Yellowee newborn

What are the main risks of jaundice in newborns? What methods of treating the disease are the most effective? How phototherapy can help in the treatment of jaundice

Jaundice call yellow or characteristic staining of visible mucous membranes and skin due to accumulation of bilirubin in the blood. In newborns, staining occurs when the level of total bilirubin is reached from 70 μmol / l, and for premature- 50 μmol / l.

More often found physiological jaundice in newborns, developing in the first 3 days after birth. Doctors include this state to border, which do not require treatment.

It is dangerous by this condition toxic action of free (non-associated) bilirubin on the central nervous system.

Such children are prone to the development of nuclear jaundice, or Bilirubin Encephalopathy. It meets only in newborns and leads to difficult consequences: children’s cerebral paralysis and mental retardation.

Classification of the disease

In the period of the newborn, several types of jaundice distinguish:

one. Indirect or unconjugated hyperbilirubinemia. More than 85% of the total bilirubin falls on indirect;

2. Conjugated or direct hyperbilirubinemia, when a direct bilirubin accounts for 15% or more of the level of total bilirubin; Conjunational jaundice in newborns may indicate hereditary diseases;

3. Hemolytic jaundice;

4. Parenchimtotic jaundice;

five. Mechanical (common) jaundice.

Physiological jaundice in the period of the newborn is called transitary, develops in 60% of dadish healthy children for 2-3 days. At the same time, the level of bilirubin in premature children reaches 85-103 μmol / l and in the docking – 51-60 μmol / l.

It is customary to share the development of jaundice to phases:

one. In the first five days after birth, the fraction of direct bilirubin in the blood is growing relatively rapidly;

2. In the second phase there is a moderate decrease in unbound bilirubin to 50 μmol / l for 11-14 days of a newborn life.

Rarely the second phase can last up to month. This is due to the functional maturity of the child and with the type of feeding (longer than the jaundice keeps with breastfeeding).

Painting of the skin of the baby occurs naturally: in turn painted face, neck, body and limb.

The disappearance of jaundice staining is observed in the reverse order: limbs, torso, neck and face. Some factors contribute to the prolongation of jaundice: the lack of breast milk in the mother or, on the contrary, jaundice is sometimes associated with the effects of mother’s milk to the kid’s body.

Causes of the disease

The causes of jaundice in newborns are different:

one. In childbirth, there was a large release of red blood cells;

2. Initially, the high amount of fetal hemoglobin in the blood of a newborn;

3. Fast decay of fetal hemoglobin after delivery;

4. Lack of liver enzymes that participate in the conjugation of the indirect bilirubin fraction;

five. Incorrect breastfeeding mode.

Physiological jaundice in newborns has its own characteristics:

one. It appears externally after 48 hours (2 days) after birth;

2. The level of bilirubin does not reach the critical value that can cause the development of bilirubin encephalopathy;

3. The general condition of the newborn remains satisfactory.

In children feedable with breast milk, the highest level of bilirubin is observed for 4-5 days, as in the first days they get less fluid due to unspecified lactation.

In prematurest children, the degree of severity of jaundice depends primarily on the maturity of the child and pathologies of the mother during pregnancy, and not on the weight of the newborn. The frequency of jaundice is higher among children who received generic injury, in children from multiple pregnancy and from maternays suffering from diabetes.

Treatment of jaundice in newborns

The main method of treatment of physiological jaundice remains frequent feeding, applying to the chest on demand, sometimes you have to wake up such children for feeding. Nursing mother recommended to adjust drinking mode. Not small importance is given to the right nutrition and recreation of the mother.

The child who gets breast milk is not recommended to give any substitutes, as it is believed that maternal milk is able to provide all the needs of the infant and promote the speedy normalization of the level of bilirubin.

If the overall condition of the child becomes unsatisfactory, jaundice increases, it is recommended to determine the level of bilirubin. If the jaundice developed after 8 days of the life of a newborn or lasts more than 2 weeks, the true cause of this state should be established.

The treatment of hyperbilirubinemia has its own principles:

one. The first step is to eliminate the reasons for increasing the level of toxic bilirube of blood;

2. Measures should be taken to prevent further growth of the level of toxic bilirubin;

3. Apply methods that contribute to the fastest removal of unnecessary bilirubin of blood.

These methods include phototherapy and replaceable blood transfusion, which is shown by newborns who have a rhesus conflict or incompatibility for a blood group with a mother.

The final decision on the use of this method is taken after studying the detailed history, obtaining the results of blood test results for the presence and level of antibodies, with the appearance of clinical signs of the increase in bilirubin at a rate of 17 μmol / l / h, and with a bilirubin indicator below 110 μmol / l in cord blood.

Phototherapy is applied during jaundice in newborns for 30 years. With properly, this method is not negative consequences. Worldwide, phototherapy is the main technique in the treatment of this state in newborns.

The method is based on the transition of a fat-soluble form of bilirubin, which is toxic for the brain, into a water-soluble non-toxic shape, which easily leaves the body. This process is under the influence of ultraviolet rays.

A greater effect is achieved by increasing the illuminated body area. Therefore, such children are usually completely divided, but for the conservation of heat are in the clusters.

Under the influence of light bilirubin disintegrates on non-toxic fractions. The main one is lumirubin. For 12 o’clock, he completely leaves the child’s body with wheel masses and urine.

Sometimes during phototherapy, a newborn has a frequent liquid chair, peeling of skin, excessive drowsiness. After the termination of this procedure, the following phenomena pass without a trace.

The effect of the blue part of the spectrum of the light wave is toxic, so the child closes the eyes with special glasses and genitals with dark cloth.

So that the exposure affect the greatest body of the child, he should change position every 2 hours.

While the readings for phototherapy are preserved, it must be carried out at regular intervals. The most acceptable regime for most of the newborns is the alternation of phototherapy and feeding breaks.

Continuous phototherapy mode is recommended if there is a critical level of bilirubin or its intensive rise.

The average duration of therapy is from 1 to 3 days.

The effect of treatment is estimated not only by external data on skin coloring, but also by laboratory indicators. Newborn needs to control the level of bilirubin using blood analysis to 2-3 times a day. In the first 12-24 hours from the start of phototherapy sessions, the child in the body is stabilized by the level of indirect bilirubin.

This method has contraindications: liver pathology and obtuctive jaundice.

Currently there is an alternative to phototherapy – fiber optic method. The child is swearing in a blanket containing a fiber optic layer. It is he who has a direct impact on skin. Plus the method is the possibility of free feeding of the child, it can be worn on hand.

It is worth remembering that fiber-optic therapy gives a slightly smaller effect than traditional phototherapy in dead children.

The most effective is the combination of both methods.

After the child and mother will discharge from the maternity hospital, the mother recommend walking with the baby under indirect sunlight, frequent feeding of breast milk (on demand). It should be remembered that the Maladenz, which is on phototherapy, should be wakeful for the next feeding.