Patient's question:
The baby is full-term. On the second day of birth, jaundice was discovered. On the third day, the measurement was 15. On the fourth day, the jaundice level was 17. On the fifth day, the jaundice level reached 21. The baby was immediately hospitalized for treatment, and it was diagnosed as physiological jaundice. Blue light therapy was administered, and albumin was injected. By the tenth day, the jaundice level had decreased to 12. The baby continued to be hospitalized for treatment. However, on the twelfth day, the jaundice level did not decrease but instead rose to 13. Is a jaundice level of 12 high? What is the normal range? Can the baby be treated at home with medication to gradually reduce the jaundice? Why does the jaundice level fluctuate and rise again?Doctor's answer:
Neonatal jaundice is the appearance of yellow discoloration of the skin, sclera, and mucous membranes during the neonatal period, also known as neonatal hyperbilirubinemia. Its etiology is specific and complex, and severe cases can lead to bilirubin encephalopathy (kernicterus), often resulting in death and severe sequelae. Neonatal jaundice is generally divided into two major categories: physiological jaundice and pathological jaundice. Physiological jaundice is a normal physiological phenomenon. Due to the metabolic characteristics of bilirubin in newborns, approximately 60% of full-term infants and over 80% of preterm infants may develop jaundice 3-5 days after birth, but they are generally in good condition. In full-term infants, jaundice typically resolves within 14 days, while in preterm infants, it may persist for up to 3-4 weeks. Pathological jaundice, on the other hand, is abnormal and is generally associated with the following factors: ① bacterial infections and neonatal sepsis, as well as viral infections such as hepatitis A virus, hepatitis B virus, and cytomegalovirus; ② neonatal hemolytic disease; ③ congenital biliary atresia and biliary cysts; ④ breast milk jaundice, which typically appears 4-7 days after birth, peaks within 2-3 weeks, and the bilirubin level can decline within 1-3 days after stopping breastfeeding. If there is no significant decrease in 3 days, breast milk jaundice can be ruled out; ⑤ other factors such as genetic diseases.