2-4 days after birth. Such jaundice disappears within a maximum of 2-3 weeks after birth in full-term babies (3-4 weeks in premature babies), without medical intervention and a violation of the general condition of the child. But fading, that is, less jaundice, should begin already at the end of the first week of life.

Physiological jaundice: symptoms

• orange skin tone baby;
• the general condition of the child is normal;
• hemoglobin concentration is normal;
• urine and feces of natural color.

Physiological (conjugation) jaundice: consequences

Physiological jaundice, which disappears within 2-3 weeks after birth without any complications, does not have any consequences for the vital functions of the child's organs. If at the maternity hospital they tell you that the baby has jaundice, but they don’t do any tests, and you don’t observe capriciousness and refusal of the breast, then you have physiological jaundice.

Physiological (conjugation) jaundice: treatment

Such jaundice does not need medical intervention if there are no violations in the general condition of the baby. In the maternity hospital, the course of this disease is monitored daily by pediatricians who assess the degree of jaundice of the child every day and decide whether there is a need for a blood test for the amount of bilirubin contained in the blood.

After discharge, parents monitor the baby at home, fixing every day whether the jaundice has become stronger. If it fades away, then you should not consult a doctor. If you notice that the integument of the baby has become yellower than before, then you should consult a doctor for advice.

Sometimes, after discharge, a 5% glucose solution is prescribed for jaundice, which after 1-1.5 should help relieve jaundice with a non-pathological course.

The sun's rays are beneficial effect and on the mood of mother and baby, and a good cure for physiological jaundice.

Pathological neonatal jaundice

As mentioned earlier, neonatal jaundice can be of two types. One of them is discussed above (physiological), while the second type - pathological neonatal jaundice - is not as harmless as the first type.

If jaundice continues for more than a month, then you should start to worry. Most likely, you are faced with the pathology of the course of jaundice. You cannot do without a blood test and consultation of an experienced doctor.

Types of pathological jaundice:

1. Nuclear.
2. Hemolytic.

Pathological jaundice of newborns: symptoms

Pathological jaundice of newborns occurs on the first day after birth, in contrast to physiological jaundice. Also a distinctive indicator of the pathological course of this disease is the duration of the yellow color of the child's skin (more than 3 weeks) and the high level of bilirubin in the blood.

Another symptom is lethargy, refusal of food or inhibition of the sucking reflex. A child with yellow skin color may be lethargic and drowsy. Muscular hypertension and the baby's monotonous cry can also indicate the pathological course of newborn jaundice.

As well as long course jaundice (more than a month), the child may experience a permanent yellow color of the skin and mucous membranes, darkening of urine and discoloration of feces - this is the main thing that even parents can notice at home.

If the symptoms are not noticed in time, then more severe symptoms: convulsions, bradycardia, shrill cry, stupor and coma.

Nuclear pathological jaundice of newborns: causes

Pathological jaundice of newborns occurs due to the excess of bilirubin in the blood of a child. The main reason for the occurrence of an excessive amount of bilirubin in the blood of an infant is the lack of enzymes in the body that supply bilirubin to the liver. The absence of such enzymes is associated with:

• prematurity;
• massive hemorrhages on the skin and head of the child;
• very pronounced jaundice in previous children, if they were in the family.

Most of all, of course, the likelihood of developing such a course of jaundice in a newborn is precisely in premature babies, since their organs are not ready for independent life without the participation of the mother's body.

Nuclear pathological jaundice: consequences

Nuclear jaundice got its name because, penetrating into the blood of an infant, it reaches the brain and affects the nuclei of its cells. Nuclear jaundice in newborns, in the absence of timely and correct treatment, can lead to a delay in mental and physical development, to cerebral palsy, deafness, decreased vision up to blindness. The activity of the entire nervous system is disrupted, and a very serious neurological defect occurs. In some cases, kernicterus leads to paralysis of the child.

Nuclear pathological jaundice: treatment

An excessive amount of bilirubin in the blood should be determined even in the hospital. Experienced doctors should eliminate the main reasons for the increase in the concentration of this substance in the baby's blood.

The most common way to eliminate excess bilirubin from the baby's blood is phototherapy. Phototherapy usually uses quartz lamps that can break down the bilirubin that has accumulated in the skin of the newborn. As long as there is an indication, phototherapy sessions should be repeated regularly. The optimal phototherapy regimen for most newborns is the sequential alternation of phototherapy sessions with breaks for feeding.

There is also the possibility, with not very severe courses of nuclear jaundice, to use droppers with special drugs that help remove excess bilirubin from the child's body. Droppers with 5% glucose solution are used.

In especially severe cases, they resort to a replacement blood transfusion in order to completely cleanse the small body of excess bilirubin cells that negatively affect its vital functions.

Hemolytic pathological jaundice: causes

It is not for nothing that women who become registered in antenatal clinic for pregnancy, they immediately take a whole group of tests. One of these tests is a blood test to determine the group and Rh factor. If a woman ends up with group 1 or with a negative Rh factor, then they definitely require that future father also passed the analysis on the group and Rhesus.

This is done in order to exclude the occurrence of a “conflict” between the blood of the mother and the fetus as a consequence. Such conflicts can lead either to pathologies of fetal development or to miscarriages.

Thus, another reason for the accumulation of bilirubin in the blood of a child may be a mismatch between the blood groups of the mother and the child, or a mismatch of blood rhesus (negative in the mother and positive in the child).

Hemolytic pathological jaundice: consequences

Like the symptoms, the consequences of this jaundice are the same as those of kernicterus, since both of them prevent the removal of bilirubin from the body, lead to its absorption into the bloodstream and affect all vital organs.

All children who have had hemolytic jaundice are observed by a neurologist, ophthalmologist, orthopedist every month during the year. Such children are given a 1-year exemption from vaccinations.

Hemolytic pathological jaundice: treatment

As for pathological kernicterus, both phototherapy and an IV can be used. But most in an efficient way is a replacement blood transfusion, which instantly relieves the baby of excess bilirubin.

If the doctor thinks surgical intervention impractical, then most often a course of droppers is carried out, since the lamp in this case can be a waste of time.

How to determine how serious neonatal jaundice is?

If yellowness of the baby's skin and other symptoms of the pathological course of this disease appear in the maternity hospital, then it is considered necessary to take blood from the baby for analysis. The analysis is taken from a vein on an empty stomach. According to the results of the tests, which will show the level of concentration of bilirubin in the blood, the doctor prescribes treatment or says that everything will soon pass by itself.

There is a norm for the concentration of bilirubin in the blood of a newborn - 255 µmol / l. If this norm is exceeded, a conservative or surgical treatment(depending on the degree of excess of the norm). But even if the norm is met, but your baby has a low weight, then the pediatrician may consider it necessary to carry out conservative treatment phototherapy or droppers.

Prevention of neonatal jaundice

The best way to prevent neonatal jaundice is early and frequent breastfeeding. Colostrum is a natural laxative that causes more quick exit meconium in a baby, with which excess bilirubin also comes out.

Since children with elevated bilirubin are very sleepy, they should even be woken up for feeding: when the time is right, and the baby does not wake up. There are moments when breast-feeding is the cause of jaundice diabetes mothers), but even in this case, the refusal of breastfeeding is not welcome.

Thus, the jaundice of a newborn is the acquisition of a yellowish tint of the skin and visible mucous membranes of the baby due to the excess of the bilirubin content in the blood of the baby. May appear on the first day or after 2-3 days.

There are two types of jaundice: physiological - practically harmless and passing on its own in 2-3 weeks after birth; and pathological - a serious excess of the amount of bilirubin in the blood, which, without medical intervention, can lead to serious consequences: paralysis, deafness, blindness and mental and physical retardation. With manifestations of jaundice, the main thing is daily monitoring of general condition baby and the degree of yellowness of the surfaces.

Answers

Jaundice in newborns is not just often - but it happens almost always. Any mother will easily notice the first symptoms. The baby becomes unusually swarthy or as if filled with yellowness, the whites of the eyes turn yellow. What is it - a disease or a feature small child? This will become clear later, after a few days of observation. Most often, there is no reason for concern, this condition is due to some physiological features the body of a newborn baby.

Why does jaundice appear?

Bilirubin is primarily to blame here.. What is it and where does it come from? Everything is pretty simple. A child who has not yet been born has special blood with special (fetal) hemoglobin. It carries oxygen through the baby's blood vessels. When a baby is born, it begins to breathe with 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 small organism begins to get rid of it.

For a child, this is a very difficult task. Just like that, bilirubin cannot be removed. First, it enters the liver and mixes with special enzymes there, then it dissolves in the urine and even then it is easily excreted. If the liver fails and there is a lot of bilirubin in the blood, jaundice will begin.

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

• blood type incompatibility;
• Rhesus conflict;
• viral damage to the liver;
• genetic metabolic disorders;
• 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 complicated, but you can not delve into it. If it’s really interesting, the blood test takes place at the molecular level. If the results of the analysis show that the content of bilirubin is slightly higher than normal, the doctor understands that 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 it is different...

Why jaundice appears is already clear. And why in general there are difficulties with a conclusion of a bilirubin? Could this be a sign of pathology? Unfortunately yes. Doctors distinguish between two groups of jaundice - physiological and pathological. Consider 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 may be noticed by the mother or one of the relatives, others are recognized only by the doctor.

Hemolytic disease

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

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

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

Mechanical jaundice

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

• gallbladder problems;
• violation of the patency of the bile ducts;
• liver problems.

Most often, obstructive jaundice is caused by genetic disorders or birth injuries of the baby. The manifestations of this disease become noticeable when the baby is two to three weeks old. The skin at the same time looks not just yellow, but with a greenish tint. The baby's stool becomes abnormally light, almost colorless. The doctor will feel that the liver is thickened, and the spleen is enlarged. If obstructive jaundice is suspected, various additional examinations are prescribed - for example, ultrasound. Treatment will depend on the type of pathology..

There are also border states when prolonged postpartum jaundice turns into pathology:

1. Conjugative jaundice associated with poor liver function. Liver enzymes do not bind bilirubin well and cannot cope with its removal from the blood.
2. Nuclear jaundice occurs with a sharp increase in the level of bilirubin during postpartum jaundice. At the same time, bilirubin enters 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 state 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 a mother has a lot of estrogen in her milk (this is a female sex hormone). Then the baby's liver first of all begins to remove estrogen, and only then - bilirubin. In this case, the baby remains icteric until three months . At the same time, the baby develops perfectly - he has a good appetite, sleep and weight gain and height. This condition is not dangerous and goes away on its own.

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

neonatal jaundice

And finally, the most common type. This is jaundice, which appears in most children.. It is not a disease and does not require treatment. Such jaundice of newborns passes by itself and does not lead to complications. True, there is another view: if jaundice has appeared, 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, the whites of the eyes. They become bright yellow, almost lemon in color.

When more than two weeks pass, and the baby's skin has not acquired a normal color, you should consult a doctor. Before treating jaundice, an analysis will be prescribed for the level of bilirubin in the blood. The level of bilirubin depends on many factors and it is impossible to unambiguously interpret the results of the tests. The doctor will make conclusions about the state of health of the child according to big picture health status.

Symptoms pathological species jaundice is manifested in a change in the color of the skin. The differences are in the time of their appearance and some features of the manifestation:

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• change in skin color appears immediately after birth;
• after three or four days the yellow becomes brighter, all symptoms increase;
• yellowness of the integument persists for more than one month;
• the onset of symptoms of jaundice is undulating: it will appear, then it will disappear;
• in addition to yellow, skin color can also acquire a green tint.

In addition to the change in the color of the skin, other symptoms are added:

• feces are discolored;
• urine is dark in color
• spontaneous bruising;
• there is an increase in the liver and spleen;
• the general well-being of the child is deteriorating.

With nuclear jaundice, the sucking reflex fades, severe drowsiness and convulsions occur.

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

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

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

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

• attach 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.

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

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

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

Sometimes in addition to breast milk prescribe irradiation with a special lamp for the treatment of jaundice - 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.

During phototherapy, you may experience side effects. The child may develop drowsiness, the skin begins to peel off and there is a disorder of the stool.

Sunbathing has the same effect. The baby's body in the light begins to actively produce vitamin D. It speeds up the process of removing bilirubin from the blood.

With severe jaundice, glucose and activated charcoal tablets may be prescribed by the doctor. Glucose helps to improve the active functioning of the liver. Activated carbon absorbs harmful substances like a sponge, including bilirubin. Further, coal, together with bilirubin, is excreted naturally with feces.

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

In the treatment of jaundice, different types of therapy are used:

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

They are used both individually and in combination under close 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.. That is why it is especially important to observe the baby in the first days of life. What to pay attention to?

1. Jaundice arose a few hours after the birth of the baby (blood conflicts are possible).
2. The child develops poorly, he is sleepy and lethargic (a significant excess of bilirubin in the blood, including with hemolytic disease).
3. Jaundice is accompanied by convulsions, constant crying (this may be kernicterus). With such a diagnosis, the child may develop hearing impairment, motor pathologies, in the most severe case, the baby may die.
4. The newborn has birth trauma.

As soon as the newborn has jaundice, careful observation is necessary to prevent the development of pathologies. If the treatment is carried out on time, the baby will recover very soon and will grow up 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 cause is in the mother's milk, then the condition may drag on for another one or two months. After that, the skin and eyes of the baby are completely freed from the yellow tint. All this time the child is fully developed. The main thing for him is the care of his mother, relatives and doctors. And then the baby will grow up healthy and happy.

Physiological jaundice in healthy children does not harm the body, does not affect further development child. Pathological jaundice increases the risk of occurrence and development of cirrhosis or liver cancer with age. In 90% of children who have been ill in infancy hepatitis, the consequences of jaundice remain for life. This is expressed in a weakened immune system and poor liver function.

Transferred nuclear jaundice in the future can lead to deafness, complete or partial paralysis, mental retardation. Toxic action high level bilirubin on the nervous system has the most severe consequences.

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