It is no coincidence that, unlike many adults, increased bilirubin is considered a frequent occurrence in newborns. This is often due to the destruction of typical fetal hemoglobin, which in its structure is always slightly different from the hemoglobin formed after birth. Since fruit hemoglobin is always actively destroyed, this provokes an increase in the level of bilirubin. Often, even the most physiological jaundice goes away with time without any treatment. But in some serious cases, phototherapy is indicated.
It must be said that bilirubin is a special bile pigment of an unusual yellow-brown color. It is always formed during the destruction of proteins and hemoglobin in the blood. In addition, it is found in plasma. The norms of the level of bilirubin in a newborn and an adult differ significantly. As a rule, in most children older than one or one and a half months, and in many adults, the content of bilirubin usually varies from 8,5 to 20,5 µmol / l. But in many newborns, it can reach 205 µmol / l, and in some cases even more.
No need to be scared, because such high rates in newborns are always understandable. While in the womb of its mother, the child does not breathe on its own. However, oxygen enters all of its tissues through red blood cells, which contain fetal hemoglobin. It is this fetal hemoglobin that immediately after birth begins to break down, the baby no longer needs it. This is why the baby’s skin begins to take on a darker hue.
This free indirect bilirubin is insoluble and cannot be excreted by the kidneys. It circulates in the newborn’s blood for a certain amount of time until the child’s enzyme systems are fully mature. As soon as these unique systems begin to work actively, free bilirubin easily turns into direct bilirubin and is quickly excreted from the child’s body.
Jaundice in newborns
An increase in this pigment significantly above the norm in newborns makes it possible to diagnose jaundice. Jaundice can be physiological or pathological. Normal physiological jaundice occurs in the vast majority of newly born babies. It appears on about 3 or 4 days, and then disappears without a trace.
Such jaundice does not harm a small body. The specific level of increase in bilirubin depends primarily directly on the maturity of the fetus itself. Also, jaundice is affected by the very course of pregnancy in the mother. Various problems and diseases of the mother can provoke an increase in the pigment in the blood of the child after birth. The main factor can be noted the diabetes of the expectant mother. In other cases, the occurrence of such jaundice is due to intrauterine hypoxia or fetal asphyxia.
Pathological jaundice is characterized by a significant increase in bilirubin in the blood of a baby. The causes of this condition are infectious lesions of the liver, severe intestinal obstruction, genetically determined severe destruction of red blood cells, incompatibility of the mother and the newborn by the Rh factor or blood type, mechanical jaundice, hormonal disorders, as well as constitutional hepatic dysfunction, in other words, the dangerous Gilbert’s syndrome.
There are many reasons and only a highly qualified doctor can make a correct diagnosis. One of the initial diagnostic methods is considered to be a complete study of a child’s blood test for bilirubin and its various fractions. After determining such indicators, other tests and examinations are prescribed, after which the doctor makes a final diagnosis and prescribes the necessary treatment.
How dangerous is an increase in bilirubin in newborns?
The main danger of increased bilirubin in newborns is toxic effects. This pigment cannot be completely blocked by typical blood albumin, which is why it enters the nervous system. This condition is extremely dangerous for all vital nerve centers and, of course, for the brain of a child. This dangerous bilirubin encephalopathy usually manifests itself on the first day after the birth of the baby.
The disease is manifested by such a decrease in the sucking reflex, severe drowsiness of the newborn, a significant decrease in blood pressure, motor restlessness and convulsions, as well as a significant increase in the liver and spleen. In some cases, in the absence of the necessary treatment, by the age of 6 months, the baby’s hearing is impaired, mental development slows down, and paralysis is possible. That is why high bilirubin in a newborn is a reason for serious treatment and further observation by a neurologist.
With physiological jaundice, phototherapy, in other words, phototherapy, is always considered the simplest and at the same time effective method of reducing a high level of bilirubin. It is under the influence of light that typical indirect bilirubin is instantly converted into non-toxic simple lumirubin, and then, within about 12 hours, it is excreted from the body with feces and always with urine. Side effects of this treatment may include loose stools and noticeable flaking of the skin, but they pass quickly.
In any case, the treatment of such a disease always takes place in a hospital under the strict supervision of pediatricians for a dynamic improvement in the condition of the newborn.