Patient's question:
My child was born at 37 weeks and is now 18 days old. The bilirubin level has reached 20. Will this affect the child?Doctor's answer:
Neonatal jaundice is the occurrence 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. Full-term infants typically recover from jaundice within 14 days, while preterm infants may take up to 3-4 weeks to fully recover. Pathological jaundice, however, 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 2-3 weeks later, and the bilirubin level drops within 1-3 days after stopping breastfeeding. If there is no significant decline after 3 days, breast milk jaundice can be ruled out; ⑤ other factors such as genetic diseases, drug-induced jaundice, etc. If a newborn exhibits any of the following conditions, it should be considered pathological jaundice: early onset of jaundice (appearing within 24 hours after birth); severe jaundice or rapid progression; prolonged duration of jaundice (full-term infants lasting more than 2 weeks, preterm infants lasting more than 4 weeks); reappearance of jaundice after it has subsided. Pathological jaundice caused by any factor or etiology should be treated by identifying and addressing the underlying cause. This is particularly crucial for premature infants within the first week of life and those with severe hypoxia, acidosis, intracranial lesions, or severe infections, who must receive prompt and aggressive treatment to avoid adverse outcomes.