Beware Of Newborn Jaundice

Some babies have more severe jaundice symptoms than in other babies. Basically, neonatal jaundice due to indirect bilirubin is very common, the disease occurs in 25-30% in term infants and most in preterm infants.
The disease usually occurs in the first month of age but the most dangerous is happening in the first 2 weeks. Neonatal jaundice may be mild (physiological jaundice) but it may be more advanced (pathological jaundice).
Physiological jaundice
Occurs with most newborns, usually occurring from day 2 after birth

. Children are still good, eat well, sleep well: Urine and yellow stool, every day they go out 2 to 3 times. By day 10 - 15 skin yellowing without treatment. The physiological jaundice does not affect the child's activities and is not dangerous
Children physiological jaundice is due to the womb, the body has a high number of red blood cells (about 5-6 million red blood cells / mm3).



About 2 days after birth, when the child is able to breathe well, excess red blood cells are broken down in a series of hyperbilirubinemia.
This bilirubin is transferred to the liver, metabolized there and then excreted through the excretory route, the skin will be yellow.
An important factor to be sure of physiological jaundice is that it only appears 24 to 28 hours after birth. Thus, if he was born and he has already jaundiced, he must immediately notify the doctor because it is not physiological jaundice anymore!
On the other hand, although the baby's jaundice is still normal, the stool is still good and the urine is a bit dark, but nothing special.
In addition to the cause of erythrocyte rupture, jaundice may also be due to the presence of beta carotene (vitamin A prefix) in the mother's milk because the mother's daily diet is high in green vegetables, or the fruits are colored. like carrots, papayas.
What is pathological jaundice?
Dr Khu Thi Khanh Dung - Deputy Director of the National Hospital of Pediatrics said that in term infants, jaundice is normally considered physiological when they meet the following criteria:
- Appears after 24 hours of age.




- Expires within 1 week for full term babies and 2 weeks for preterm infants.
- Mild jaundice (only jaundice on face, neck, chest and abdomen above the navel).
- Jaundice alone, not combining other abnormal symptoms (anemia, hepatosplenomegaly, aborted feeding, lags ...).
- Bilirubin / blood concentration does not exceed 12 mg% in term infants and no more than 14 mg% in preterm infants.
- The rate of increase in bilirubin / blood must not exceed 5 mg% in 24 hours.




Jaundice is considered to be a disease when any abnormalities from one of the above criteria are to be taken immediately to a pediatrician to be diagnosed and treated immediately, as soon as possible to avoid happening. Bilirubin neurotoxicity indirectly penetrates the brain, resulting in the death of the child or life-long cerebral palsy.
Jaundice is easily recognized by the naked eye in a well-lit place. So every day, mothers need to observe the baby's body color in the bright place.
In cases where it is difficult to recognize (pink or black red skin), the thumb should be gently pressed on the child's skin for a few seconds, then let go, if the child has jaundice, the place where the finger will be marked yellow. When a child appears to have suspected pathological jaundice, the child should be taken to a doctor for examination.
Jaundice is divided into 2 levels: Mild, slightly yellow skin on face, body; the baby is still well fed; or jaundice appears late, after the 3rd day. Severe dark yellow skin, spreads to hands and feet; poor feeding, giving up feeding; or jaundice appears early, within 1-2 days after birth.



Babies born prematurely, infected, and asphyxiated are prone to severe jaundice.
What to do when a child has pathological jaundice?
According to Dr. Khanh Dung with mild cases, can be treated at home by sunbathing. Place your child near the window, where the sun is soft (at 8 - 8:30 every morning, when it's not too hot or too cold). Breastfeed many times a day because breast milk helps eliminate bilirubin from the digestive tract quickly.
Need to monitor the progress of jaundice every day for 7-10 days after birth.
So far, the Neonatal Department has been treated with three main methods of providing adequate water and energy (through breastfeeding or intravenous fluids), Albumine infusions and certain medications to speed up the metabolism. Indirect bilirubin; Phototherapy is the most effective, safe, simple and most economical way to treat neonatal jaundice; Exchange blood when the symptoms of neurotoxic threat due to bilirubin in the blood increase.




Doctors may use one, two or three methods at a time depending on the situation. Newborn doctors recommend that sunlight only help children with mild jaundice, but can not treat cases of severe neonatal jaundice.
For children who are early in jaundice, they can sunbathe warmly in the morning, but if they have a lot of jaundice, they must go to the specialist soon to get treatment right away.

The risk of pathological jaundice phenomenon
If your newborn baby has any of the following risk signs, seek immediate medical attention so that bilirubin levels can be closely monitored:
- Children who have had siblings before have jaundice.
- Children urinate do not wet diapers and make diapers dirty.
- Bruising k.

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