Premature infants with recurrent jaundice
Release time : 03/06/2025 09:30:02
Recurrent jaundice in preterm infants: what to do? Preterm infants, who are prone to jaundice, have experienced a decline after the initial onset of symptoms. However, one concern remains unaddressed—is jaundice in preterm infants likely to recur? Jaundice in newborns is characterized by the accumulation of bilirubin within the body, manifesting as yellowing skin, sclera, and mucous membranes. In full-term neonates, this condition typically appears within 2-3 days postnatally, peaks between 4-5 days, and generally resolves within 2 weeks. In preterm infants, this process can be delayed until 3-4 weeks postnatally.
Pathological jaundice occurs early, usually within 24 hours.
Generally speaking, physiological jaundice does not recur; however, if pathological jaundice is not effectively treated, it may lead to recurrent episodes.
If the jaundice in preterm infants appears early, and then reappears after the physiological jaundice subsides with a deepened color and accompanied by other symptoms, it may be pathological jaundice.
The symptoms are skin yellowing, white eyes, tears and urine sometimes also yellow. If the newborn is tired and weak, does not cry, does not eat milk, it should be taken to the hospital for examination as soon as possible and accept the doctor's advice for further treatment and nursing.
How to Diagnose Jaundice in Premature Infants? How can parents diagnose the type of jaundice and promptly detect signs of jaundice in their babies, ensuring that their baby receives the best possible treatment? Below, we will share some points for parents to pay attention to, allowing accurate judgment. 1. **Observe the Baby's Skin**: - If the baby's skin appears yellow or yellow green, it may indicate jaundice. 2. **Observe the Baby's Urine Color**: - The color of the baby's urine may deepen, also a sign of jaundice. 3. **Pay Attention to the Baby's Mental State**: - Jaundice can cause the baby to appear lethargic and tired. 4. **Examine the Baby's Eyes**: - Jaundice can lead to the baby's eyes appearing white or yellow. 5. **Measure the Baby's Body Temperature**: - Jaundice can cause the baby's body temperature to be slightly higher. 6. **Monitor the Baby's Diet and Bowel Function**: - Constipation or diarrhea could also be a reason for jaundice. 7. **Seek Medical Attention Promptly**: - If you suspect your baby has jaundice, take them to the hospital for an examination immediately to determine the type and severity of the jaundice, and to initiate appropriate treatment measures. In summary, for premature infants with jaundice, parents should closely monitor their baby's health status and promptly address any abnormalities.
1. The Onset of Jaundice: Physiological jaundice usually appears around day 3 postnatally, though some may show slight skin yellowing as early as the second day after birth or even delay until day 5.
Its progression gradually worsens and is usually most pronounced on the 2nd to 3rd day following the appearance of jaundice.
Pseudo-hyperbilirubinemia: The jaundice appears early, often within 24 hours after birth.
If a newborn shows jaundice shortly after birth, the first place it appears is the sclera and face. This indicates a potentially dangerous signal.
2. The degree of jaundice: physiological jaundice is mainly determined by the measurement of serum bilirubin.
Physiological jaundice, the maximum value should not exceed 12 mg% in full-term neonates and 15 mg% in premature neonates.
The sequence of jaundice appearance is first in the sclera, face, and neck, followed by its spread to the trunk and limbs.
Pathological jaundice: The jaundice progresses rapidly, gradually spreading from the face to the trunk and limbs. If the palms and soles of a newborn are all yellowish, it suggests that their serum bilirubin value exceeds 12mg%.
3. Time for the regression of jaundice: In physiological jaundice, neonates born at term generally experience a regression of jaundice within 7 to 10 days after birth, with the earliest not exceeding 2 weeks and those born prematurely potentially delayed until 3 to 4 weeks post-birth.
Permanent jaundice: exceeding 2 weeks, premature infants over 3 weeks.
If the baby's jaundice persists for two weeks after birth, regardless of the serum bilirubin level, it is an abnormal situation. The parents are advised to take the baby to the hospital for necessary examinations so as to find out the cause of the jaundice.
4. Other Details: Physiological Jaundice, in newborns, aside from jaundice, other aspects such as feeding, sleep, crying, bowel movements, and body temperature are normal.
Pathological Jaundice: The newborn's mental state is noticeably poor, sometimes exhibiting symptoms such as fixated gaze in one direction, screaming or convulsions.
Normal value for neonatal jaundice in preterm infants: Neonatal jaundice is caused by the accumulation of bilirubin in the body, leading to skin or other organ discoloration. It is the most common clinical problem during the period of preterm birth.
In premature infants, jaundice can be observed with a bilirubin level above 5 to 7 mg/dl (more than 2 mg/dl in adults).
Generally speaking, jaundice appears in full-term infants within 2 to 3 days after birth, peaks around Day 4 to 5, and usually resolves within 2 weeks. In premature infants, this can last up to 3 to 4 weeks.
Pathological jaundice occurs early, usually within 24 hours.
In medicine, jaundice in infants under one month old is referred to as neonatal jaundice. The main symptoms include jaundice of the skin, mucous membranes, and sclera, poor appetite, restlessness, and possible increase in body temperature.
Neonatal jaundice is a common disease in newborns. Clinically, 60% of full-term infants show jaundice within one week after birth and 80% of preterm infants show jaundice within 24 hours after birth.
Premature infant jaundice, primarily due to the immature liver function and abnormal bilirubin metabolism in premature infants leading to elevated levels of bilirubin in their blood, can be categorized into physiological jaundice and pathological jaundice.
How long does premature infant jaundice typically resolve? Many newborns experience premature infant jaundice, which is quite normal for parents to be concerned about. As long as it's not pathological jaundice, the condition will quickly subside.
Parents, all you need to do is take good care of them.
So, how long does neonatal jaundice typically resolve? If it is physiological, there is no need for treatment. However, if it is pathological, the main treatment method is to expose the baby to blue light therapy. Therefore, it is necessary to seek medical attention at the pediatric department and undergo treatment after re-testing the bilirubin level to assess the effectiveness of the treatment.
Pathological jaundice, regardless of the cause, can lead to kernicterus when severe, with a poor prognosis. Apart from causing neurological damage, it can also result in death.
Neonatal Physiological Jaundice: Neonates exhibit jaundice starting from the 2nd to 3rd day after birth, peaking on the 4th to 5th day, and naturally subsiding over 7 to 14 days. They generally appear well-nourished with no adverse reactions, referred to as "physiological jaundice." Premature infants may continue to have jaundice until the 14th day of their lifespan. Newborns' Milk-Based Jaundice: The onset of jaundice in newborns occurs between the 4th and 7th days after birth, lasting for about two months. It is primarily characterized by an increase in non-conjugated bilirubin without clinical symptoms.
Neonatal pathological jaundice: The jaundice appears early, occurring within 24 hours of birth.
The jaundice persists for an extended period, with the jaundice remaining persistent after 2 to 3 weeks postnatally, deepening or even resolving and then deepening.
The severity of jaundice is severe, presenting as yellow or jaundice throughout the body, with noticeable jaundice in the palms and soles, or serum bilirubin greater than 12-15 mg/dL.
Presenting with anemia or a decrease in stool color.
Individuals exhibiting abnormal body temperature, poor appetite, and vomiting.
What should be done for premature neonates with jaundice? What should be done for premature neonates with high jaundice? The jaundice in premature neonates is generally more pronounced than that in full-term infants and tends to appear earlier, last longer, and have a higher index of jaundice. It also takes longer to resolve.
If jaundice appears early, if it is severe, and if it does not subside or if the jaundice recurs after it has subsided, one should seek medical attention immediately.
Traditionally, prematurity with hyperbilirubinemia refers to serum bilirubin levels exceeding the current physiological criteria for jaundice (>15 mg/dL) and is considered pathological. In previous clinical practices, it was often believed that pathological jaundice always involved hyperbilirubinemia or vice versa. This perspective is not entirely accurate.
In some preterm infants with nonhemolytic jaundice, such as: asphyxia, hypoxia, infection, hypercapnia and hypoproteinemia.
The bilirubin levels of these preterm infants are not yet at the level considered pathological in traditional terms, and there is also a possibility of developing jaundice encephalopathy.
Therefore, pathological jaundice in preterm infants is not necessarily characterized by hyperbilirubinemia exceeding the physiological jaundice standards.
Hyperbilirubinemia exceeding the physiological range should be considered pathological, as it usually indicates jaundice of a non-physiological nature.
In fact, premature infants and normal children are not much different.
The critical thing is to ascertain the cause of the child's yellowing.
In cases where necessary, various treatment methods such as medication and phototherapy can be adopted to manage premature infant jaundice.
The medical information provided in this text is for reference only.
In case of discomfort, it is recommended to seek medical attention immediately for a professional diagnosis and treatment.