How long does it take for premature infant jaundice to subside? What is the normal value?

Jaundice is a common disease in babies, and premature babies are more likely to suffer from jaundice. So how to judge premature baby jaundice? What should I do if premature babies have repeated jaundice? What is the normal value of premature baby jaundice? How long will it take for premature baby jaundice to subside? What should I do if premature babies have high jaundice? The following editor will give you a detailed introduction.

What to do if premature babies have recurrent jaundice

Premature jaundice is the yellowing of the skin, sclera and mucous membranes caused by the accumulation of bilirubin in the body during the neonatal period! It appears 2-3 days after birth in full-term infants, reaches a peak at 4-5 days, and usually disappears within 2 weeks. It can be extended to 3-4 weeks in premature infants; pathological jaundice appears earlier, usually within 24 hours.

Generally speaking, physiological jaundice will not recur, but pathological jaundice may recur if it is not cured. If premature babies have jaundice early, and it reappears and becomes darker in color after the physiological jaundice subsides, accompanied by other symptoms, it may be pathological jaundice. Its symptoms are yellow skin, white eyeballs, tears and urine are sometimes also yellow. If the newborn is mentally tired, cries weakly, and refuses to eat, he should go to the hospital for examination as soon as possible and receive the doctor's advice for further treatment and care.

How to identify jaundice in premature infants

1. When does jaundice appear?

Physiological jaundice: generally appears about 3 days after birth, and in some cases, the skin may turn slightly yellow from the second day after birth, or may be delayed to the fifth day after birth. It gradually worsens and is usually most obvious on the second to third day after the onset of jaundice.

Pathological jaundice: Jaundice appears early, often within 24 hours after birth. If a newborn develops jaundice a few hours after birth, usually the first parts to appear are the sclera and face, then this is a dangerous signal.

2. The degree of jaundice

Physiological jaundice: mainly determined by measuring serum bilirubin. The highest value of physiological jaundice should not exceed 12mg% for full-term newborns and 15mg% for premature infants. The order of jaundice is from the sclera, face, neck, and then spreads to the trunk and limbs.

Pathological jaundice: Jaundice progresses rapidly, gradually spreading from the face to the trunk and limbs. If the palms and soles of the newborn are found to be yellow, it usually indicates that the blood bilirubin level exceeds 12mg%.

3. Time for jaundice to subside

Physiological jaundice: Newborn jaundice usually disappears 7-10 days after birth, and no later than 2 weeks after birth. Jaundice in premature infants may be delayed until 3-4 weeks after birth.

Pathological jaundice: usually lasts for more than 2 weeks, and for premature infants for more than 3 weeks. If a newborn still has jaundice 2 weeks after birth, it indicates an abnormality regardless of the serum bilirubin level. Parents should take the baby to the hospital for necessary examinations to find out the cause of the jaundice.

4. Other details

Physiological jaundice: Except for jaundice, the newborn behaves normally in other aspects, such as feeding, sleeping, crying, urination, defecation, body temperature, etc.

Pathological jaundice: The mental state of the newborn is obviously not very good, and sometimes the baby stares in one direction, screams, or convulses.

Normal values ​​of jaundice in premature infants

Jaundice in premature infants is a yellowing of the skin or other organs caused by the accumulation of bilirubin in the body. It is the most common clinical problem in premature infants. Jaundice can be seen with the naked eye when the bilirubin in the blood of premature infants exceeds 5-7 mg/dl (more than 2 mg/dl in adults). Generally, jaundice appears 2-3 days after birth in full-term infants, reaches a peak at 4-5 days, and usually disappears within 2 weeks. It can be extended to 3-4 weeks in premature infants; pathological jaundice appears earlier, usually within 24 hours.

Medically, jaundice in babies less than one month old (within 28 days of birth) is called premature jaundice. The main symptoms are yellowing of the skin, mucous membranes, and sclera. The baby will have a loss of appetite, become restless, and his body temperature may also rise.

Premature jaundice is a very common disease in newborns. Clinically, 60% of full-term babies will develop jaundice within one week after birth, and 80% of premature babies will develop jaundice within 24 hours after birth. Premature jaundice is mainly caused by the imperfect development of premature liver function, abnormal bilirubin metabolism, and increased bilirubin concentration in the blood. It can be divided into physiological jaundice and pathological jaundice.

How long does it take for premature babies to recover from jaundice?

If it is physiological jaundice, no treatment is needed. If it is pathological jaundice, the main treatment is blue light, so you must go to the hospital's pediatric department for treatment and retest the transcutaneous bilirubin to understand the treatment effect. Regardless of the cause of pathological jaundice, severe cases can cause kernicterus, which has a poor prognosis. In addition to causing damage to the nervous system, severe cases can cause death.

Neonatal physiological jaundice: Neonatal jaundice begins to appear 2-3 days after birth, is most obvious after 4-5 days, and disappears naturally in 7-14 days. The general condition is good and there are no adverse reactions. This is called "physiological jaundice". Jaundice in premature infants can last up to 14 days.

Neonatal breast milk jaundice: Jaundice starts 4-7 days after birth and lasts for about 2 months. It is mainly characterized by increased unconjugated bilirubin and has no clinical symptoms.

Neonatal pathological jaundice: Jaundice appears early, within 24 hours after birth. Jaundice is persistent, and jaundice persists or even deepens 2-3 weeks after birth, or deepens after relief. Severe jaundice, golden yellow or all over the body, with obvious jaundice on the palms and soles, or serum bilirubin greater than 12-15 mg/L. Accompanied by anemia or pale stool color. Abnormal body temperature, poor appetite, vomiting, etc.

What to do if premature babies have high jaundice

Jaundice in premature babies is generally more obvious than that in full-term babies. It usually appears earlier, lasts longer, has a higher jaundice index, and disappears later. If jaundice appears early, is severe, never disappears, or reappears after jaundice disappears, you should seek medical attention immediately.

In traditional concepts, hyperbilirubinemia in premature infants refers to serum bilirubin levels exceeding the current standard of physiological jaundice of 255μmol/L (>15mg/dl), which falls into the category of pathological jaundice. In previous clinical work, it was often believed that pathological jaundice was hyperbilirubinemia, or hyperbilirubinemia was pathological jaundice. This statement is incomplete.

In some premature infants with non-hemolytic jaundice, such as asphyxia, hypoxia, infection, hypercapnia and hypoproteinemia, the bilirubin levels of these premature infants have not yet reached the level of pathological jaundice in the traditional sense, and there is also the possibility of developing bilirubin encephalopathy. Therefore, pathological jaundice in premature infants is not necessarily hyperbilirubinemia that exceeds the standard of physiological jaundice. Hyperbilirubinemia that exceeds the standard of physiological jaundice should mostly be considered pathological.

In fact, there is not much difference between premature babies and normal children. The most important thing is to find out the reason why the child is jaundiced. If necessary, various treatments for premature jaundice such as drug treatment or phototherapy can be adopted.