Preventing jaundice in newborns

Learn about neonatal jaundice

Jaundice is a common condition in newborns. Newborn babies can have physiological jaundice and pathological jaundice. Children with physiological jaundice may recover if their mothers know how to take care of their babies properly. Children with pathological jaundice, yellowing of the skin need prompt treatment, otherwise they may have neurological sequelae or death.

Just for subjectivity

8-day-old Duong Duc Viet, weighing 2.3kg, was admitted to Saint Paul Hospital's neonatal department in a condition of increasing jaundice, irregular breathing, shortness of breath, 3 to 4 seconds, no defecation . After two days of lighting and infusion, her illness still does not decrease.

Pham Thi Nga, 27, was born in the 34th week of pregnancy in Vietnam. Ms. Nga recounted, the first 4 days after giving birth, the Vietnamese child was eating and sleeping very well. On the 5th day, I only saw that my face was yellow. She intends to take her child to check-up but her grandmother and friends say it is common jaundice in newborns, only a few more days will be gone. Hearing that, she felt more reassured and did not let her go to the doctor anymore. 2 days later, Viet's skin became darker yellow. She was really worried when she saw her sleeping, only when she woke up and did not go to the toilet for 4 days. Seeing something unusual, on the 7th day, Nga decided to let her go to the National Hospital of Pediatrics. After being indented and tested for blood, Viet was diagnosed with jaundice and transferred to Saint Paul Hospital.

Be replaced in time

After the examination and testing, the doctors at Saint Paul Hospital have the same conclusion: Vietnamese grandchildren have jaundice. You get lights and transfusion immediately. By the second day, the skin was still not yellow. Just press lightly with your fingertips to see that the skin is very clear yellow. Results of blood bilirubin measurements were 519 umol / l. Doctors quickly decided to carry out blood replacement for Vietnamese grandchildren. Dr. Lien said that at this time, her jaundice was very severe, only light and fluids could not reduce the disease. If blood transfusions are not timely, excessive levels of bilirubin in the blood will quickly run to the brain, damaging the brain, making it difficult to avoid the risk of death or sequelae such as systemic paralysis, hearing and vision loss. force .

In the evening of May 26, Vietnamese grandchildren were replaced with blood. The amount of blood exchanged is 350ml. According to the initial test results, her health status is relatively stable. Measure the bilirubin concentration of 297.6 mol / l again, reaching the permitted level. Vietnamese grandchildren will continue to be monitored, about 3 days away from hospital.

Do not be confused

Doctor Tran Thi Lien, head of the Department of Neonatology, Saint Paul Hospital, said newborn jaundice is a physiological phenomenon that occurs because fetal red blood cells are destroyed to be replaced by mature red blood cells. When ruptured, erythrocytes release into the blood a large amount of yellow pigment bilirubin. It is the increase of this substance that makes the skin yellow. There are 2 types of neonatal jaundice: physiological jaundice and pathological jaundice.

How to recognize jaundice in newborns?

Jaundice is easily recognizable by the naked eye where there is enough light. Therefore, every day, mothers need to observe the skin color of the whole body in a bright place. In case of difficulty recognizing (red or black baby skin), gently press the thumb on the baby's skin for a few seconds, then let go; If the child has jaundice, the place of the finger press will be markedly yellow. When the child has a suspicious appearance of jaundice, it should be taken to a doctor for examination.

Jaundice is divided into 2 levels:

1. Light : slightly yellowish skin on face and body; children still suck well; or jaundice appears late, after the third day.
2. Severe : Dark yellow skin, spread to hands and feet; poor suckling, breast-feeding; or jaundice appears early, within 1-2 days after birth. The premature babies, infections, asphyxia are prone to severe jaundice.

What to do when your child has jaundice

In cases where it is difficult to recognize as a pink or black baby skin, gently press the child's skin with your fingertips for a few seconds, then remove your hands.

1. If your child has mild-grade jaundice, it can be treated at home by sunbathing: place the child near the window where the sun's sun is shining (around 8:00 am to 8:30 am).
2. Breastfeeding many times a day because breast milk helps quickly eliminate bilirubin through the gastrointestinal tract.
3. Every day, it is necessary to monitor the spread of jaundice and the symptoms that appear. Continuous monitoring within 7-10 days after birth.

Immediately take the child to the doctor in case:

1. Suck less than half as normal.
2. Urine in.
3. Sleep a lot.
4. Jaundice appears early, within 24 hours of birth.
5. Jaundice spreads to the hands and feet.
6. Jaundice lasts more than 15 days.

Physiological jaundice occurs in most newborns, usually appearing from day 2 after birth. Children are good, eat well, sleep well: Urine and yellow stool, every day they go from 2 to 3 times. By day 10-15, the skin will run out of gold without treatment.

Physiological jaundice does not affect a child's life and is not dangerous. Children with physiological jaundice are due to being in the womb, their bodies have high levels of red blood cells (about 5-6 million red cells / mm3). About 2 days after birth, when the child is able to breathe well, the excessive amount of red blood cells that rupture increases bilirubin in the blood. This bilirubin is transferred to the liver, metabolized there and then excreted through the excreted route, the young skin will go out of gold. In addition to rupture of red blood cells, newborn babies with jaundice may also have high levels of beta carotene in their breast milk (vitamin A prefix) because the mother's daily diet has too many colored vegetables or fruits. like carrots, papaya.

Pathological jaundice accounts for about 25-30%. The phenomenon of free bilirubin in the blood is too high. Your baby's skin can become yellow from the first day of birth. The areas of yellow skin spread very quickly, starting from the face, to the chest, abdomen and then spreading down to the hands and legs. The accompanying symptoms such as a baby sleep thinly, a little feeding, a high fever. Clear urine, defecate once a day. The main cause of jaundice is mother and child disagreeing with APO or Rh blood group, hypoglycemia, polycythemia, hemorrhage .

Jaundice - an incurable disease

According to Dr. Lien, children with jaundice often get worse in cases of premature, preterm, and low birth weight babies. Children with jaundice, if not detected and treated early, bilirubin quickly runs to the brain, causing brain damage leading to yellowing of the skin. Yellow skin spreads to the palms and feet. The initial symptom of jaundice is systemic stiffness, twisting, convulsions, hepatomegaly. Dr. Lien added that, at present, human skin is still one of the most difficult to cure diseases. Children are more likely to die or suffer from long-term sequelae: vision loss, hearing loss, mental retardation .

Some treatments for jaundice

Babies with jaundice often get lights

Light up:

Indicated for children (weighing more than 2.5 kg) with serum bilirubin concentration on day 1: 40mg / l; day 2: 130mg / 1; Tuesday: 160mg / l.

Using blue light source from compact light bulb, hallogen acts on bilirubin molecules under young skin. These molecules are turned into optical, non-toxic, water-soluble isomers that are easily excreted in the urine. Screening continuously for 3 - 15 days, depending on the extent of the disease. Can light children in incubator, keep the temperature from 30-32oC. The lower the child's weight, the higher the incubator temperature.

Note when lighting : need for children to drink more water, to drink more to replenish water for the body. Or infuse a 10% sugar solution.

Blood exchange:

Indicated for children (weighing more than 2.5 kg) with serum bilirubin concentration on day 1 and day 2: 180mg / l; 3rd day: 200mg / l.

Through the umbilical vein, using a syringe to draw a certain amount of blood then pump it into the body of the same amount of blood. After each exchange of blood, the level of bilirubin should be checked again. If this concentration is still high, it is necessary to change it next time until the level of bilirubin reaches the permitted level.

Blood volume is indicated for term babies from 150 to 160ml / kg / time; Premature babies from 180-190ml / kg / time.