Bilirubin is a yellow-brown bile pigment that is formed by the destruction of hemoglobin and other blood proteins and is contained in the plasma. The norm of bilirubin in the blood of an adult and a newborn varies. In adults and children older than 1 month, its content varies between 8.5 and 20.5 μmol / l. In newborns, the level of bilirubin can be increased to 205 μmol / l or more.
Such high rates of bilirubin in newborns are understandable. While the child is in the womb, he does not breathe on his own. Oxygen enters its tissues with the help of erythrocytes containing fetal hemoglobin (fetal hemoglobin). After birth, this hemoglobin is destroyed, since it is no longer needed. As a result, a new bilirubin can be observed in the newborn. This is indirect (free) bilirubin, which is insoluble, can not be excreted by the kidneys and will circulate in the baby's blood until its enzyme systems fully ripen. After a while, when these systems in newborns can actively work, indirect bilirubin will be turned into a direct and removed from the body.
Jaundice of newborns
Increased bilirubin above the norm causes the appearance of jaundice in newborns, which can be:
- physiological;
- pathological.
Physiological jaundice
It happens in about 70% of all babies, appears on 3-4 days and eventually disappears without a trace without harm to the body. The level of increase in bilirubin in the blood of newborns depends on the degree of maturity of the fetus, as well as on how the pregnancy with the mother: whether there were any diseases or other problems. Often the occurrence of jaundice provokes intrauterine fetal hypoxia, asphyxia, diabetes maternal diabetes.
Pathological icterus
With a significant increase in bilirubin in the blood in newborns develops pathological jaundice, the causes of which can be:
- incompatibility of mother and child by blood groups or Rh factor;
- genetically determined destruction of erythrocytes;
- infectious liver lesions;
- mechanical jaundice;
- intestinal obstruction;
- Gilbert's syndrome (constitutional hepatic dysfunction);
- hormonal disorders, etc.
As we see, there are a lot of reasons, and only a specialist can understand them.
An important method of diagnosis is the study of blood analysis in newborns for bilirubin and its fractions. Based on this and other tests and examinations, the doctor will diagnose and prescribe the necessary treatment.
The danger of a very high level of bilirubin in a newborn is that it can not be completely blocked by blood albumin and enters the nervous system, exposing it to toxic effects. This is dangerous for the brain and vital nerve centers. This condition is called "bilirubin (nuclear) encephalopathy" and manifests itself in the first 24 hours after birth in the form of the following symptoms:
- severe drowsiness;
- lowering the sucking reflex;
- convulsions and motor anxiety;
- lowering of blood pressure;
- enlargement of the liver and spleen.
By the age of six months, the child may experience hearing loss, mental retardation, paralysis. Therefore, a high level of bilirubin in newborns always requires serious treatment, and in the future, dispensary observation from a neurologist.
How to reduce bilirubin in a newborn?
With physiological jaundice, the most effective method of reducing high bilirubin is light therapy (phototherapy). Under the influence of indirect light, bilirubin is converted into a nontoxic "lumirubin" and is excreted within 12 hours with feces and urine. But phototherapy can give side effects: skin peeling, loose stools, which pass after cessation of treatment. A good prevention and treatment of physiological jaundice is an early application to the breast and frequent feeding. Colostrum promotes the excretion of meconium (original feces) together with bilirubin.
In pathological jaundice, in addition to phototherapy and frequent feeding with breast milk, treatment is necessary taking into account the cause of the disease. This treatment is carried out in a children's hospital by neonatologists.
Do not forget, the high bilirubin in a newborn is always the subject of close attention and dynamic observation.