Which department should a newborn with jaundice go to?

Written by Yao Li Qin
Pediatrics
Updated on December 14, 2024
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If a newborn has jaundice, it is first necessary to distinguish whether it is physiological jaundice or pathological jaundice. For physiological jaundice, it is self-healing, so there is no need to visit a hospital.

As for pathological jaundice, it occurs within 24 hours after birth, or the daily increase in jaundice is particularly large, exceeding the normal range. In such cases, the child should be taken to the hospital for timely medical treatment. Generally, for general hospitals, it is appropriate to visit the pediatric department. If it is a children's hospital or a municipal maternal and child health hospital, then the child should be taken to the neonatology department. Neonatologists will actively treat the child's jaundice and, as a rule, pathological jaundice requires hospitalization.

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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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Symptoms of higher neonatal jaundice

Neonatal jaundice is one of the common symptoms during the neonatal period, with about 80% of full-term infants visibly exhibiting jaundice. Jaundice may occur as part of the normal developmental process or as a manifestation of certain diseases. It is categorized into physiological jaundice and pathological jaundice. High levels of jaundice may indicate pathological jaundice. Generally, if the baby's skin and mucous membranes are obviously yellow, and the jaundice has spread to the limbs or even beyond the palms and soles, which are also notably yellow, it is a sign that the jaundice is severe. Parents can typically observe a clear yellowing of the sclera, the white part of the eyes. The baby may also show other signs of discomfort, such as significant crying and restlessness, pronounced vomiting or increased regurgitation, or even symptoms like abdominal bloating, diarrhea, reluctance to feed, prolonged feeding times, lethargy, or potentially even fever and other discomforts.

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Neonatology
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How does neonatal jaundice resolve quickly?

Neonatal jaundice is one of the common symptoms during the newborn period. It can be divided into physiological and pathological jaundice. Physiological jaundice typically appears in full-term infants two to three days after birth and peaks around the fourth to fifth day. It usually subsides around ten days and generally doesn't last more than two weeks. Physiological neonatal jaundice typically doesn't require intervention. If it is pathological jaundice, where the jaundice progresses quickly and is severe, it is important to consider whether hospital treatment is necessary. The quickest and most effective treatment for severe jaundice is phototherapy with blue light to reduce the bilirubin levels. Additionally, if there are pathological causes, such as infection or hemolysis, treatment should target these underlying causes. Even though phototherapy can reduce bilirubin levels, jaundice may rebound if the underlying issues are not promptly controlled. Therefore, treatment of pathological jaundice should focus on addressing the causes and symptomatic phototherapy.

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Newborn jaundice should visit which department?

Which department to visit for neonatal jaundice depends on the child's specific situation and the departments available in the hospital. For hospitals with only a general pediatrics department, it is advisable to visit the pediatric outpatient clinic during normal working hours and the pediatric emergency department during non-working hours such as noon, evenings, weekends, and holidays. In specialized children's hospitals, if the jaundice is in a preterm infant, then the preterm infant clinic should be visited. If it is a normal full-term infant, a visit to the neonatology outpatient clinic is generally sufficient. However, if there is a suspicion that the baby's jaundice might be caused by surgical factors, such as congenital biliary atresia or choledochal cyst, then a visit to the hepatobiliary surgery clinic is advised.

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Why does neonatal jaundice recur?

Neonatal jaundice is one of the most common conditions in newborns, especially in early-born infants. If a baby has jaundice, it is important to determine whether it is physiological or pathological jaundice. If it is physiological, the jaundice will not appear too early or be too severe, and will gradually subside on its own within a certain period, typically without recurrence. If the jaundice decreases or has already subsided and then reoccurs, be vigilant for pathological jaundice. The causes of pathological jaundice are numerous and depend on the increase in bilirubin. If direct bilirubin is elevated, liver and biliary diseases should be suspected. If indirect bilirubin is elevated, it may indicate pathological factors causing destruction of red blood cells, leading to an increase in jaundice. Therefore, if there is recurring jaundice, it is advisable to seek timely medical attention at the hospital.