Formed by the destruction of hemoglobin and other proteins in the blood and contained in the plasma, the bile pigment, which has a yellow-brown color, is bilirubin. Its norm in the blood is not the same: in children older than one month of age and adults, the concentration of this pigment is 8.5-20.5 µmol/l, in infants - up to 205 µmol/l and even more.
So increased bilirubin in newborns is quite understandable. The baby cannot breathe on its own while in the womb. Oxygen enters its tissues with the help of red blood cells, which contain fetal hemoglobin. It becomes unnecessary after the baby is born, as a result of which it collapses. Therefore, there is an increased bilirubin in the newborn. It is a free, in other words, indirect pigment, which is insoluble. The kidneys cannot remove it, so it circulates in the blood until the enzyme systems in the body fully mature. When this happens, indirect bilirubin is converted to direct bilirubin and excreted.
Jaundice in infants
Elevated bilirubin in newborns causes jaundice. In most babies, it is physiological, manifests itself approximately 3-4 days after birth, and eventually disappears without a trace, without causing any harm to the body. Often jaundice occurs in cases where there is intrauterine hypoxia of the fetus, diabetes mellitus in the mother. Significantly elevated bilirubin in newborns can provoke the development of pathological jaundice. The reasons for its appearance include the destruction of red blood cells, genetically determined, the incompatibility of the mother and baby according to the Rh factor or blood types, liver damage of an infectious nature, intestinal obstruction, hormonal disorders, constitutional hepatic dysfunction, etc. Find out what exactly caused the occurrence of the pathology, can only a specialist, based on the results of a blood test and other studies.
Bilirubin encephalopathy
If there is a greatly increased bilirubin in newborns, there is a danger of its penetration into the nervous system and exerting toxic effects on it. Such a dangerous condition for the nerve centers and the brain is called bilirubin, or nuclear, encephalopathy. Its symptoms are manifested in a decrease in the sucking reflex in a newborn, a decrease in blood pressure, severe drowsiness, and convulsions. By the age of six months, the baby may experience hearing impairment, paralysis, mental retardation.
Elevated bilirubin: treatment
If your baby has physiological jaundice, phototherapy is the most effective treatment. With the help of light exposure, free bilirubin is converted into non-toxic, which is then excreted in the urine and feces within 12 hours. However, phototherapy can cause side effects such as loose stools and skin peeling. After stopping phototherapy, they disappear. In addition, for faster elimination of physiological jaundice, it is recommended to frequently breastfeed the baby. Due to colostrum, the original feces (meconium) are excreted from the body together with bilirubin. In case of pathological jaundice, in addition to using the above methods of treatment, therapy should also be carried out aimed at eliminating the cause of the disease.
