The most common neonatal clinical symptom in our maternity ward and pediatric clinic is "newborn jaundice", but we have found that parents have mixed understanding of neonatal jaundice. Director Zhou Tao of Pediatrics will tell you about this issue. Knowledge about neonatal jaundice.
What is neonatal jaundice?
和 巩膜黄染的临床现象。 Neonatal jaundice is a clinical phenomenon of yellow staining of skin, mucosa and sclera due to bilirubin accumulation in the body during neonatal period . Most newborns, including term and preterm infants, develop jaundice after birth. The incidence of neonatal jaundice is increasing year by year. （即核黄疸），可造成神经系统永久性的损害和功能障碍，甚至会有生命危险。 Most neonates with jaundice have a good prognosis. Children with severe jaundice may develop bilirubin encephalopathy (ie, nuclear jaundice), which may cause permanent damage to the nervous system and dysfunction, and may even be life threatening.
Why pay attention to neonatal jaundice?
Bilirubin encephalopathy is one of the important causes of cerebral palsy. Unlike cerebral palsy caused by other causes, cerebral palsy caused by bilirubin encephalopathy is the most easily preventable brain injury in newborns. 全国及 世界各地胆红素脑病的病例并不少见，即使在美国和其他医疗保健体系健全的国家，急性胆红素脑病仍然是急需处理的临床紧急情况。 In recent years, cases of bilirubin encephalopathy are not uncommon throughout the country and around the world. Even in the United States and other countries with sound health care systems, acute bilirubin encephalopathy is still a clinical emergency that needs urgent treatment. Therefore, to reduce the incidence of severe and very severe hyperbilirubinemia and bilirubin encephalopathy, families and medical staff should pay attention to neonatal jaundice.
How to identify neonatal jaundice?
皮肤、黏膜 和 巩膜 开始逐渐 黄染，一般先出现于面部皮肤，随着黄疸程度加重逐渐扩散至躯干和四肢。 Normal newborn newborns skin rosy, as age increases, skin, mucous membranes and sclera began jaundice, skin usually appears first on the face, with the aggravation of the jaundice gradually spread to the trunk and limbs.
Jaundice characteristics of normal full-term children: preterm children appear 2-3 days after birth, peaked at 4-5 days, 7-10 days subsided, not later than two weeks.
Features of jaundice in preterm children: birth occurs 3-5 days, 5-7 days peaked at 10-15 days subsided, the longest extended to four weeks.
Now no longer with a physiological or pathological judge neonatal jaundice. Adopting the hours of age or age bilirubin curve points, evaluated according to the different hours of age and gestational age and birth risk factors and determining whether there is present normal or whether bilirubin level security, and the need for therapeutic intervention . Bilirubin encephalopathy most severe or very severe jaundice, often exceeds the concentration of bilirubin in the blood 342.2umol / L (20mg). When bilirubin encephalopathy occurs in premature children, not necessarily high concentration of bilirubin in the blood, but most of them have high-risk factors. Hemolytic, head hematoma, skin congestion, asphyxia, hypoxia, acidosis, sepsis, high fever, hypothermia, hypoalbuminemia, hypoglycemia belong to high-risk factors.
Scientific understanding, the right to face
In practice, we encounter a considerable part of the treasure dad Baoma on neonatal jaundice does not establish a correct understanding of the whole body baby jaundice, and transcutaneous jaundice value is also very high, and even some parents also believe that " 10 baby nine yellow ", to feed some sugar water, the sun will be good, and for the medical advice fell on deaf ears, making it possible to delay the timing of treatment, worse, cause irreversible adverse consequences. So, here, I would like to tell all parents: When your baby has jaundice, urged pediatricians to hear suggestions and comments, so that scientific knowledge, careful observation, with the process, try to avoid the baby jaundice and severe cerebral palsy occurred.
Of course, we did not need to talk about "jaundice" pale, for the following reasons:
1, Jaundice is easier to be visually observed.
2, usually 1-2 days of birth, the medical staff will make your baby jaundice test, performed using transcutaneous jaundice meter, simple, fast and painless.
3, check for blood serum total bilirubin, if necessary.
4, the doctor will be based on the specific circumstances of the baby (full term or premature birth? Age? Risk factors? Etc.) to develop appropriate treatment programs, such as medication, light therapy, injections of gamma globulin or albumin, blood transfusion and so on. The key is to observe the early jaundice, and accurately capture the development trend of the disease and timely administration of therapeutic treatment corresponding to avoid and reduce the chance of severe jaundice and bilirubin encephalopathy.
5, parents can be a force to prevent or reduce the baby's jaundice, you have to do is as soon as possible, sufficient to continue to breastfeed your baby! After a series because bilirubin metabolism, and finally excreted with the feces will most baby in the body, thereby reducing the concentration of bilirubin in the body. Therefore, early breastfeeding and regular breastfeeding are very important to prevent and reduce baby's jaundice! Here we must emphasize that neonatal jaundice have a special type of jaundice is called "breast milk jaundice", it is now a component of breast milk of bilirubin in the intestine can not easily be discharged changes related to the occurrence. This kind of jaundice appears later and lasts longer. Generally, you don't need to stop breastfeeding. If the degree of jaundice is severe, you can reduce the number of breast milk, closely observe the changes of jaundice, wait for the jaundice to ease a little, and then gradually return to normal breastfeeding.
1. Pay attention to percutaneous bilirubin monitoring: it is best to use the same instrument at the same time during the test; avoid the sun or strong light before the test to avoid errors.
2. Regarding the problem of sunlight exposure: Although sunlight exposure has a certain effect on reducing jaundice (the spectrum has blue light used by jaundice phototherapy), its strong ultraviolet rays can cause harm to the delicate skin of babies, so parents are advised Use this method with caution, especially in summer, and try to avoid strong light from 10:00 am to 16:00 pm, and do not shine through glass. The irradiation time is shorter, and it can be used a small number of times, and the eyes, perineum and anus should be protected with dark shielding.