Jaundice of newborns is not a disease as such, but its symptom. It is characterized by yellowing of the skin and the eyeballs of the child. With preterm birth, the likelihood of jaundice is increased and approaches 100%. This type of jaundice - a disease in newborn children is quite frequent. Because you will be worth learning about this more.
How does this happen?
Yellowing of the skin of babies is due to increased bilirubin (the main component of human bile pigments) as a result of hemoglobin - the red pigment of the blood. In the spleen, the red blood cells (erythrocytes) are destroyed and the hemoglobin released from them is processed into bilirubin. It is transported in the blood serum to the liver. Part of bilirubin, which is transported through the body, is called free or unbound. It is a fat-soluble component, but it is poorly soluble in water. In the liver, bilirubin is captured from the compounds with albumin. So bilirubin is formed, soluble in water, which passes into the intestine, where it is excreted with feces. The ability to capture the body of a newborn bilirubin and bind glucuronic acid is weak. The effectiveness of liver enzymes in infants is much lower than in adults.
Why is this happening?
There are various causes of jaundice - a disease in newborns. They are both physiological and pathological. However, I would like to mention the most common.
Relative fetal hypoxia
The fetus lives and develops under conditions of relative hypoxia. Infants are born with a higher level of hematocrit and hemoglobin, with large amounts of red blood cells in the blood. The life span of newly created cells is reduced. The result is that, because of the greater number of red blood cells, the baby's spleen is expanding. A greater amount of hemoglobin is supplied to the spleen.
Abnormal bowel movement
Before birth, the child is fed from his mother. From the first hours of his life after birth, he quickly begins to reject meconium - something that has accumulated in the intestines of a child even with intrauterine life. This is the first task of newborns. A child born prematurely, or if his mother was malnourished during pregnancy, experiences problems with the intestines. Its function is disrupted, resulting in an increase in the level of bilirubin in the blood.
Rhesus-conflict
This is a conflict of the Rh factor of the mother and child - if the child is a Rh-positive and Rh-negative mother. Thanks to immunoglobulin prophylaxis (after the birth of the child, the mother receives an anti-Rh-D immunoglobulin within 72 hours, which protects the immune system from allergies to the blood of the baby), the mother does not produce antibodies that can threaten the baby at the next pregnancy.
There may also be conflict of major blood groups. For example, a woman with group III blood has natural antibodies against group IV cells. In such situations, the conflict is most pronounced during the first pregnancy. In subsequent pregnancies, the risk of such conflicts decreases.
Hemorrhage
Birth is an injury to the child. He has to fulfill a difficult task - to squeeze through the narrow birth canal. Sometimes this process does not do without damage. The birthmarks of the woman at this moment are filled with blood, in which a very high content of bilirubin. If damaged, this blood gets to the baby, bilirubin in turn falls into his body. The level of it increases and jaundice arises.
Hypoxia
Newborns can be, for example, entangled in the umbilical cord. Sometimes in such cases, jaundice occurs due to liver hypoxia, which increases its failure in the neonatal period.
Breast-feeding
The amount of food in the first days of life can be slightly less than your child would like to eat. Therefore, there may be a delay in the passage of food through the baby's digestive tract. As a result, jaundice may occur.
It may happen that the baby is healthy, is exclusively breastfed, gaining weight well, but jaundice is retained for a long time and can last up to 2-3 months. It is caused by enzymes that are present in breast milk and help to combine bilirubin with glucuronic acid and its output with feces. Sometimes such children can reach high values of bilirubin. However, this does not threaten the life and health of children.
Pathological factor
Often, jaundice - a disease of newborns suffer from initially sick children. It can be a congenital bacterial or viral infection. One of the symptoms is severe jaundice. There are also genetic diseases in which there is liver dysfunction and its ability to bind bilirubin to glucuronic acid.
How can I treat my baby in newborns ?
Phototherapy
This is the most effective method of treating this disease. Excess free bilirubin in the skin breaks down into non-toxic water-soluble products, which are then simply excreted in the urine. With this method, different types of light can be used: white, blue and green. The most effective is light blue. Phototherapy is effective only when light falls on the baby's bare skin. If your child lies on his stomach, his entire back is irradiated, if he lies on his back - the front. The child's eyes are covered with a special material that does not allow radiation. The boys also have testes.
In the case of severe jaundice, the newborn is placed in the intensive care room of the room where it undergoes bilateral phototherapy. The child lies on a special mattress, which is connected to fiber-optic light sources and is illuminated from above with a special lamp. Phototherapy usually lasts two days - this, as a rule, is enough. Sometimes the course is extended to three days.
Luminal
With a slight acuity of the jaundice in the treatment, luminal (phenobarbital) is used. It is a soothing and anticonvulsant that is well tolerated by infants. In a low dose, it activates the production of liver enzymes and accelerates the metabolism of bilirubin. With a small amount of jaundice is an effective tool.
Weaning
This is a controversial method used in the treatment of chronic jaundice in newborn infants. The substances present in breast milk and responsible for jaundice are eliminated and the level of bilirubin is reduced. You can return to breastfeeding after two or three days off. In the blood of the baby again there will be an increase in bilirubin, but not at such a high degree.
Blood transfusion
This is the final method of treating jaundice - a disease in newborns. An umbilical vein is inserted into the catheter, through which the blood of the child is removed in small portions, and the donor's blood is injected. The child is thus deprived of excess bilirubin. This method allows you to clean the blood of children with antibodies to blood cells.
Sometimes, with very severe jaundice, albumin can be given, which, as is known, transmits bilirubin. The significance of bilirubin in the blood of full-term newborns is unacceptable for a premature baby. The smaller the child, the less body weight, the lower the value of bilirubin, which the newborn is able to withstand.
Doctors neonatologists take into account the weight of the child, clinical status (with a more severe clinical condition, lower bilirubin values are allowed). The value of bilirubin on the second day of a child's life is no longer acceptable on the fourth and subsequent days.
Toxic effect of bilirubin
Bilirubin readily dissolves in fats, enters the central nervous system, where it causes irreversible damage. He is responsible for the development of encephalopathy. The penetration of bilirubin into the central nervous system is more difficult for a child with a low birth weight as a result of premature birth. Such children are susceptible to infections that degenerate into acidosis. The risk of damage to the central nervous system is high when the level of bilirubin is significantly exceeded.
Once it was believed that the concentration of bilirubin by 20 mg. is an indication for exchange blood transfusion. World literature does not provide for encephalopathy in children on breast-feeding, even at very high values of bilirubin.
Are there any complications?
If properly treated jaundice in newborn babies, then it passes without consequences. At the current level of medicine, this is not a therapeutic task (of course, with good cooperation with the mother of the child). Children who have undergone this disease develop correctly, there are no violations in their development.
Physiological jaundice occurs on the second or third day of a child's life and lasts up to 8 days, while in preterm patients it takes about 2 weeks. Jaundice is ill in about two-thirds of full-term newborns. In premature babies it occurs in 80-90%. The earlier the baby was born, the higher the probability of jaundice and close to 100%. Jaundice in healthy newborns in the first day of life is a symptom of pathological jaundice.