Patient's question:
BB was born at 36 weeks and 6 days via normal delivery. Dad has B blood type, Mom has O blood type, and BB has B blood type. On the fourth day, BB had jaundice at 14.4 and was under blue light for 6 hours. From the fifth and sixth days, no follow-up check on jaundice was conducted. BB eats 50 milliliters of breast milk every three hours without vomiting. BB falls asleep for naps after being full, has yellow stools with both watery and pellet-like textures, and has a bowel movement 10 times a day. On the eighth day in the morning, the jaundice level was checked at 17.2. In the afternoon, all milk feeding was vomited out. Before being admitted to the hospital on the eighth day, the jaundice level was rechecked at 31. What could be the reason for the sudden increase in jaundice? Hemolysis tests: Direct test, free test, and release test were all negative.Doctor's answer:
There are many reasons for newborn jaundice, which can be divided into physiological and pathological types. Physiological jaundice typically appears 2-3 days after birth and gradually fades away within 7-10 days. In contrast, pathological jaundice usually appears earlier, often within 24 hours after birth, and takes longer to fade, sometimes lasting for more than a month. Pathological jaundice is more commonly associated with:① Neonatal hemolytic disease. Common causes include glucose-6-phosphate dehydrogenase deficiency, spherocytosis,
② Glucuronyl transferase activity defects, which are transient in premature infants due to enzyme activity abnormalities and congenital enzyme defects in Crigler-Najjar syndrome, as well as metabolic acidosis,
③ Breast milk jaundice, which typically occurs in the first week after birth and may be related to insufficient caloric intake,
④ Delayed passage of meconium.