January 23, 2021

The cause of jaundice in a newborn

By admin

What is neonatal jaundice? Happened at what stage? Why is it necessary to detect and treat early?

Neonatal jaundice is caused by an indirect increase in Bilirubin (VDSS), which is very common, occurs in 25-30% in term infants and mostly in preterm infants.The disease usually occurs in the first month of age but is most dangerous in the first 2 weeks.

Newborn jaundice can be mild (physiological jaundice), but it can also be severe (pathological jaundice).


If not detected and treated in time pathological jaundice, complications of neurotoxicity (also called nuclear jaundice) may occur because Bilirubin indirectly penetrates into the brain, resulting in death or death of the child. lifelong cerebral palsy.

What is pathological jaundice in a newborn? Where should I take the baby?

In term babies, jaundice is normally considered physiological when it meets the following criteria:

  1. Appears after 24 hours old.
  2. Ends within 1 week for full-term babies and 2 weeks for preterm infants.
  3. Mild jaundice (jaundice only in the face, neck, chest, and abdomen above the navel).
  4. Simple jaundice, not associated with other unusual symptoms (anemia, hepatosplenomegaly, missed feeding, drowsiness …)
  5. Bilirubin / blood concentration does not exceed 12mg% in term babies and not more than 14mg% in preterm infants.
  6. The rate of increase of bilirubin / blood should not exceed 5mg% in 24 hours.

Jaundice must be considered pathological when there is an abnormality from one of the above criteria, it is necessary to immediately bring the child to a pediatrician for immediate diagnosis and treatment of VDSS, as soon as possible to avoid it. neurotoxicity complications.

What are the current treatments for VDSS?

Up to now, in Neonatology departments, VDSS is treated by three main methods, which are:

  1. Adequate water and energy supply (through breast-feeding or infusion), Albumine infusion and taking some drugs to speed up bilirubin metabolism indirectly.
  2. Phototherapy is the most effective, safe, simple and most economical treatment for neonatal jaundice.
  3. Blood change when the baby has symptoms threatening neurotoxicity caused by Bilirubin in the blood increases.

Doctors may use one, two, or three methods at the same time, depending on the case.

Why can phototherapy be able to treat neonatal jaundice? When is there an indication? Which lamp should I use?

Using light with wavelengths from 400-500nm, peak 450-460nm corresponds to the absorption peak of Bilirubine (blue light).Light energy penetrates the skin to act on Bilirubin molecules located in the subcutaneous fat layer to convert the bilirubin molecules indirectly (toxic to the child’s brain) into isomer products or photo-oxidation products. Soluble in water, non-toxic and will be excreted by the liver (through bile) and kidney (through urine).

Indication:
Appears after 24 hours of age.

  • Jaundice increases indirectly Bilirubine has no symptoms of pre-toxicity or neurotoxicity.
  • Back-up lighting in cases with risk of neonatal jaundice such as premature, severe bruising, heavy bleeding, serous tumor, osteoblast, large skull, hemolytic children …

Contraindications: in congenital porphyria / urinary tract, is a very rare disease.

How to choose the light system: the blue light system works best, followed by the green light and the white light system is the least effective.

Light-emitting technique: using a light to illuminate the skin of a child who is exposed to the ceiling, covering the eyes and genitals, rotating to increase the skin area exposed to light. Lighting can be continuous or intermittent, illuminating one way or two directions.

Can sunbathing help treat VDSS?

Sunlight can only help a child with mild jaundice go away more quickly, but severe cases of neonatal jaundice cannot be treated promptly.

For children with jaundice, warm sunbathing in the morning can be done, but if the jaundice is a lot, they must soon see a specialist for immediate treatment.

Deploying a light to treat jaundice for children right in the mother’s room.┬áBenefits of the program.

For normal, well-fed babies with only mild or moderate pathological jaundice, light can be illuminated in the mother’s own room in the treatment area on request, under the supervision of the whole physician. doctors, midwives and family members.

The benefits of this program are:

  • With early lighting, when children leave the hospital, the vast majority of children no longer have the risk of severe jaundice.
  • Not isolate mother and child.
  • It is possible to make the most of the source of breast milk, to avoid losing breast milk due to the separation of the baby’s mother’s milk.
  • Families are directly cared for and monitored for their children, creating a sense of peace of mind and avoiding worry for mothers and families.
  • Reduce overload in neonatology.
  • There is no risk of hospital infection.