home Audience 12 Newborn jaundice has not improved for 2 months. Jaundice in newborns: causes and consequences, diagnosis and treatment

Newborn jaundice has not improved for 2 months. Jaundice in newborns: causes and consequences, diagnosis and treatment

At the moment of birth, the baby, entering a new environment, experiences severe stress. In the fragile children's body Minor disruptions may occur, leading to the phenomenon of jaundice in newborns. What is this, and should parents panic?

Why does jaundice appear?

Causes of jaundice in newborns

Most often, pathological jaundice affects children whose mothers had a difficult pregnancy, say, they were in danger of miscarriage, or had early or late toxicosis.

What else, besides this, can be the cause of the disease?

Hemolytic disease, which was caused by incompatibility of the blood of the baby and the mother according to the Rh factor.
Heredity.
Infection of a child's liver with a virus in the womb.
Underdevelopment of liver cells.
Reduced function thyroid gland- hypothyroidism.
Abnormalities in the bile ducts.
Premature birth in women with diabetes, including diabetes that only appears during pregnancy (gestational diabetes).
Introduction of oxytocin into the mother's body.
Giving the child antibiotics such as cefazolin or ampicillin.

How does the disease manifest? Tests for jaundice

In infants, changes in the skin may be accompanied by additional manifestations jaundice. The baby's urine becomes dark in color, and the feces, on the contrary, become discolored. Bruises may appear on the baby’s body for no reason. Getting worse general health child, while the liver and spleen enlarge.

If the baby's skin does not acquire a normal shade 2-3 weeks after birth, you need to consult a doctor for laboratory tests.

Before starting treatment, a test is prescribed to determine the amount of bilirubin in the blood. In full-term babies, the critical indicator is 324 µmol/l, and in premature babies it is only 150-200 µmol/l.

Since this value depends on several reasons, the doctor will prescribe treatment based on the general condition of the baby. In addition, ultrasound is performed abdominal cavity in order to determine the condition internal organs, and also take samples for hemolysis.

How to treat jaundice in a newborn

If a child has a physiological form of jaundice, then we're talking about not about treatment, but only about helping the little man.

What needs to be done to help the child cope with the problem that has arisen faster?

You need to start breastfeeding as early as possible to promote improvement metabolic processes in the baby's body.
To prevent your baby from having digestive problems , mom must stick to a diet.
The baby needs to visit more often fresh air and, if possible, sunbathing.

Methods for treating jaundice in newborns

If pathological jaundice is detected, treatment of the infant should be started immediately.

Lamp against jaundice in a baby

This is a treatment based on the effect of ultraviolet rays on the baby's skin. When irradiated with light under the skin of a child at a depth of 2-3 mm, chemical reactions, which convert indirect fat-soluble bilirubin into its water-soluble form - lumirubin. It dissolves freely in the blood of the newborn and is excreted from the body in the urine.

Phototherapy is carried out in a hospital under the supervision of a doctor and compliance with certain rules...

The baby's eyes are closed special glasses or a bandage.
Time treatment session strictly regulated; for this purpose, the lamp is equipped with a timer.
The procedure can cause peeling of the skin and dehydration of the body, so it is carried out under the constant supervision of a medical professional.

After phototherapy sessions, the child's stool color and character may change. This is normal, as excess bilirubin is excreted from the body in the baby's stool.

Together with phototherapy, the doctor may prescribe infusion therapy. It will be needed to restore water balance. This may be a glucose solution, membrane stabilizers, electrolytes and drugs that improve microcirculation.

Medicines to help with treatment

One of the medicines is Hofitol - a preparation that contains an extract from the leaves of the field artichoke. It improves liver function, promotes the rapid removal of bile and a significant reduction in the level of bilirubin in the baby’s body. Ursofalk has a similar effect on the body. Little babies are prescribed medicine in the form of a suspension.
As aids enterosorbents are prescribed, such as Polyphepan, Smecta or Enterosgel . The drugs limit the circulation of bilirubin between the liver and intestines.
To stimulate metabolic processes and strengthen the immune system, children are prescribed Elkar - a product consisting of carnitine. The drug breaks down fatty acid, helping to produce additional energy in the baby’s body.

When is a blood transfusion necessary?

Blood transfusion is used for severe forms pathological jaundice. If indirect bilirubin levels quickly increase and significantly exceed the norm, then an exchange blood transfusion cannot be avoided. Most often, the procedure is performed when a Rhesus conflict occurs.

Exchange blood transfusion involves replacing a small amount of a child's blood with donor blood. This helps flush bilirubin from the baby’s body.

Folk remedies in the treatment of jaundice

Under no circumstances should you risk the health of your newborn and self-medicate! Folk remedies can only be used as an addition to treatment prescribed by the attending doctor and only with his approval.

To improve the general condition of the newborn, you can resort to a strengthening agent, the role of which can be played by a weak rosehip decoction. Can be given to a child as an absorbent Activated carbon by dissolving in water an amount of powder corresponding to its weight.

You should not give your baby any medicinal fees as a diuretic and cholagogue. No one can say for sure how the child’s body will react to them.

Why is jaundice dangerous - the consequences of the disease

If physiological jaundice passes quickly, leaving no trace in the little person’s body, then the pathological form of the disease can cause serious consequences.

For kernicterus affected nervous system child, which leads to serious neurological abnormalities. In addition, the child may experience deterioration in hearing and vision, and in the most severe cases develop cerebral palsy. IN in rare cases the disease can lead to paralysis of the sick baby.

If the jaundiced color of the baby’s skin does not subside in due time, consult a doctor immediately. If a baby's jaundice appears in pathological form, it needs to be treated immediately.

Video about jaundice, Komarovsky:

Don't be scared! Despite the severity of the name, “jaundice in newborns” is by no means a disease, but just physiological symptom certain processes that occur in the baby’s body while he adapts to new living conditions. What to do with a “golden” child, how exactly physiological jaundice occurs in infants, is it possible Negative consequences We will look into this phenomenon and whether jaundice in newborns requires any treatment.

Jaundice in newborns: why did my baby turn yellow?

For the sake of your maternal peace of mind, let us repeat: the fact that your newborn baby suddenly turned orange on the second or third day of life should in no way make you nervous or frightened. Jaundice in newborns is not a disease! This is just an indicator (a kind of marker) of certain physiological processes, which occur in the child’s body due to his “moving” from the mother’s womb into the light of day.

In order to understand exactly how a newborn’s skin changes color from romantically pink to hysterically yellow, it makes sense to recall some paragraphs from a school anatomy course:

The mechanism of jaundice. In human blood there are special red blood cells - erythrocytes, whose task is to carry oxygen and oxygen throughout the body. carbon dioxide. Every day, approximately 1% of all red blood cells that rush through our body die (the lifespan of each red blood cell is no more than 120 days). When these cells collapse, they release a substance contained inside red blood cells - bilirubin - a special yellow pigment that is actively involved in hemoglobin metabolism. Bilirubin itself is a rather dangerous and toxic substance for internal organs, so normally, as soon as the blood brings it to the liver, it is immediately neutralized by special liver enzymes. In medical language, the process of neutralizing the harmful yellow pigment in the liver is called “bilirubin conjugation.” The neutralized bilirubin then passes through bile ducts and is eliminated from the body by the excretory system.

If any link in this chain of formation and excretion of bilirubin is disrupted, the level of this substance increases, the yellow pigment penetrates the skin, coloring the face and body in “autumn tones.” And if we were talking not about newborns, but about older people, then we should consider jaundice as an obvious symptom of a serious disease (for example, liver disease like hepatitis, acute poisoning, intoxication, inflammation of the gallbladder, stagnation of the bile ducts, etc.).

Physiological jaundice in newborns is within normal limits

But jaundice in newborns is most often physiological norm. The bottom line is that a child, barely born, has a very high level of hemoglobin, which begins to decline sharply in the new conditions of the baby’s life. In addition, a newborn baby has a not yet fully formed “army” of liver enzymes. In other words, the newly born baby in the first days of life is simply physically unable to cope with high level bilirubin in your blood. That is why the baby is rapidly turning yellow.

At least 60% of absolutely healthy full-term newborn babies on the second or third day of life are “colored” in yellow. This is normal and does not threaten the child with any harm. In medicine there is even a term - physiological jaundice newborns. Physiological means natural, normal, without pathology.

So, even if you are in this 60%, there is no reason to be afraid. And if it so happens that the child was born premature (which means that he has even fewer capable liver enzymes than a healthy toddler), then you have an even greater chance of admiring his yellow color - 80-90% of all babies born ahead of schedule, experience physiological jaundice of newborns.

Those at risk for jaundice in newborns include babies whose mothers have diabetes, as well as twins (twins, triplets, etc.)

Normally, jaundice in a newborn baby should go away within two to three weeks. But what to do in cases where the child turns yellow naturally, but doesn’t seem to be going back to pink, even after three weeks?

Why does a baby's jaundice not go away after 21 days?

If the “golden” color of the baby’s skin has not disappeared in three weeks (which means the process of neutralizing toxic bilirubin by liver enzymes has not improved), it is imperative to consult a doctor, who, with the help of analyzes and tests, will determine at what stage of the cycle “ existence” of bilirubin in the baby’s body, malfunctions occur and why. The reasons can be, relatively speaking, dangerous. For example:

1 As a result of any disease of the child, the destruction of the red blood cells of his blood occurs intensively and constantly (for example, with hemolytic disease, which often develops in children whose Rh factor differs from the maternal one). Accordingly, the level of bilirubin in the blood is constantly increased.
2 The liver’s function has not developed properly (for example, due to hereditary hepatitis). In this case, jaundice is rightly called hepatic.
3 Normally, after bilirubin is neutralized in the liver, it enters the gallbladder and is excreted from the body through the bile ducts. Often, jaundice in a newborn does not go away due to disruption of the functioning of this particular organ. For example, a baby may have an obstruction biliary tract- in this case, jaundice is called mechanical.

If the cause of jaundice in a newborn lies in one of these serious illnesses, then with the help of special analyzes and tests, doctors will determine this and prescribe adequate treatment, in which it will not be the symptom itself that will be treated, but the disease.

Physiological (that is, absolutely normal, harmless) jaundice in newborns can also last more than three weeks - in some babies the liver enzymes quickly “master their purpose”, in others - more slowly.

Jaundice in newborns can last for over 21 days and for no reason at all. After all, every baby is individual and you can’t predict exact dates When he learns to walk, when he learns to talk, and when his liver learns to process bilirubin, not a single child’s “aesculapian” can do it, even if he is the most outstanding medical genius.

As a caring and intelligent parent, you must understand that a newborn baby (as well as an older child) is in itself an excellent indicator of its physical condition. Simply put, if your baby has turned yellow and has continued to stay that sunny tone for over three weeks, but he is not showing any signs of distress - not crying, eating with appetite, gaining weight, regularly filling his diapers and sleeping soundly, then there is no reason You shouldn’t have to worry about prolonged jaundice.

The only thing you need to do is, with the help of an experienced and observant pediatrician, begin to regularly monitor the level of bilirubin in your baby’s blood.

Jaundice in newborns - consequences for everyone

During those couple of weeks, while the level of toxic bilirubin in the newborn’s blood was elevated and his skin had a “golden” tint, nothing bad could happen to the child. Although bilirubin is toxic, its amount (even though it is elevated in the baby during this period) is still not enough to cause significant harm to the baby.

But if the jaundice has prolonged and gone beyond 21 days (which means the level of bilirubin in the body continues to remain high), it is imperative to contact a pediatrician and put the baby’s bilirubin “on the counter” - that is, it must be constantly measured and monitored. If the bilirubin level remains above normal, but does not tend to increase, there is no need to be alarmed; under the systematic supervision of a reasonable doctor, such jaundice does not threaten the child with any serious consequences.

Jaundice in newborns can pose real problems only in those situations in which the level of bilirubin in the blood rises 10 times higher than normal and has a progressive tendency to increase. In such cases, damage may be caused to the baby’s central nervous system, his liver, etc. But if you consulted a pediatrician in time, no responsible doctor would simply allow such a development.

Critical indicators of bilirubin in the blood are for full-term and premature infants, respectively: 324 µmol/l and 250 µmol/l. You, parents, do not need to know these numbers; the main thing is that the doctor observing the condition of the newborn remembers them.

Treatment methods for jaundice in newborns

It is not entirely correct to talk about the treatment of jaundice itself in the context of newborns - since this, as has already been said fifty times, is not a disease, but only a symptom.

If jaundice is a symptom (indicator or consequence) of some serious disease, then, naturally, it is not jaundice that is treated, but this very disease. But no disease can be cured overnight, and there are situations when, simultaneously with therapy, it is necessary to reduce the level of bilirubin in the blood, which is dangerously “creeping” to a critical level.

Even 15-20 years ago, in a situation where the level of bilirubin became alarmingly dangerous and could cause irreparable damage to the baby’s central nervous system, the child was given an exchange blood transfusion.

Today, this method of treating jaundice in newborns is also used, but only in extreme cases. And in less severe situations last decades practice another effective method fight against increased bilirubin- a bright lamp!

Phototherapy for jaundice: let there be light!

Scientists made this discovery by accident - during medical research It was discovered that toxic bilirubin in human skin begins to actively break down under the influence of bright light rays, turning into a non-toxic isomer. This is how the most common method of treating jaundice in newborns today was “born” - phototherapy.

The point is simple: if the baby’s bilirubin level is elevated and no positive dynamics are observed, he is laid out naked, but with protection over his eyes, under a bright lamp: sometimes for several hours a day, sometimes for several days (around the clock with breaks only for feeding and hygiene and massage).

The phototherapy method is good, safe and very common. He returned many children to their usual skin color, and their parents - peace of mind.

Breastfeeding jaundice: mother gilded

There is another type, fortunately, completely safe jaundice, which can be observed in newborns and which can last more than three weeks. This is the so-called jaundice natural feeding. As the name suggests, it only happens to babies who are fed their mother's milk.

The bottom line is this: there is a substance in mother’s breast milk that blocks the action of liver enzymes in the baby.

Not a single “sane scientist” has yet managed to figure out why nature came up with this mechanism. Nevertheless, it works and is very active - many infants turn noticeably yellow in the first days of life precisely because their mothers’ milk “slows down” the activity of enzymes in the child’s liver.

Moreover, this type of jaundice, as a rule, smoothly “takes over” from physiological jaundice and can last much longer than 21 days completely safely for the baby.

If you are scared and you want to make sure at all costs that your “orange” baby has safe jaundice breastfeeding, and not some kind of symptom dangerous disease- Stop breastfeeding for 1-2 days (give formula). If the yellow color of the skin noticeably brightens, this is what it is, you can calm down and return your baby to his natural nutrition.

Jaundice in newborns: Epilogue

Despite the fact that the child is entirely yours, it is not you who should decide what to do with him if he turns yellow. And the health workers. And deal with it.

Find out whether your baby’s jaundice is dangerous (that is, is it a symptom of a serious illness?) or completely harmless, treat it or be patient and just wait, and if treated, then in what way - all these issues can only be resolved by pediatrician. Your task is to present your newborn to him for examination and tests.

Because in the case of jaundice in newborns, the probability of making a mistake is very high: it can be completely normal physiological state taken as a symptom of a serious illness, and vice versa. Are you really ready to guess if the health of your beloved, “golden” in every sense of the word, baby is at stake?

Jaundice is a yellow discoloration of the skin, sclera and mucous membranes due to the deposition of bile pigments in them. Fat-soluble bilirubin, which is formed during the breakdown of red blood cells, accumulates in the skin.

The liver does not have time to neutralize decay products. Therefore, an excess amount of this pigment appears in the blood.

Bilirubin is:

unconjugated or indirect. It is fat soluble;
conjugated or direct. This bilirubin is water soluble.

Therefore, direct bilirubin is freely excreted in bile and urine, while indirect bilirubin is excreted as a result of a complex biochemical process in the liver.

Direct bilirubin does not have a neurotoxic effect. Its level is determined only for the purpose of diagnosis. Indirect bilirubin is neurotoxic.

This happens only at a very high level. In full-term children, one level is above 342 µmol/l, in premature infants another – from 220 µmol/l, in very premature infants the third – from 170 µmol/l.

The threshold level of neurotoxicity also depends on the duration of exposure and a number of other circumstances. Jaundice in newborns is quite common. 60% in full-term and 80% in premature.

Neonatal jaundice of newborns and its types

Physiological jaundice of newborns becomes noticeable on the second - third days, reaching a maximum on the second - fourth. Jaundice should go away when the baby is 5 to 7 days old.

If neonatal jaundice is exactly like this, then it is classic physiological jaundice associated with insufficiency of bilirubin conjugation in the liver. But it is considered so only after excluding other causes of postpartum jaundice.

Jaundice in a newborn can occur on the first day of birth and appear later. It depends on the reason.

When is neonatal jaundice considered severe?

They appear on the first day of life.
For viral and bacterial infections.
In the presence of hemorrhage.
In case of incompatibility of mother and child by Rh antigens and blood group.
In case of prematurity or immaturity of the newborn.
With insufficient nutrition.
If older children in the family have jaundice.

Jaundice in a child begins from the face. The higher the bilirubin level, the lower the color (yellow) of the body.

Jaundice has a bright yellow, even orange color due to indirect bilirubin and a greenish or olive color due to direct bilirubin. The difference is clearly visible with severe jaundice.

Pathological jaundice occurs:

conjugation at enzyme deficiency liver;
hemolytic when changing the normal structure of hemoglobin and red blood cells;
hepatic for liver diseases;
obstructive, or mechanical, jaundice when the normal outflow of bile is disrupted.

If jaundice worsens, symptoms of hemolysis, or infections occur, be sure to laboratory test blood. Define total bilirubin, direct and indirect, blood type and Rh factor. A microscopy of a blood smear is performed to determine the percentage of reticulocytes and a Coombs test. To determine the level of bilirubin, non-invasive transcutaneous determination of bilirubin is used.

This is the determination of pigment using a reflectance photometer, which, based on the color of the skin, determines the level of bilirubin in the blood.

When can pathological jaundice be suspected in newborns?

If infantile jaundice develops at birth, or on the first day, then it requires increased attention.

It is necessary to exclude the following conditions in the child: hemolytic disease of newborns, infections (syphilis, toxoplasmosis, rubella), hidden hemorrhages;

on the fourth - seventh day, jaundice occurs more often with congenital infections;
the causes of jaundice after the 1st week of life are infections, hypothyroidism, hepatitis, biliary atresia, cystic fibrosis;
in case of persistent jaundice during the first month of life, it is necessary to exclude infections and hereditary genetic pathologies;
Among the causes of hemolytic disease of newborns are bile thickening syndrome, bile stasis, pyloric stenosis, biliary atresia and other pathologies.

In clinically healthy children who are not at risk, it is sufficient to control bilirubin levels.

Jaundice in newborns can develop after the 1st week of life. This is due to the beginning of breastfeeding. Increased level bilirubin levels in infants can last up to 10 weeks during breastfeeding.

If breastfeeding is stopped for 1 - 2 days, then the jaundice from breast milk will go away, and bilirubin levels in the blood will quickly decrease. When breastfeeding is resumed, hyberbilirubinemia usually does not return. General state the child is usually normal.

Although such jaundice in infants is rarely accompanied by bilirubin encephalopathy, cases of its occurrence have been described. Why this happens is not yet clear to medicine.

Why is bilirubin encephalopathy, also known as kernicterus of newborns, dangerous?

The risk of bilirubin encephalopathy is higher in immature newborns. Bilirubin penetrates the neurons of the brain and has a toxic effect on them.

Clinically this manifests itself:

weakening of sucking;
hyperextension of the neck;
lethargy;
lethargy;
convulsions.

As it progresses, reflexes disappear, breathing problems and a sharp, piercing cry appear. Severe defeats nervous system are fatal.

Consequences of kernicterus in newborns

in a child with a larger share delay in motor development is likely to develop;
after the first year of life – movement disorders, deafness;
by three years - convulsive syndrome, mental retardation, hearing loss, strabismus, motor disorders;
with obvious neurological symptoms, the prognosis is unfavorable, mortality reaches 75%.

Bilirubin encephalopathy is a rare phenomenon nowadays.

But there are always risk factors:

discharge from the maternity hospital before the 3rd day without follow-up for two days;
lack of alertness and underestimation of the severity of jaundice.

How to treat jaundice in newborns?

Treatment of jaundice in newborns aims to reduce bilirubin levels to levels that do not exceed the threshold of neurotoxicity (the ability to damage brain neurons).

There is no consensus at what level of bilirubin it is necessary to start phototherapy. But since for visible result should take 6-12 hours, then phototherapy should begin with safe level bilirubin.

In the process of phototherapy, indirect bilirubin is converted into direct, “non-dangerous”, and is easily removed from the body. Conventional phototherapy is carried out continuously.

The child is often turned to illuminate the skin as much as possible. Phototherapy is carried out until the bilirubin level decreases to the maximum safe level.

Skin color is not always indicative, since under the influence of light the yellowness of the skin decreases, and the bilirubin content in the blood remains high.

When carrying out phototherapy, protect the child's eyes.

Complications of phototherapy – skin rashes, diarrhea. After undergoing a course of phototherapy, “bronze child” syndrome may occur—discoloration of the skin in a gray-brown color.

No long-term effects of phototherapy have been recorded, but it is not recommended to prescribe phototherapy without indications. Scientific research in vitro showed the possible pathological effects of the applied light radiation on DNA.

If phototherapy is ineffective, use exchange transfusion blood. Treatment of jaundice in newborns in this way is a very unsafe procedure associated with the risk of serious side effects. But if necessary, repeated blood transfusions are possible.
Other treatment methods include single intramuscular injection on the first day of life, the drug Tinmesoporphyrin, which reduces the need for phototherapy. This method practically not used due to little knowledge.
Infusion therapy (intravenous administration of solutions) is used as necessary during phototherapy when the child loses a lot of fluid. Indirect bilirubin not output with intravenous administration any solutions.
Prescribing medications that reduce bile density makes sense for bile thickening syndrome.
The effectiveness of prescribing sorbents has not been proven.

Prevention of jaundice

It is carried out during the pregnancy stage.

Complete examination of a pregnant woman.
Prevention of risk factors in pregnant women.
Early breastfeeding.

It is also necessary to understand that even a seemingly harmless jaundice needs consultation with a neonatologist or pediatrician. It is possible to judge the safety of a child only after exclusion pathological conditions when monitoring bilirubin levels.

In this educational publication, you will find out how long jaundice lasts in newborns, when physiological and prolonged jaundice should go away.

The most common illness in newborns and infants is jaundice. It has nothing to do with hepatitis, but is associated with physiological changes the baby's body adapts to the new environment. Most often it occurs in premature babies.

Young mothers should not worry too much about this, since jaundice in infants is not a serious illness. But you should still study how it proceeds and how long it lasts.

Jaundice in a newborn: how long does it take to go away?

In most cases, the cause of jaundice is the incomplete development of liver enzymes. In other words, liver enzymes are not ready for independent existence and development of the body. There is no need to worry too much about this, since it is natural state newborns.

Jaundice in a newborn is detected approximately on the 10th day of the child’s life; the duration of the disease can be up to 2 months. There is no need to worry if the level toxic substance does not exceed the permissible norm.

What symptoms can you use to determine the onset of the disease and when does it go away:

begin to turn yellow eyeballs and skin in children;
high hemoglobin level;
high level of bilirubin in the blood;
disappears after the removal of bilirubin from the intestines.

The incubation period for jaundice is 8-10 days, after which it should resolve. However, what to do if the baby’s hepatitis has not gone away for a month. Basically, the disease goes away on its own and lasts for 3 weeks, without any intervention. Protracted illness requires immediate appeal see a pediatrician and prescribe treatment.

How long does physiological jaundice last in newborns?

Jaundice in newborns appears on the 2-3rd day of his life and goes away on its own without intervention. After birth, hemoglobin levels change dramatically and are different compared to when the baby was in the womb.

The fact is that in the womb the child received oxygen through the blood, and after birth an oxygen molecule must join the hemoglobin of red blood cells. If the process is delayed, on the second day after birth the baby’s skin color changes and begins to turn yellow.

Physical jaundice develops according to the following reasons and when should it happen:

early birth (premature baby);
immaturity of the liver makes it difficult to bind proteins with bilirubin and remove them from the child’s body;
inability of the intestines to quickly remove bilirubin from the body;
Depending on the condition of the newborn, it passes on the 10-11th day.

How long does it take for jaundice to pass? The norm is 6-7 days; on the tenth day, the child’s skin gradually turns pink, acquiring a natural color. The baby is awake, actively feeding, does not vomit or have convulsions, and behaves normally. You should worry about the health of newborns if the disease does not subside for more than a month.

Have you seen ? You will see this here. You might want to know how often they are, since they are not always unsafe.

If you are interested in how breast milk works when a baby has a runny nose, because infancy Breast milk can either help or harm a runny nose.

When should a prolonged illness pass?

It is important for parents to closely monitor the child’s condition so that hepatitis does not cause complications in the future. On what day can jaundice begin in normal children - 22 days after birth.

Complications and prolonged illness with jaundice can lead to the development of pathological diseases:

nervous and of cardio-vascular system newborns;
liver;
digestive system.

How many days should jaundice go away? If after three weeks the jaundice does not subside, you should consult a doctor. Pediatrics treats the disease, and that’s where you should go.

In many cases, the disease may not subside for a month, but the baby feels completely normal. You need to worry if the child lies down and sleeps all the time, activity is reduced, and appetite disappears.

Treatment is carried out different ways, the most effective of them is phototherapy. The newborn should lie under a blue light lamp. This helps speed up the breakdown of bilirubin. In extreme cases, a blood transfusion may be given to reduce the amount of harmful substances.

A beautiful and long-awaited baby who was born suddenly turned yellow. On the third day after giving birth, just in time for the discharge that the whole family was waiting for, the baby acquired an unusual orange color, once and for all erasing the mother’s dreams of beautiful photo shoot with a newborn. Joyful thoughts were replaced by anxiety - what kind of jaundice is this and why is it dangerous? These questions are answered by a famous pediatrician, TV presenter and author of books and articles about children's health, respected by millions of mothers, Evgeniy Komarovsky.

What's happened?

Jaundice in newborns is a fairly common phenomenon; it is observed in 50-60% of full-term and 80% of premature babies. You shouldn't treat it like a disease. Skin the child turns yellow completely physiological reasons. Fetal hemoglobin in the baby's blood (which was natural for him during pregnancy) changes to normal human hemoglobin A. The baby adapts to environment. Its enzyme system is immature, like its liver. It is this organ that is responsible for the excretion of bilirubin, which is formed in all people during the breakdown of red blood cells. These blood cells are constantly renewed, hence the need to “recycle” aging cells.

The baby has postpartum period when hemoglobin is replaced with normal one, red blood cells that age also disintegrate, but the poorly functioning liver cannot yet remove bilirubin. This bile pigment, which remains in the body, causes the skin to turn yellow. This metamorphosis usually occurs with a newborn on the third day after birth.

The enzyme system is improving quite quickly. As the liver, receiving the necessary enzymes, begins to work at full strength, bilirubin begins to leave the body, the skin brightens, first acquiring a peach tint, and then returning to normal color. Usually this process is completely completed by the 7-10th day of life, so after discharge in 4-5 days, less often in a week, the jaundice should completely go away. Prolonged neonatal jaundice can be observed in premature babies, but doctors try to treat and monitor them in a hospital setting.

Another type of harmless jaundice is breastfeeding jaundice. According to Komarovsky, breast milk contains special substances, which slow down the binding of bilirubin in the liver. This situation is normal and does not require treatment, much less the abolition of breastfeeding and the transfer of the baby to feeding with adapted formulas.

How to treat?

Since the process is natural, Evgeniy Komarovsky advises mothers to calm down and not bother themselves with questions about the treatment of neonatal jaundice. Modern medicine does not use special medications for these purposes. It is believed that the most effective method Somewhat speed up the process of normalizing the child's skin color - phototherapy. To do this, use a “blue” lamp, which illuminates the child’s skin. As a result, the pigment bilirubin, under the influence of rays, breaks down into substances that the newborn’s body is quite capable of excreting with urine and feces.

Komarovsky advises using regular “white” lamps at home if there are no LED lamps, since any bright light neutralizes the toxicity of bilirubin.

Another effective medicine from jaundice, it was created by nature itself - mother’s breast milk. It contains natural substances to enhance immune defense child. Therefore, the sooner the baby is put to the breast, the more often he will be fed breast milk, the faster and easier his body will cope with physiological jaundice. Feeding such children is a special story. As a rule, babies with increased bilirubin are different increased sleepiness and may skip feedings. It is important to ensure that the baby eats on time, wake him up if necessary, but in no case overfeed him.

Therapeutic effect They will also enjoy walks with such a baby. It needs to be taken outside more often so that the child has contact with indirect sun rays. If the weather and season permit, a child with jaundice should spend a total of most day.

Pathological situations

A condition in which a child, after birth, begins a massive breakdown of red blood cells, which are not only outdated and in need of replacement, but also completely healthy, is considered abnormal. The bilirubin level in this case is very high, and we are no longer talking about functional jaundice. Doctors talk about hemolytic disease of the newborn (HDN). This pathology can develop in children whose blood type and Rh factor are different from their mother’s. If an immunological conflict occurs, the mother's immunity develops specific antibodies against fetal blood cells.

Such jaundice develops already in the first hours after the baby is born. As a result, severe anemia is observed in the newborn, his liver, central nervous system, and brain suffer. Doctors closely monitor bilirubin levels. When certain critical levels of this pigment in the blood are reached, a replacement blood transfusion is prescribed. Sometimes several such procedures are required to reduce the toxic effects of bilirubin on the body and all its systems. In the case of rapid and severe hemolytic disease, death can occur.

Another one pathological jaundice characteristic of children, associated with biliary atresia. This congenital pathology, in which these pathways are not formed or formed incorrectly due to some genetic error. This disease is very rare and is susceptible to it, according to official medical statistics, one of 15 thousand children born into the world. This condition is eliminated surgically, the operation is very complex and high-tech, but it gives the child a chance for a further normal life.

There are other reasons for the appearance of jaundice that is abnormal for a newborn:

Overdose of vitamin K. The drug "Vikasol" (a synthetic analogue of vitamin K) is used during childbirth to prevent or eliminate heavy bleeding in a woman. If there is an error in dosing or there is an urgent need for large quantities The drug for a woman may cause an overdose in the baby.
Diabetic fetopathy. A condition in which the baby's liver and enzyme system are not sufficiently developed due to the fact that the fetus suffered during pregnancy due to diabetes mellitus moms.
Genetic (hereditary) liver malformations. These are some types genetic syndromes, in which structural genetic errors arose at the level of organ formation in the fetus.
Intrauterine infections. Some infectious diseases that the mother suffered during pregnancy can cause pathologies in the development of the fetal liver.