What is considered high for neonatal jaundice?

Written by Li Jiao Yan
Neonatology
Updated on January 02, 2025
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Neonatal jaundice is common during the neonatal period and can be divided into physiological jaundice and pathological jaundice. Physiological jaundice does not require intervention or treatment, and the baby's condition is generally okay. For physiological jaundice, the bilirubin level typically does not exceed 6 within the first 24 hours after birth, then not exceeding 9 from 24 to 48 hours, not exceeding 12 from 48 to 72 hours, and not exceeding 15 after 72 hours. If the monitored bilirubin levels exceed these ranges, there may be pathological jaundice, indicating abnormally high levels.

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Written by Li Jiao Yan
Neonatology
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Neonatal jaundice symptoms

Neonatal jaundice is most commonly seen in the skin and mucous membranes, and the sclera, or what we refer to as the eyes, presenting with a yellow discoloration of the white part. The most common symptom is yellowing of the skin. There may also be other symptoms such as crying and restlessness, fever, or rapid and irregular breathing. Some babies might sleep longer than usual, have difficulty feeding, or experience issues with bowel movements, such as a significant decrease in stool frequency or a reduction in urine output. These could be accompanying symptoms of neonatal jaundice. Each baby presents differently with jaundice; more accompanying symptoms often indicate a more severe condition. If the jaundice is limited to skin discoloration without other significant symptoms, it may indicate an early stage of the condition. Generally, if the jaundice is pronounced, it is considered pathological jaundice, and it is advisable to go to the hospital. A pediatric specialist can conduct relevant examinations and decide if immediate intervention and treatment are necessary.

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Written by Li Jiao Yan
Neonatology
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What is the normal bilirubin value for newborn jaundice?

Neonatal jaundice is the most common occurrence during the newborn period, and it is routine to monitor jaundice in babies after birth until they are one month old. During the peak period of jaundice, the frequency of testing tends to increase. Normally, we say that jaundice levels should not exceed 6 within 24 hours, 9 within 48 hours, 12 within 72 hours, and ideally not exceed 15 after 72 hours. If the levels are higher than these values, or if the jaundice progresses too quickly, meaning that the rate increases by more than five milligrams per deciliter every twenty-four hours, this might indicate a pathological condition. In such cases, it is advisable to go to the hospital promptly for a specialist neonatologist to conduct a detailed examination of the baby to see if intervention is needed. Generally, if the baby's jaundice level has risen, it is best to monitor jaundice daily whenever possible after two weeks.

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Written by Li Jiao Yan
Neonatology
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Does neonatal jaundice cause fever?

Fever in newborns with simple jaundice is relatively rare. If a newborn has jaundice accompanied by fever, it is important to be vigilant for the possibility of sepsis. Since the symptoms of sepsis in newborns are atypical and non-specific, it is essential to take this seriously. It is recommended that parents promptly take the child to the hospital for examination. A blood culture should be performed to determine if sepsis is present. If the jaundice is excessively high, active phototherapy may be necessary to reduce the bilirubin levels.

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Written by Li Jiao Yan
Neonatology
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What to do if a newborn has high jaundice?

If a newborn baby has high jaundice that exceeds normal values, it is considered pathological jaundice. Pathological jaundice requires timely intervention. It is generally recommended to go to the hospital, where a specialist in neonatology will conduct a thorough examination of the baby. If necessary, hospitalization or medication might be required for treatment. It is advised that parents should not handle high jaundice on their own, as they generally do not know when the newborn is in a pathological state. It is best to have a specialist doctor manage and treat the baby’s jaundice, and the specialist will also guide the treatment of the jaundice.

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Written by Li Jiao Yan
Neonatology
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Neonatal jaundice blue light therapy

Blue light therapy is one of the most common and effective treatments for neonatal jaundice, mainly targeting jaundice due to elevated indirect bilirubin. The principal mechanism of phototherapy involves transforming bilirubin into isomers, turning it from lipid-soluble to water-soluble, which can then be excreted through bile and urine without liver synthesis. Generally, the need for light therapy indicates a severe level of jaundice, but it is important to ascertain the type of bilirubin elevation before starting treatment. If the elevation involves conjugated bilirubin, light therapy will not be effective. Thus, if light therapy is necessary, it should be confirmed that the liver function issue involves elevated indirect bilirubin, in which case the effects of phototherapy are usually positive. The duration of treatment typically depends on the degree of jaundice and whether there are any complicating pathological factors. The method usually involves intermittent light exposure, generally spanning six to twelve hours. If the jaundice is more severe, continuous phototherapy lasting twenty-four to forty-eight hours might be required to reduce the bilirubin levels.