Patient's question:
The baby is 32 days old. Yesterday, the indirect bilirubin was 199.4 at the hospital check-up, and the direct bilirubin was 9.3. What should be done?Doctor's answer:
Hello: Your baby is now 32 days old. Whether they are a full-term or premature infant, jaundice should have subsided by now. However, your baby's total bilirubin level is still 208.7, which falls under pathological jaundice and requires treatment.Newborn jaundice can be divided into physiological and pathological types:
1. Physiological Jaundice
Due to the metabolic characteristics of bilirubin in newborns, approximately 50%-60% of full-term infants and 80% of premature infants develop physiological jaundice. Its characteristics are:
① Generally, the baby is in good condition.
② In full-term infants, jaundice typically appears 2-3 days after birth but should not persist beyond 2 weeks. In premature infants, jaundice usually appears 3-5 days after birth and can last up to 3-4 weeks.
③ Daily serum bilirubin levels increase by less than 85 μmol/L.
2. Pathological Jaundice
① Jaundice appears within 24 hours after birth.
② Serum bilirubin levels:
- Full-term infants > 221 μmol/L
- Premature infants > 257 μmol/L
- Or daily increase > 85 mg/L
③ Duration of jaundice:
- Full-term infants > 2 weeks
- Premature infants > 4 weeks
④ Jaundice reappears after subsiding.
⑤ Serum conjugated bilirubin > 34 μmol/L.
If any of the above conditions are met, it can be diagnosed as pathological jaundice.
If bilirubin levels are too high, it can lead to bilirubin encephalopathy, causing neurological symptoms. This may result in long-term consequences such as athetosis, hearing loss, intellectual disability, and eye movement disorders. Therefore, pathological jaundice must be treated promptly.
With timely treatment, the prognosis for pathological jaundice is generally good. Common treatment methods include:
1. Blue light therapy, which has minimal side effects and is effective.
2. Infusion of albumin or plasma, which can reduce bilirubin levels.
3. Use of liver enzyme inducers, such as phenobarbital tablets.
4. Oral administration of Yinzhihuang oral liquid.
At the same time, it is important to keep the baby warm, feed them promptly, and provide plenty of boiled water.
Wishing your baby a healthy growth!