What does the baby's jaundice value mean?

The jaundice value is actually to monitor the bilirubin level. Bilirubin has two units, one is mg/dl and the other is umol/L. Their relationship is 1mg/dl=17.1umol/L.

For example, if a baby who is 24 hours old has a jaundice value of 13.6mg/dl, then the baby is in the high-risk area and needs active treatment, while the cause of the jaundice needs to be found. If a baby who is 60 hours old has a jaundice value of 160umol/L, then the baby is in the low-risk area and does not need treatment and can be rechecked after 2 days.

If the baby's jaundice value is in the low-medium risk area, phototherapy can be considered, and the jaundice changes need to be observed within a short period of time; if it is in the high-medium risk area, phototherapy must be performed. Of course, this is a simple judgment, and the specific treatment measures must be combined with the baby's gestational age and the rate of progression of jaundice.

Jaundice in children: Jaundice in babies needs treatment

If baby jaundice needs treatment, phototherapy is the first choice. The most commonly used is blue light, which is more easily absorbed by bilirubin on the surface of the skin. Light exposure can accelerate the oxidation and decomposition of fat-soluble free bilirubin into water-soluble bilirubin, allowing the bilirubin deposited in the skin to be excreted from the body as soon as possible. In addition to blue light, white light can also be used.

During phototherapy, the baby is placed naked in a phototherapy box, with the eyes and perineum covered with a black cloth, and irradiated with a single-sided or double-sided light. Because phototherapy mainly acts on the superficial tissue of the skin, the disappearance of jaundice cannot be used as the basis for stopping phototherapy, but the decrease in serum bilirubin concentration must be used as the basis, otherwise, jaundice will rebound.

The side effects of phototherapy are relatively few. Diarrhea and rash may occur occasionally, but they are not serious and will not affect continued treatment. The side effects of phototherapy are much lower than the damage caused by bilirubin encephalopathy. Children can generally recover on their own after stopping phototherapy, so parents do not need to worry too much.

When the degree of jaundice exceeds a certain range, blue light therapy alone is not enough. In order to prevent the occurrence and aggravation of bilirubin encephalopathy, blood transfusion therapy may be required.

For example, if a baby is 48 hours old and has a gestational age of 35-37 weeks and has risk factors, a transfusion is required if the bilirubin is 17mg/dl; if the baby is >38 weeks old and has risk factors or a healthy baby of 35-37 weeks has a bilirubin of 19mg/dl, a transfusion is required, and if the baby is ≥38 weeks old and has a bilirubin of 22mg/dl, a transfusion is required. Transfusion therapy has certain risks, such as the risk of infection caused by blood transfusion.

Therefore, if the baby's jaundice reaches a certain level, the doctor hopes that parents can understand and start blue light treatment as soon as possible.

Otherwise, once the disease develops to the point where blood transfusion therapy is required, not only the risk of the treatment itself, but also the risk of bilirubin encephalopathy and sequelae will be greatly increased.