I managed to get used to the lack of informing the patient about anything during these few days, but it was a huge shock for me. The day before, no one had noticed anything disturbing to the child, in the evening the daughter had blood drawn and twice, because in the laboratory they were kind to spoil the sample. Suddenly such a message here. Again, I don't know what's going on. I am sent to a newborn ward for an exposure mat. I still don't know why. I'm going. I can see there something like a pan. The lady instructs me how to mount this miracle to a hospital trolley, which I called the "soap dish". I only learn that my daughter has physiological jaundice and let me be happy that they leave us in the hospital and I can be with her. When asked "what is this jaundice" I heard that you can't inform, I can go to the doctor for information. The doctor can be seen having similar conversations every day, because she gave me a laconic explanation that this is not a disease, it is common and I have not to worry. The daughter just has thick blood. End. To my question, how common can this be, since my first daughter did not have anything like that, the doctor was not kind to answer.
My husband and reliable uncle Google and my pediatrician friend came to help, who calmly explained everything to me. Therefore:
What is neonatal jaundice?
Neonatal jaundice is common phenomenon. Occurs in about 60% of babies born on time and almost 100% of premature babies. The characteristic yellowish skin color appears on the second and third day of life and is the result of an immature liver. It is not dangerous for kids, but its frequent occurrence does not mean that it can be underestimated.
The baby, being in his mother's stomach, draws oxygen from placental blood. It needs a large amount of red blood cells (so-called fetal erythrocytes) for its transport. After birth, when the baby begins to breathe on its own, he must get rid of unnecessary blood cells. Bilirubin (a yellow pigment) is formed as a result of the rapid breakdown of erythrocytes.
If everything is normal, after processing by the liver, bilirubin goes to the intestines with bile and is excreted from the body. It leaves no consequences for the child and does not require treatment. In these cases, approx. 60% an immature pediatric liver cannot cope with the excretion of bilirubin (the level exceeds 2 mg%), so it goes back into the blood and becomes the cause yellowness of the skin. Bilirubin is deposited then in places where there is a lot of adipose tissue (in the skin or in the mucosa), giving them a characteristic yellow color that is earliest visible on the whites of the eyes.
Yellowing of the skin is already noticeable in II - III day of the child's life. It is most clearly and strongly visible in IV and V days of life. Then the discoloration on the skin gradually disappears. The whole process takes no more than 10 days. For premature babies jaundice starts later, only around the fifth day and lasts up to 3 weeks.
By taking the baby's blood on the 3rd or 4th day, when bilirubin is highest, doctors look at bilirubin. In case of children born on term are considered 12mg% as the norm, and u newborn prematurely 15mg%. If during the examination the result exceeds the norm, there is a physiological jaundice which qualifies the child for treatment. At the level at the limit of the norm, doctors decide on further treatment or discontinuation. And so if the norm limit occurs on the third day, doctors will usually order treatment, as the risk of bilirubin increase is very high (peak is IV or even V day). If the test was performed in In the 4th day of the child's life, the baby will probably be sent home without further treatment. If the result significantly exceeds the level of normal, you should definitely undergo treatment so that fat-loving bilirubin does not precipitate in the child's brain (nerve cells are made of, among others, fat), causing irreversible changes. Fortunately, such consequences are extremely rare.
Where does neonatal jaundice come from?
Probably there are many more likely causes, however, the six most common are distinguished:
- Insufficient bowel function. It is usually caused by too late or too scarce excretion of mecon, and thus bilirubin 'retention' in the body, which resulted in reabsorption. That is why it is so important to feed your child from birth as often as possible, because it is one of the elements improving the work of the intestines and the entire digestive system.
- Serological conflicts in the field of RH factor and the AB0 system (haemolytic jaundice) if during delivery they appeared on the baby's body. extravasation (places where the blood is outside the blood vessels).
- hypoxia caused e.g. by umbilical cord wrapping. It reduces liver function, including hypoxia.
- Bad general condition of the child, serious infection e.g. sepsis or pneumonia.
- Congenital malformation of red blood cells - although fortunately rare cases.
- In some cases, the cause may be ... mother's milk. In about 50% of children with jaundice, yellowing can persist up to the 12th week of a child's life. This is due to the composition of mother's food, which contains substances that inhibit the maturation of digestive enzymes, so that instead of being excreted from the body, bilirubin goes back into the bloodstream. In this case, the doctor occasionally recommends weaning the child for a maximum of 2 days. If the diagnosis is confirmed, the mother may return to feeding, and the subsequent possible increase in bilirubin should no longer worry us.
How is jaundice treated in newborns?
With a slight severity of jaundice, doctors will probably give it Luminal - a sedative and anticonvulsant drug, which in a low concentration has an active effect on liver enzymes and speeds up metabolism.
In case of noticeable exceeding of the bilirubin level norm, doctors will reach for another weapon. Currently, the most popular method of fighting neonatal jaundice is to subject the child to phototherapy, popularly called "children's solarium". These are specially selected light rays that support the breakdown of bilirubin, thus making it harmless to the nervous system. This method works in crushing most cases and children after 2 - 5 days return home. However, if your bilirubin level continues to rise despite irradiation, you may need a blood transfusion (so-called exchange transfusion). After a few days everything returns to normal.
The most important in the treatment and prevention of jaundice is appropriate defecation of the newborn baby. That is why it is so important to quickly put the baby to the breast after delivery and to feed him as often as possible. Thanks to this, the work of the intestines, and thus the entire digestive and excretory system, starts. It is important to, that the baby should give tar as soon as possible after delivery, thus making the excretory system unobstructed and to pee as much as possible. Among other things, it is recommended that feeding breaks not be longer than 3 hours, regardless of the child's "demand".
Nowadays, with proper treatment, jaundice does not leave any traces in the child's body and there are no complications. It also does not affect the development of the baby in the next life.