What to do if premature infants have high jaundice
Release time : 01/18/2025 18:13:27
What should be done if a premature infant presents with hyperbilirubinemia? The jaundice of preterm infants is generally more pronounced than that of term infants, often occurring earlier and lasting longer. The index of bilirubin is high, and the regression is slow.
If premature infants exhibit early jaundice and the condition is severe, or if jaundice does not subside after a period of recovery, then immediate medical attention should be sought.
Traditionally, preterm infants with hyperbilirubinemia are considered pathological jaundice when serum bilirubin levels exceed the current physiological jaundice standard of 255 μmol/L (15 mg/dl). However, this view is incomplete.
What should be done for preterm infants with high jaundice? In the case of preterm infants with high jaundice, it is essential to first determine the cause of the jaundice. In some populations of preterm infants with non-hemolytic jaundice such as asphyxia, hypoxia, infection, hypercapnia, and hypoproteinemia, we need to take corresponding treatment measures based on specific circumstances. 1. Asphyxia: If the preterm infant has been asphyxiated leading to jaundice, revival treatment is required to restore breathing function and reduce the burden on the liver. 2. Hypoxia: If the preterm infant is due to hypoxia resulting in jaundice, we need to provide sufficient oxygen to improve blood circulation and lessen the burden on the liver. 3. Infection: If the preterm infant has an infection causing jaundice, timely anti-infection treatment is necessary to control the infection and protect the liver. 4. Hypercapnia: If the preterm infant is suffering from hypercapnia, we need to adjust the parameters of the ventilator to lower the carbon dioxide level, reducing the impact on the liver. 5. Hypoproteinemia: If the preterm infant is presenting with hypoproteinemia, we need to supplement proteins to promote liver metabolism and alleviate the burden on the liver. In summary, for preterm infants with high jaundice, we need to take corresponding treatment measures based on the specific cause to alleviate the burden on the liver and promote the recovery of the preterm infant. At the same time, we must also pay attention to the changes in the condition of the preterm infant and adjust the treatment plan in a timely manner.
The bilirubin levels of these preterm infants have not yet reached the pathological level traditionally, and there is also a possibility of developing kernicterus.
Therefore, pathological jaundice in preterm infants does not necessarily involve hyperbilirubinemia that exceeds the physiological threshold for jaundice.
The hyperbilirubinemia that exceeds the physiological standard of jaundice is mostly pathological.
Therefore, for the issue of jaundice in premature infants, there is no significant difference compared to normal children.
What's crucial is to clarify the reason behind the child's yellowing.
Parents should remain calm when dealing with high bilirubin levels in premature infants, and pay attention to keeping the baby warm.
Provide adequate calories to reduce the hepatic recirculation of bilirubin; promptly correct acidosis and hypoglycemia, avoid drugs that cause hemolysis or inhibit hepatic enzyme activities (such as vitamin K, sulfonamides, etc.).
Additionally, it is important to note that if breastfeeding is involved, consideration should be given to lactational jaundice, which primarily arises from the high levels of β-glucuronidase in human milk, which can hydrolyze conjugated bilirubin into unconjugated bilirubin and facilitate active enterohepatic circulation.
You can bring your baby to the hospital for examination, and inquire whether it is necessary to temporarily stop breastfeeding and switch to formula milk. During the period of breastfeeding interruption, it is essential to suck out the breast milk regularly, and once your baby has fully recovered, you can resume breastfeeding.
The high incidence of jaundice in preterm infants often puzzles parents. In fact, the phenomenon of physiological jaundice in premature infants is a unique occurrence. The physiological jaundice in full-term infants begins on the second or third day, when the skin turns light yellow and the sclera (white eyeball) appears mainly blue with a slight yellow hue, with slightly yellow urine but not staining the diapers. It peaks on the fourth to fifth day, while the full-term infant's jaundice fades by the tenth to fourteenth day, with normal liver function and increased serum unconjugated bilirubin levels.
Physiological jaundice in preterm infants tends to occur earlier and at a higher level, persisting for a longer duration. It may delay until 3-4 weeks before subsiding.
Although jaundice is present, the child shows no signs of discomfort; therefore, physiological jaundice in children, as a normal physiological phenomenon, does not require treatment.
However, there may be other causes for the high jaundice in preterm infants: 1. Infectious jaundice: Infectious jaundice occurs due to viral or bacterial infections, primarily damaging liver cells and causing jaundice. It is recommended to examine the child's blood routine.
2. Milk-induced jaundice: Jaundice in newborns who are fed with milk is referred to as milk-induced jaundice. This condition arises from the presence of progesterone in breast milk, which inhibits the activity of glucuronidase in the newborn's liver. As a result, the concentration of bilirubin in the blood cannot be promptly metabolized and excreted, leading to an increase in the bilirubin levels in the blood, resulting in skin and sclera yellowing in the newborn.
High jaundice in preterm infants, precautions: The issue of high jaundice in preterm infants is a matter that parents must pay attention to frequently.
Most preterm infants exhibit physiological jaundice within 2-3 days postnatally, reaching its peak at 4-6 days and naturally subsiding between 10-14 days. However, a minority may persist for 3-4 weeks, with a higher incidence in preterm infants.
Therefore, if the jaundice of preterm infants continues for more than four weeks, it is advisable to have the parents bring their child to see a doctor.
Please observe the newborn under natural light conditions to avoid any influence on judgment due to lighting.
What are the precautions for high jaundice in premature infants? 1. If a premature infant has severe jaundice (occurs within 24 hours of birth, and the serum bilirubin exceeds 255 micromoles/L), which has been treated and improved at the hospital, then the jaundice is gradually alleviated (as can be determined from initial household visits).
If jaundice subsides again and then worsens, accompanied by mental symptoms (which may or may not occur), parents are advised to seek medical attention in a timely manner.
2. Suggest that parents keep a baby diary, which helps the caregivers make judgments and accumulate experience.
3. Please note that excessive jaundice can lead to sequelae in infants.
For example, hyperbilirubinemia can lead to kernicterus, the main sequelae of which are hemiplegia, deafness, dental hypoplasia, and ocular motor disturbances.
What is the treatment for neonatal jaundice in preterm infants? How should newborn jaundice be treated? There are many types of medications available on the market for treating neonatal jaundice. If medication is necessary, parents should choose according to their child's actual needs and should consult with a doctor before administering any medication. It is important to avoid blindly taking medication.
Generally speaking, Western medicine is more effective but with greater side effects, while traditional Chinese medicine has less side effects but slower onset of action.
How to treat jaundice in premature infants? Generally, the common method for treating jaundice in premature infants is phototherapy.
Due to the insufficiently processed bilirubin in babies' bodies, it reaches the skin through the bloodstream. Through phototherapy, it can convert the bilirubin in the body into another substance, allowing the continuously accumulated bilirubin to find an alternative pathway, thereby improving symptoms of jaundice.
At the same time, when parents are taking care of a baby with high jaundice, it is more important to closely observe their daily life. This includes checking the baby's skin color, physical condition, and stool color. Moreover, it is advisable not to keep the house too dark, but rather let natural light shine in, as bright spaces can improve mood.
What should be done if premature infants have recurrent jaundice? What should be done if premature infants have recurrent jaundice? Jaundice is a common physiological phenomenon in newborns, and generally does not require treatment for physiological jaundice, which usually subsides after about half a month.
So if the jaundice of preterm infants repeatedly high, what should be done? Neonatal jaundice is a skin, sclera and mucosal yellowing in newborns due to bilirubin accumulation in the body. Full-term infants appear after 2-3 days, reach the peak after 4-5 days and usually disappear within 2 weeks, but preterm infants can extend it to 3-4 weeks.
Pathogenic jaundice occurs early, usually within 24 hours.
Generally speaking, physiological jaundice in premature infants does not recur; however, persistent pathological jaundice, if left untreated, may lead to recurrence.
If the jaundice of preterm infants appears early, and then reappears after the physiological jaundice has subsided and the color deepens while other symptoms are present, it may be pathological jaundice.
The symptoms include jaundice, yellowing of the whites of the eyes, and sometimes tears and urine are also yellow. If a newborn shows signs of fatigue, lack of crying, or refusal to feed, parents should take the baby to the hospital as soon as possible for further examination and treatment.
If treatment is indeed necessary, irradiating the baby with blue light is an effective method.
The medical information provided in this text is for reference only and should not be used for medical diagnosis or treatment.
In the event of discomfort, it is recommended to seek medical attention immediately. The diagnosis and treatment should be based on a face-to-face medical consultation.