What to do if premature infants have high jaundice
Release time : 06/08/2025 09:30:01
What should be done if the premature infant exhibits high jaundice? The jaundice in premature infants is generally more pronounced than that in full-term infants, typically occurring earlier and lasting longer. The jaundice index is high, and it does not resolve quickly.
If premature infants present with jaundice at an early stage and the condition is severe, or if jaundice does not subside after it has been treated, or if jaundice recurs, they should seek medical attention immediately.
Traditionally, preterm infants with hyperbilirubinemia are considered pathological jaundice if their serum bilirubin levels exceed the current physiological range of 255 μmol/L (>15 mg/dl). However, this viewpoint is not entirely accurate.
In the case of premature neonates experiencing high jaundice, it is important to take appropriate measures to manage this condition. Here are some suggestions: 1. Observation and Assessment: The doctor will closely observe the newborn's physiological indicators such as weight, length, head circumference, and the severity and distribution of jaundice. This helps determine the cause and severity of the jaundice. 2. Feeding and Nutrition Support: Ensure that the newborn receives ample nutrition, including breast milk or formula. A good nutritional status is beneficial for maintaining liver function, thereby reducing the risk of jaundice. 3. Phototherapy: In some cases, the doctor may recommend phototherapy, which involves the use of specific wavelengths of light to expose the newborn's skin and promote the metabolism and excretion of bilirubin. Phototherapy is typically carried out in hospitals by professional medical staff. 4. Medication: For some premature infants, medication may be required to help reduce bilirubin levels. These medications might include hepatoenzyme inducers (such as phenytoin) or other drugs. Please follow the doctor's advice and prescriptions strictly. 5. Monitoring and Follow-Up: During the treatment process, the doctor will regularly monitor the newborn's jaundice level and liver function. Additionally, attention should be paid to any other related symptoms and complications. 6. Prevention and Avoidance of Inducing Factors: It is important to understand and take measures to prevent the high incidence of jaundice in premature infants, such as apnea, hypoxia, infection, etc. This can help reduce the risk of jaundice occurrence. 7. Home Care: Parents need to understand how to provide proper care at home for their premature infant. This includes keeping the skin clean, avoiding excessive wrapping, etc. At the same time, promptly report any abnormal situations to the doctor. In summary, managing premature neonatal jaundice requires comprehensive assessment and treatment. Parents should work closely with the doctor and follow the doctor's advice and guidance for the best care and support for their newborn.
The bilirubin levels of these preterm infants have not yet reached the traditional pathological levels, and there is also a possibility of jaundice encephalopathy.
Therefore, pathological jaundice in preterm infants is not necessarily characterized by hyperbilirubinemia exceeding the physiological range.
Hyperbilirubinemia exceeding the physiological range should be considered pathological.
Therefore, there is no significant difference in the issue of jaundice in preterm infants compared to full-term infants.
It's crucial to clarify the reason for the yellowing of the child's skin.
Parents of premature infants with high jaundice should remain calm and pay attention to keeping the baby warm.
Provide adequate calories to reduce the hepatic reticuloendothelial circulation of bilirubin; promptly correct acidosis and hypoglycemia, to avoid the use of drugs that cause hemolysis or inhibit hepatic enzyme activity (such as vitamin k, sulfonamides, etc.).
Additionally, it is important to note that breastfeeding may result in cholesteric jaundice, primarily due to the high concentration of β-glucuronidase in breast milk, which can hydrolyze conjugated bilirubin to unconjugated bilirubin, thereby facilitating an active enterohepatic circulation.
It is advisable to visit the hospital and ask the doctor whether it is necessary to temporarily stop breastfeeding and switch to formula milk. During this period of breastfeeding suspension, you must ensure that you continue to express breast milk regularly. Once your baby has fully recovered, you can resume breastfeeding.
The high level of jaundice in preterm infants often puzzles parents. In fact, the physiological jaundice in premature babies is a unique phenomenon. The physiological jaundice in full-term infants begins on the 2nd or 3rd day, and at this time, the skin turns light yellow with a blue tint mainly around the white part (the sclera). The urine is slightly yellow but not stained under the nappy. It reaches its peak on the 4th to 5th day and subsides by the 10th to 14th day in full-term babies. During this period, liver function tests are normal, and serum unconjugated bilirubin levels increase.
Physiological jaundice in preterm infants tends to appear earlier and at a higher intensity, persisting for a longer duration. The onset may be delayed until the third or fourth week.
Although jaundice is present, the child does not exhibit any discomfort, making physiological jaundice generally considered a normal physiological phenomenon and therefore not requiring treatment.
However, there may be other reasons for the high jaundice in preterm infants besides these: 1. Infectious Jaundice: Infectious jaundice is caused by viral or bacterial infections that primarily damage the liver cells and lead to jaundice. It is recommended to check the child's complete blood count.
2. Breastmilk jaundice: Jaundice in newborns who are breastfed is known as breastmilk jaundice. This occurs due to 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 metabolized and excreted in a timely manner, leading to an increase in the concentration of bilirubin in the blood. This results in jaundice in the skin and sclera of the newborn.
Premature infant jaundice is a concern that parents need to pay close attention to.
The majority of preterm infants exhibit physiological jaundice within the first 2 to 3 days postnatally, with peak levels occurring between 4 and 6 days. The condition typically resolves naturally within 10 to 14 days, although some may persist for a period of 3 to 4 weeks, particularly among preterm infants.
Therefore, if jaundice in premature infants persists beyond four weeks, it is advisable for parents to take their child to see a doctor.
Pay attention to observing newborns under natural light conditions to avoid any influence on judgment due to lighting.
What are the precautions for premature neonates with jaundice? 1. If the premature infant has severe jaundice (develops within 24 hours after birth and is of a severe degree, serum bilirubin exceeds 255 micromoles per liter), it is gradually reduced after hospital treatment and discharge, as can be determined by initial assessment when they return home.
If jaundice subsides again and there is a recurrence or worsening, accompanied by mental symptoms (which may or may not occur), parents should promptly take their child to the hospital.
2. It is suggested that parents take good care of their baby's diary, which not only helps the caregiver to make judgments, but also accumulates experience for the caregiver.
3. Be aware that high levels of jaundice can lead to long-term sequelae in infants.
For example, hyperbilirubinemia can lead to kernicterus, with the primary sequelae being ataxia, hearing impairment, dental enamel hypoplasia, and ocular motor dysfunction.
How to treat premature infants with high jaundice? What to do with neonatal jaundice and how to treat it? There are many types of drugs on the market to treat neonatal jaundice. If it is necessary to take medicine, parents should choose it according to the actual needs of the child. It is best to use the medicine under the guidance of a doctor and remember to use the medicine blindly.
Generally speaking, western medicine takes effect quickly and has greater side effects, while traditional Chinese medicine has fewer side effects, but takes effect slowly.
How to treat premature infants with high jaundice? Under normal circumstances, for the treatment of high jaundice in premature infants, blue light is now commonly used in medicine.
Because bilirubin in the baby's body that has no time to process reaches the skin through blood circulation. By shining light, the bilirubin in the body can be converted into other substances, allowing the bilirubin that is constantly accumulating in the body to find another outlet, and the symptoms of jaundice can be improved.
At the same time, when taking care of babies with high jaundice, parents need to pay more attention to carefully observe the baby's daily life, including skin color, physical condition, stool color, etc. Moreover, don't be too dark at home, try to let natural light shine down. A bright space can make your mood better.
What should be done if the jaundice of preterm infants recurs? Jaundice is a common physiological phenomenon in newborns, and generally, it does not require treatment. It usually subsides after about half a month.
If the jaundice in premature infants is repeatedly high, what should be done? Neonatal jaundice is a skin, sclera, and mucous membrane yellowing due to the accumulation of bilirubin in the body during the neonatal period. Full-term babies develop it within 2-3 days after birth, reaching its peak 4-5 days later, and usually resolves within 2 weeks. Premature infants may prolong this process to 3-4 weeks.
Pathological jaundice appears early, usually within 24 hours.
Generally speaking, physiological jaundice in premature infants does not recur. However, if pathological jaundice persists without a cure, it may recur.
If the jaundice in premature infants appears at an earlier time, and if it reappears after the physiological jaundice has subsided and is of a deeper color, accompanied by other symptoms, then it may be pathological jaundice.
Symptoms include jaundice, which can also manifest in white eyes, tears, and urine. If a newborn exhibits symptoms such as lethargy, weak crying, or refusal to feed, parents should promptly take the infant to the hospital for examination and receive further treatment and care as recommended by the doctor.
If it is indeed necessary to treat the condition, irradiating the baby with blue light can be an effective treatment method.
*The medical information provided in this text is for reference only.
If you feel unwell, it is recommended to seek medical attention immediately, and the medical diagnosis and treatment will be subject to offline diagnosis.