Why does neonatal jaundice not subside? When will neonatal jaundice subside?

Many newborns are accompanied by jaundice after birth. Generally, jaundice in newborns will disappear naturally after a period of time, but some babies will not disappear after the jaundice symptoms appear. Many people don’t know why newborn jaundice does not disappear. So why does newborn jaundice not disappear? When will newborn jaundice disappear?

1. How long does it take for neonatal jaundice to subside?

Newborns: Resolve within 2 weeks

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 without adverse reactions. This is called "physiological jaundice."

Premature infants: Resolve within 2-4 weeks

Because liver function is more immature, jaundice will appear later, around the 3rd or 4th day, and will last longer, normally lasting 2-4 weeks.

Neonatal breast milk jaundice: lasts about 2 months

Jaundice begins 4-7 days after birth and lasts for about 2 months. It is mainly characterized by elevated unconjugated bilirubin and has no clinical symptoms.

Neonatal pathological jaundice: lasting for more than 2 weeks

Jaundice appears early, within 24 hours after birth. Jaundice is persistent, and jaundice persists or even deepens 2-3 weeks after birth, or it deepens after being relieved. Severe jaundice is golden yellow or spreads all over the body, with obvious jaundice on the palms and soles, or serum bilirubin is greater than 12-15 mg/L. There are cases with anemia or lighter stool color. There are cases with abnormal body temperature, poor appetite, vomiting, etc.

2. Reasons why newborns are prone to jaundice

(1) Physiological jaundice

Neonatal physiological jaundice is a phenomenon unique to the neonatal period. Because the fetus is in the hypoxic environment in the uterus, the red blood cells in the blood are overproduced, and these red blood cells are mostly immature and easily destroyed. After the fetus is born, it causes excessive bilirubin production, which is about twice that of adults.

The immature liver function of newborns limits bilirubin metabolism, which causes jaundice in newborns for a period of time.

(2) Breast milk jaundice

Breast milk contains the hormone pregnanediol, which can inhibit the activity of glucuronyl transferase in the liver of the newborn, causing the bilirubin in the blood to not be metabolized and excreted in time. As a result, the bilirubin concentration in the blood increases, causing yellowing of the newborn's skin and sclera.

(3) Hemolytic jaundice

The most common cause of hemolytic jaundice is ABO hemolysis, which is caused by the incompatibility of blood types between the mother and the fetus. Blood exchange therapy can be performed in the early stages. If the symptoms are mild due to ABO blood type, phototherapy can be used.

(4) Infectious jaundice

Jaundice is caused by damage to liver cell function due to viral infection or bacterial infection. Viral infection is mostly intrauterine infection, with cytomegalovirus and hepatitis B virus infection being the most common. Other infections such as rubella virus, Epstein-Barr virus, and toxoplasmosis are relatively rare. Bacterial infection is most common with septic jaundice. The characteristic is that physiological jaundice persists or persistent jaundice appears after physiological jaundice subsides.

(5) Obstructive jaundice

Obstructive jaundice is mostly caused by congenital bile duct malformations, with congenital biliary atresia being the most common. The characteristic of jaundice is that jaundice appears 1-2 weeks or 3-4 weeks after birth and gradually deepens. At the same time, the color of the stool gradually turns light yellow or even white clay. This type of jaundice can usually be diagnosed by B-ultrasound examination.

3. What to do if neonatal jaundice persists

Physiological jaundice does not require treatment. You can try the following methods to get rid of your baby's jaundice as soon as possible. If it is pathological jaundice, it is recommended to seek medical treatment as soon as possible.

1. Supplement water appropriately

Giving newborns some water will help with the excretion of bilirubin.

2. Get some sun

After exposure to light, bilirubin can produce conformational isomers, structural isomers and photooxidation products. Among them, the formation of structural isomers is the most important. It can be quickly excreted from bile and urine without being metabolized by the liver. It is the main reason why phototherapy reduces total serum bilirubin.

Note! Avoid direct sunlight on the newborn's eyes when sunbathing, and limit the sunbathing time to about 20 minutes.

As a parent, you should pay more attention to your child's situation so that your baby can grow up healthily.

4. How to prevent neonatal jaundice

1. Fetal jaundice is often caused by the pregnant mother being invaded by damp heat, which affects the fetus, resulting in fetal jaundice after birth. Therefore, during pregnancy, the pregnant mother should pay attention to food hygiene, eat and drink in moderation, not eat raw or cold food, not be too hungry or too full, and avoid alcohol and spicy and hot foods to prevent damage to the spleen and stomach.

2. If a woman has a history of hepatitis or has had a baby with pathological jaundice, it is advisable to measure the antibodies in the blood and their dynamic changes before delivery, and take corresponding preventive medication measures. During delivery, the baby should be closely monitored after delivery, and timely treatment should be given if symptoms occur.

3. If the couple's blood types are incompatible (especially if the mother's blood type is O and the father's blood type is A, B or AB), or if the mother's RH blood type is negative, they should undergo regular serological and amniotic fluid tests and deliver the baby under close supervision to prevent the occurrence of neonatal hemolytic disease.

4. After the baby is born, the scleral jaundice should be closely observed to promptly understand the onset and disappearance time of jaundice. If jaundice is found, it should be treated as soon as possible, and the color changes of jaundice should be observed to understand the progress of jaundice.

5. Keep the newborn warm and start feeding early.