In medicine, the yellowing of a baby's skin within 28 days of birth is called neonatal jaundice. Neonatal jaundice is a very common disease in newborns, with about 85% of full-term infants and most premature infants developing jaundice within the first week after birth. The main symptoms include yellowing of the skin, mucous membranes, and sclera, poor appetite, restlessness, and possible mild fever.
1: How to Determine Neonatal Jaundice
Neonatal jaundice in premature infants is generally classified into physiological jaundice and pathological jaundice. Physiological jaundice refers to when premature infants show normal behavior in all aspects except for jaundice, such as feeding, sleeping, crying, urination, body temperature, etc. Pathological jaundice refers to when premature infants have obvious changes in mental state, such as staring in one direction, screaming, or convulsions. So, how can parents determine neonatal jaundice in premature infants? What should be considered?
Yellowing appears early, with jaundice occurring within 24 hours after birth for full-term infants and 48 hours for premature infants. Jaundice persists, with jaundice still present or even worsening 2-3 weeks after birth, or after a period of improvement. The degree of jaundice is severe, with a golden yellow color or jaundice covering the entire body, and noticeable jaundice or serum bilirubin levels exceeding 12-15 milligrams per liter in the palms and soles. Other symptoms include anemia, lightening of stool color, abnormal body temperature, poor appetite, and vomiting. These are signs of jaundice.
2: Normal Levels of Neonatal Jaundice
In fact, most newborns will develop jaundice, with over 50% of full-term infants and over 80% of premature infants showing yellowing of the skin within 24 hours after birth. Neonatal jaundice is mainly caused by the deposition of bilirubin on the skin surface, causing the skin and sclera to turn yellow.
What are the normal levels of jaundice in premature infants? The normal levels of jaundice in premature infants are different from those in full-term infants. Usually, the normal level of neonatal jaundice in full-term infants is 12.9 milligrams per 100 milliliters of blood, which means that the bilirubin level in 100 milliliters of blood is below 12.9 milligrams. However, the normal level of jaundice in premature infants is 15 milligrams per 100 milliliters of blood, which means that the bilirubin level in 100 milliliters of blood is below 15 milligrams.
When the bilirubin level in a baby exceeds 12.9 mg/dL or the neonatal jaundice index increases by more than 5 mg/dL per day, or the jaundice persists for more than 14 days in full-term infants or 4 weeks in premature infants, or the jaundice recedes and reappears, it indicates unhealthy neonatal jaundice and may be pathological jaundice.
3: How Long Does Neonatal Jaundice Last
Generally, full-term infants develop jaundice within 24 hours after birth, and premature infants develop jaundice within 48 hours. So how long does it take for neonatal jaundice in premature infants to fade?
It depends on the type of jaundice. Jaundice can be classified as pathological jaundice, breast milk jaundice, or physiological jaundice. Pathological jaundice develops quickly and should be observed closely within 24 hours after birth. Physiological jaundice usually fades after about 3 weeks.
Physiological jaundice in premature infants usually appears 2-3 days after birth, with the most significant symptoms on the 4th-6th day. In full-term infants, it usually fades within 7-10 days after birth, while in premature infants, it may take 3-4 weeks to fade. Jaundice first appears on the face and neck, then spreads to the trunk and limbs. It is generally slightly yellow, with mild jaundice in the sclera, but no jaundice in the palms and soles. Apart from jaundice, the overall health of the infant is good, without any other clinical symptoms, and the color of urine and stool is normal.
When parents bring their baby for a check-up and all indicators are within the normal range, the baby can take medication to reduce jaundice. Additionally, other factors that may delay the fading of jaundice should be ruled out, such as weak constitution, low resistance, infections, and digestive disorders.
4: What to Do If Neonatal Jaundice Does Not Fade
Many babies have jaundice when they are born, which is normal and parents don't need to worry. As long as it is not pathological jaundice, it will fade quickly with proper care. However, what should parents do if neonatal jaundice in premature infants does not fade?
If neonatal jaundice in premature infants does not fade, parents should be vigilant and carefully observe their baby. Generally, neonatal jaundice appears within 2-3 days after birth, peaks at 5-7 days, and fades within 10-14 days. In premature infants, it may take 3-4 weeks to fade. However, if the baby is generally in good condition and has a normal appetite, it is recommended for the mother to observe for a few days. If the jaundice does not fade, it may be necessary to have the baby's serum bilirubin tested at the hospital. Additionally, the baby can be given sugar water and exposed to sunlight.
If neonatal jaundice in premature infants does not fade, parents should take appropriate measures based on the degree of jaundice. For mild jaundice, you can increase feeding to promote bilirubin excretion. Sunbathing can also be beneficial (indoors behind a glass window is sufficient, with as much skin exposure as possible while covering the genital area and eyes, and ensuring the temperature is neither too hot nor too cold). If the jaundice is more severe, medication to reduce jaundice can be taken. If the jaundice is very severe, hospital phototherapy may be required. The specific treatment depends on the degree of jaundice, which should be evaluated by a doctor.
5: What to Do If Neonatal Jaundice is High
High levels of jaundice in premature infants refer to bilirubin levels in the blood exceeding normal levels. Usually, hospitals will test the bilirubin levels of premature infants (some hospitals do so immediately after birth, while others may retest within 3-5 days after birth). The normal bilirubin level in full-term infants should not exceed 12.9mg/dL, and in premature infants, it should not exceed 15mg/dL. If the bilirubin level exceeds these ranges, it is considered high jaundice in premature infants. So what can be done if a premature infant has high jaundice? Here are a few methods to try:
1. Drink plain water. The baby should be given 30ml of plain water in the morning and evening. During the day, the baby should also drink an appropriate amount of water to help eliminate jaundice from the body. If the baby is breastfed, it is fine, but if the baby is formula-fed, additional water should be provided.
2. Drink glucose water. When the neonatal jaundice index is high, giving the baby some glucose water can effectively reduce jaundice. Add glucose to water and feed it to the baby.
3. Sunbathe. Expose the baby to sunlight around 10 am when the sun is not too intense. Try to expose as much skin as possible, but avoid exposing the eyes.
