Patient's question:
My baby has been looking a bit yellowish lately. Then, when I took him to the hospital, the doctor said we needed to measure the bilirubin level. It turned out to be jaundice. I heard that jaundice can be either physiological or pathological. Could you please explain how to distinguish between physiological and pathological jaundice in newborns?Doctor's answer:
Neonatal jaundice refers to the condition during the neonatal period where abnormal bilirubin metabolism leads to elevated bilirubin levels in the blood. The occurrence of jaundice in the skin, mucous membranes, and sclera is the most common clinical issue in newborns. This condition can be divided into two major categories: physiological and pathological. Physiological jaundice is a temporary condition caused solely by the characteristics of bilirubin metabolism. It typically occurs 2-3 days after birth, peaks between 4-6 days, and resolves within 7-10 days. In premature infants, the duration is longer. Apart from mild anorexia, there are no other clinical symptoms. If jaundice occurs within 24 hours after birth, the daily increase in serum bilirubin exceeds 5 mg/dL or 0.5 mg/dL per hour. In full-term infants, it remains elevated for 2 weeks, and in premature infants, for 4 weeks. It may even persist and worsen after repeated episodes or fail to resolve.