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Where does jaundice come from: Why does it affect more than half of all newborns?
Neonatal jaundice is a yellow discoloration of the whites of a newborn's eyes and skin, usually caused by high levels of a substance called bilirubin. Many newborns are affected in the first week of life, with the incidence rate being as high as over 50%. For premature babies, this rate can be as high as 80%. But why are so many newborns affected by this disease? Below we take a closer look at the causes, symptoms, complications, and treatments of jaundice.
Causes of JaundiceThe occurrence of jaundice is mainly due to two factors: first, the destruction of the fetal hemoglobin of the newborn when it is replaced by adult hemoglobin after birth; second, the metabolic pathways of the newborn liver are relatively immature and unable to Excretes bilirubin as quickly as adults. This leads to a buildup of bilirubin in the blood, causing symptoms such as jaundice.
Clinical manifestations"In many cases of jaundice there is no specific underlying physiological disease."
The main symptom of neonatal jaundice is a yellow discoloration of the whites of the eyes and skin. Other accompanying symptoms may include excessive sleepiness and poor feeding. It is usually visible when the bilirubin level in the blood exceeds 34 μmol/L (2 mg/dL), and if the feet are affected, the bilirubin level usually needs to exceed 255 μmol/L (15 mg/dL) .
Complications
If jaundice persists for too long, it will lead to hyperbilirubinemia, which may lead to chronic bilirubin encephalopathy (kernicterus). Timely and accurate treatment can help reduce the risk of kernicterus in newborns before it develops. Babies with kernicterus may have symptoms such as a high fever or seizures.
"Timely management of jaundice can significantly reduce the risk of complications."
Diagnostic methods
Diagnosis is usually made by measuring the level of bilirubin in the blood. For newborns older than 35 weeks and older than one day, a skin tester, also known as a transmissive bilirubinometer, can be used. If potential pathological jaundice occurs, further examination is required to rule out possible causes.
Treatment methods
Treatment of neonatal jaundice depends on the bilirubin level, the age of the infant, and the underlying cause. Common treatments include frequent feedings, phototherapy, or exchange transfusion.
"Phototherapy for neonates is a method of converting bilirubin into a water-soluble form."
Phototherapy and exchange transfusion
When total bilirubin levels exceed 359 μmol/L (21 mg/dL), phototherapy is required. Phototherapy, usually using a specific wavelength of blue light, helps lower the concentration of bilirubin in the blood, and further exchange transfusion is usually indicated for infants with bilirubin levels above 428 μmol/L (25 mg/dL).
Long-term impact and family considerations
Many families worry about the long-term effects of light therapy, including potential risks to their baby's future health. Although current research suggests that the benefits of phototherapy outweigh the risks, each newborn's specific circumstances must be carefully evaluated to make the best medical decision.
Conclusion
As our understanding of neonatal jaundice and its potential impacts continues to improve, this issue continues to warrant attention from healthcare professionals and families. Faced with so many newborns suffering from jaundice, should there be more effective prevention and treatment measures in the future?
