Symptoms of higher neonatal jaundice

Written by Li Jiao Yan
Neonatology
Updated on September 01, 2024
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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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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 Li Jiao Yan
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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Written by Li Jiao Yan
Neonatology
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Can newborns with jaundice drink water?

Neonatal jaundice is one of the common symptoms in newborns, especially in the early stages. It can be categorized into physiological and pathological jaundice. If it is early-stage neonatal jaundice, the general condition of the infant is still good, but the progression of jaundice can be quick with noticeable reduction in urine and stool output, and dry skin may occur, possibly due to insufficient feeding. At this point, it is necessary to strengthen feeding. If the mother's breast milk is clearly insufficient, or the baby hardly gets any milk from breastfeeding, then supplemental feeding is required. Usually, supplemental feeding primarily involves formula feeding, and generally, babies are not given water because both breast milk and formula provide sufficient hydration. Hence, it is generally recommended not to give water to newborns with jaundice; instead, simply increase feeding.

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Written by Li Jiao Yan
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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
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How should a newborn with jaundice be sunbathed?

Neonatal jaundice is one of the most common symptoms in newborns, and it is divided into physiological jaundice and pathological jaundice. In cases of physiological jaundice, the baby is generally in good condition, the onset does not occur very early, and the duration is not very long, generally requiring no special intervention. If the jaundice progresses more quickly, it usually peaks around the fourth or fifth day for normal babies. At this time, if parents are concerned, they can appropriately expose the baby to sunlight. Sunlight has a certain effect on reducing jaundice by irradiating the skin. It is generally required that the skin be exposed directly to the sun without going through glass, ideally when the sunlight is not too strong, the external air temperature is not too low, the wind is not too strong, and the weather is good. Generally, the baby should lie in the sun with skin exposed, and some may choose to lie on their backs, but it is important to protect the eyes from direct sunlight. Another method is to let the baby lie on their stomach to expose their back and buttocks to the sun. The duration of exposure should not be too long. If the skin shows obvious redness, it should be stopped immediately, as strong ultraviolet rays could potentially cause sunburn, which might lead to discomfort for the baby. Therefore, when exposing a newborn with jaundice to sunlight, parents should be careful not to overdo it, and also make sure the baby does not get too cold.