How to treat neonatal jaundice

Written by Li Jiao Yan
Neonatology
Updated on September 17, 2024
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Neonatal jaundice is the most common phenomenon during the neonatal period and generally falls into two categories: physiological jaundice and pathological jaundice. As the name suggests, physiological jaundice is a normal physiological phenomenon. It typically appears in full-term babies on days 2-3, peaks on days 4-5, and gradually decreases around day 7, and completely subsides within two weeks. This type does not require intervention as the baby is generally in good condition and usually does not need treatment. Jaundice that appears early, progresses quickly, is severe, or lasts a long time is considered pathological jaundice. The diagnosis of pathological jaundice is generally made by a doctor. It is recommended that babies be monitored daily for jaundice within the first two weeks after birth. Based on the bilirubin levels, if it is high, it is advisable to seek a thorough examination from a neonatologist. Pathological jaundice requires timely intervention, especially considering liver function. If there is a significant increase in indirect bilirubin, this type of jaundice can be neurotoxic. Persistent high jaundice might affect the brain, so prompt intervention is necessary. Hospitalization for jaundice treatment will depend on the cause, and treatment will be symptomatic. The cause might be other pathological factors; removing the cause while treating the jaundice is the usual approach. Common treatment for high indirect bilirubin involves phototherapy. If conjugated bilirubin is elevated, the underlying cause might be more complex and treatment more challenging. Therefore, if jaundice is detected and there is uncertainty, it is advised to promptly visit a hospital for intervention by a neonatal specialist and necessary treatment.

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Written by Li Jiao Yan
Neonatology
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neonatal jaundice subsidence time

Neonatal jaundice is a common phenomenon and a unique condition in newborns. If it is normal physiological jaundice, it generally subsides within two weeks for full-term infants born after 37 weeks. This means that after two weeks, the jaundice is essentially gone; the skin and eyes are no longer yellow, and bilirubin levels are typically below 6-7, which is considered normal. For premature infants, the jaundice generally clears within four weeks. If the jaundice persists longer, there might be some pathological factors involved, and it is advisable to visit a hospital for a thorough evaluation by a doctor to determine if any special treatment is needed.

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Written by Li Jiao Yan
Neonatology
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Causes of neonatal jaundice

Neonatal jaundice is generally divided into physiological jaundice and pathological jaundice. Physiological jaundice is usually considered a normal phenomenon, where the baby's jaundice can naturally recede without much impact on the baby. If it is pathological jaundice, it means that the jaundice level is high, indicating a pathological condition. Pathological jaundice can be further divided into several types, the most common being elevated direct bilirubin and elevated indirect bilirubin, each with different causes. Common causes of jaundice include increased indirect bilirubin due to infections, hemolysis, and mother-infant blood type incompatibility, such as ABO incompatibility where the mother is type O and the baby is not, or the mother has HR-negative blood and the baby has HR-positive blood. Other factors include reduced thyroid function, enzyme deficiencies such as G6PD deficiency, various types of bleeding like gastrointestinal bleeding, intracranial bleeding, or asphyxia at birth. Conditions like hypoxia or acidosis in the baby can also lead to increased jaundice. Additionally, liver function damage due to viral infections like hepatitis B, cytomegalovirus, and other infectious diseases such as syphilis, as well as other viruses like rubella virus and herpes virus can elevate jaundice levels. Developmental abnormalities of the biliary tract, commonly biliary atresia or congenital bile duct dilation, can cause elevated conjugated bilirubin levels. The causes of jaundice are complex, and some causes might remain unidentified. However, if the baby's general condition is good and the jaundice is manageable, it generally does not affect the baby. If jaundice levels are high, it is advised to visit a hospital where doctors can conduct relevant tests based on the baby's specific condition to determine if treatment is needed.

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Written by Shi Ji Peng
Pediatrics
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What are the symptoms of neonatal jaundice?

Neonatal jaundice generally appears on the 2nd to 3rd day after birth and can manifest with yellowing of the skin, conjunctiva, and oral mucosa. The degree of jaundice varies, usually more noticeable on the face and chest, but not present on the palms of the hands or soles of the feet. It is most apparent on the 4th to 6th day after birth. The duration of jaundice also varies; in full-term infants, jaundice typically subsides within 10-14 days after birth, whereas in premature infants, it can last until the third or even the fourth week. During this period, infants with physiological jaundice are generally in good condition without any other discomfort and do not require treatment. However, pathological jaundice must be investigated for its cause. Pathological jaundice is primarily characterized by an early onset, severe degree, prolonged duration, or recurrence of jaundice. In such cases, it is classified as pathological jaundice, and it is crucial to actively search for the cause and treat accordingly based on the identified cause.

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Written by Li Jiao Yan
Neonatology
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Newborn jaundice can be divided into several types.

Neonatal jaundice is one of the common symptoms during the neonatal period, especially in early newborns. It can be a symptom of the normal developmental process of newborns, or it can be a manifestation of certain diseases. Neonatal jaundice is relatively common in newborns, with about 80% of full-term infants visibly showing jaundice. Jaundice is classified into physiological jaundice and pathological jaundice. If it is pathological jaundice, there are different classifications. Based on different characteristics of bilirubin elevation, it is divided into high direct bilirubinemia and high indirect bilirubinemia. Physiological jaundice does not require intervention. However, if it is pathological jaundice, it is necessary to clarify its classification and determine which type it belongs to. Generally, if it is pathological jaundice, timely intervention and treatment are needed. If untreated, and if the jaundice level significantly increases, it may lead to serious complications.

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Written by Li Jiao Yan
Neonatology
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Is neonatal jaundice pneumonia serious?

Neonatal jaundice is one of the common symptoms in the newborn period, especially in early newborns. It can be a symptom of the normal developmental process in newborns or a manifestation of certain diseases. If a newborn has jaundice combined with pneumonia, it is possible that the pneumonia is infectious, and infection is also one of the common causes of jaundice. Therefore, if the inflammation is not controlled, it may repeatedly rebound or continue to rise. If the symptoms of pneumonia are not very severe and the baby is generally in good condition with not particularly high infection indicators, general anti-infective treatment for pneumonia along with corresponding treatment to reduce jaundice will generally have no lasting impact on the baby, as long as it is cured. However, if it is a severe case of pneumonia and the situation is not particularly good, and the jaundice remains very high and severe, it might have a slight impact on the baby later on. If bilirubin encephalopathy occurs, the possibility of neurological sequelae may be greater. Generally, ordinary pneumonia combined with jaundice does not have much impact on the baby.