The situation when bilirubin in the blood of newborns exceeds the standard values is not uncommon. Most often, this phenomenon goes away on its own. However, too high rates require additional treatment, as they can lead to significant complications. Therefore, high bilirubin should be taken very carefully.
The concept of bilirubin
Bilirubin is a product resulting from the breakdown of red blood cells. If their cycle of existence has already ended, they turn into toxic hemoglobin, from which the dye is formed.
In medical practice, it is customary to distinguish two types (fractions) of this substance: direct and indirect. Initially, indirect bilirubin is formed. It is slightly soluble and difficult to excrete from the body. Therefore, first bilirubin is converted to direct bilirubin, which enters the liver, then to the gallbladder and is excreted through the intestines.
The human body makes every effort,to get rid of this substance. However, the baby's liver is initially unable to cope with such a load. That is why in the first days of life it is so important to monitor whether the norm of bilirubin in the blood of newborns is observed. The table that compiles the indicator's thresholds is intended to help you do this.
Causes of elevated bilirubin
The situation poses a threat to the he alth of the child when the value obtained during the analysis differs from the norm of bilirubin in newborns by day. The table that compares the two has been developed through a lengthy study. His goal was to identify the causes that cause this phenomenon. The main ones are:
- deviations in the rate of intrauterine development;
- treatment of a pregnant woman with toxic drugs, as well as their use during childbirth;
- refusal to breastfeed;
- too much weight loss in the first days of life.
Children born to a woman with a negative Rh factor are also at risk. They often show an excess when a comparison is made: the result of an analysis for bilirubin is the norm in a newborn (table).
Norma
In a recently born baby, not all organs are working at full capacity. Therefore, the fetal hemoglobin formed during the decay process does not have time to quickly bind to albumin. As a result, there is an increase in the level of bilirubin.
In this case, at first the amount of the substance in the blood increases,then it starts to decline. In a normal situation, around the fourth day of life, children have minimal bilirubin. The norm in a newborn (the table below contains its values) changes significantly with age.
| Age of child | The normal value of the indicator, µmol/L |
| First day | less than 34 |
| 1-2 days | 24-149 |
| 3-5 days | 26-205 |
| 5 days-60 years | 5-21 |
There is another table that summarizes data on the normal level of bilirubin in the distribution of fractions.
| Age of child | Bilirubin value, µmol/l | ||
| General | Linked | Free | |
| Newborns | 23, 09 | 8, 72 | 14, 37 |
| Second day | 54, 22 | 8, 72 | 45, 50 |
| Fourth day | 90, 14 | 7, 87 | 82, 27 |
| Sixth day | 69, 10 | 7, 72 | 63, 28 |
| Ninth day | 53, 02 | 8, 72 | 44, 30 |
| Month | 11, 12 | 2, 57 | 8, 55 |
During the birth of a baby, the threshold value of the content of the substance can reach 51 µmol / l. Subsequently, it gradually increases, and by 3-4day of life reaches its maximum. In term-born children, the level of bilirubin should not exceed 256 µmol/l, in premature babies - 171.
Physiological jaundice
Often there is physiological jaundice in newborns. The norm of bilirubin (the table confirms this) grows in the first days of life, however, the amount of the substance should decrease on its own by the age of half a month.
Doctors identify a number of signs that allow us to talk about the presence of physiological jaundice in a child:
- appears on the second day of life;
- the norm of bilirubin in the blood is slightly exceeded;
- yellowing of the skin is noted on the face and body above the navel.
Despite everything, the child's condition remains absolutely normal, physical activity is preserved. The level of bilirubin must be continuously monitored by a pediatrician so that physiological jaundice does not develop into pathological. Normally, at the age of one week, a decrease in the amount of the substance should begin. At about 3 weeks in children who were born on time, and by a month in premature babies, bilirubin in the body normalizes.
Patological jaundice
Very quickly, physiological jaundice can turn into pathological. Severe forms are accompanied by a significant increase in the level of bilirubin: almost 90 µmol / l every 24 hours. In addition, newborns may initially have a very high value: more than 250 µmol / l.
That is, in a similar situation, the amount of a substance in the bloodsignificantly higher than normal bilirubin in newborns. The monthly table helps to compare these indicators and identify the problem in time. But there are other signs of pathological jaundice:
- yellowing of the surface of the body below the navel;
- orange color of palms and feet;
- dark urine and too light feces.
The disease is usually protracted and proceeds in waves. In addition, the general condition of the child may be disturbed: there is oppression, as well as excessive excitement.
Types and causes of pathological jaundice
There is a wide variety of types of pathological jaundice. They are allocated depending on the reasons for their appearance.
1. Hemolytic is manifested in the conflict of the Rh factor in the baby and mother, as well as genetic diseases.
2. Parenchymal jaundice occurs when the liver is damaged by congenital forms of hepatitis, cytomegaloviruses, and toxins.
3. The conjugation type manifests itself in case of violations of the enzyme system, as well as the binding of bilirubin.
4. Obstructive jaundice occurs when the outflow of bile is disturbed with anomalies of the gallbladder, as well as the hepatic ducts.
Determining the level of bilirubin
A special test is used to assess the level of a coloring agent in the blood. The sample is usually taken on an empty stomach. But such a requirement is rarely made for children, in extreme cases, it is recommended not to feed the baby 4 hours before blood sampling. In newborns, samples are taken from the heel into a special vacuum smalltest tube.
In order to fully analyze the situation, the content of all fractions of bilirubin in the blood is determined. This helps to establish not only the type of jaundice, but also the reasons for its transition to the pathological stage.
After receiving the results of the analysis, they are compared and the norm of bilirubin in newborns. The monthly table contains threshold values. If the amount of dye significantly exceeds them, the situation necessarily requires treatment.
Possible consequences
High concentration in the blood adversely affects the he alth of the baby. In particular, this applies to the situation when the norm of bilirubin in newborns (2 months) is not restored. The table makes it clear that by this age the value should correspond to that of an adult he althy person.
First of all, high bilirubin is dangerous for the brain, as well as the nervous system of the child. The danger is that the coloring matter can accumulate here. Such a situation can lead to severe intoxication of the body and, as a result, the death of brain cells and nerve endings. Subsequently, this can lead to hearing and vision problems, mental disorders, dementia and other problems.
All this leads to the fact that the pediatrician continuously monitors the possible presence of jaundice in the child. At the slightest suspicion, a blood test is done, on the basis of which it becomes clear whether the values \u200b\u200bof the pair "revealed bilirubin - the norm in the newborn" match. Tablewhile helping doctors to draw the right conclusion.
It's important for parents to know that there are several symptoms that a child with jaundice should have when they see a doctor. These include:
- lethargy and drowsiness;
- decreased sucking reflex;
- convulsions, tics, restless behavior;
- enlargement of the spleen and liver;
- lowering blood pressure.
Ways to lower bilirubin levels
It is important to understand that physiological jaundice does not require treatment. It must pass on its own. However, treatment cannot be dispensed with if such an indicator as bilirubin (the norm in a newborn) is significantly exceeded. The table allows not only specialists, but also parents to understand the need for medical intervention.
Start the fight against high bilirubin should be with the help of light exposure. It is carried out in a special cell with the obligatory use of goggles. This method is recognized as the most harmless, but at the same time quite effective and fast. Side effects of this procedure can include diarrhea and skin peeling. If treatment is stopped, the negative effects of it very quickly disappear.
However, you should know that phototherapy is effective only for physiological jaundice. If, over time, the level of the substance is higher than the value in the line"The norm of bilirubin in newborns is 1 month" (the table is presented above), it will no longer be possible to do without drug treatment.
Many do not consider jaundice in newborns a serious enough problem. But it is worth knowing and understanding that this is not true in all cases. Without proper attention and treatment, the problem can have serious consequences.
