- Main causes
- 1. Physiological jaundice
- 2. Jaundice in breast milk
- 3. Blood diseases
- 4. Liver diseases
- How phototherapy is done
Hyperbilirubinemia of the newborn or neonatal is a disease that appears in the first few days of the baby's life, being caused by the accumulation of bilirubin in the blood, and turning the skin yellow.
Any child can develop hyperbilirubinemia, the main causes of which are physiological changes in liver function, blood disorders, such as hemolytic anemia, liver diseases, caused by infections or genetic diseases, or even reactions in breastfeeding. Also check out the causes of high bilirubin and jaundice in adults.
Care to reduce the amount of bilirubin in the blood should be started quickly, and treatment with phototherapy is the most used. In some cases, the use of drugs or blood transfusions may be necessary, and are advised by the pediatrician.
Main causes
Jaundice happens when the baby is unable to properly eliminate bilirubin, which is produced by the metabolism of blood, because, before birth, the placenta performed this function. The main causes of newborn hyperbilirubinemia are:
1. Physiological jaundice
It usually happens after 24 to 36 hours of birth, being the most common type of jaundice, as the baby's liver is poorly developed and may present some difficulties in transforming and eliminating bilirubin from the blood through bile. This change usually resolves in a few days, with treatment with phototherapy and exposure to the sun.
- How to treat it: phototherapy with fluorescent light is useful to reduce the amount of bilirubin in the blood. In mild cases, exposure to the sun may be sufficient, but in very severe cases, a blood transfusion or the use of medications, such as phenobarbital, may be necessary to obtain better results. Understand better how the newborn's physiological jaundice is treated.
2. Jaundice in breast milk
This type of increase in bilirubin can happen around 10 days after birth, in some babies who are exclusively breastfeeding, due to the increase in hormones or substances in the blood that increase the resorption of bilirubin in the intestine and hinder its elimination, despite of not yet knowing the exact form.
- How to treat: in cases of more important jaundice, phototherapy can be done to control your blood levels, but breastfeeding should not be interrupted unless directed by a pediatrician. This jaundice disappears naturally around the second or third month of the baby.
3. Blood diseases
Some diseases can cause the baby to accumulate bilirubin, such as autoimmune or genetic changes, and they can be severe and appear in the first hours after birth. Some diseases are spherocytosis, thalassemia or incompatibility with the mother's blood, for example, but the main one is the newborn's hemolytic disease, also known as fetal erythroblastosis.
- How to treat: in addition to phototherapy to control the amount of bilirubin in the blood, treatment is usually done with blood transfusion and, in some cases, medications can be made to control immunity.
4. Liver diseases
The baby may be born with changes in liver function, due to several causes, such as bile duct deformities, cystic fibrosis, congenital rubella, congenital hypothyroidism, infections by viruses or bacteria, or by genetic syndromes, such as Crigler-Najjar syndrome, Gilber and Gaucher disease, for example.
- How to treat: to control blood hyperbilirubinemia, together with phototherapy, treatments are done to improve the disease that caused the increase in bilirubin, such as treating infection with antibiotics, surgery to correct liver malformations or hormone replacement in hypothyroidism, for example.
The treatment to reduce the body's greatly increased bilirubin, especially phototherapy, should be done quickly after detecting the change, as excess bilirubin in the baby's body can cause serious complications, such as brain poisoning known as kernicterus, which causes deafness, seizures, coma and death.
How phototherapy is done
Phototherapy consists of leaving the baby exposed to fluorescent light, usually blue, for a few hours, every day, until the improvement. For the treatment to take effect, the baby's skin must be fully exposed to light, but the eyes must not be exposed, so a special fabric or glasses are covered.
The light penetrates the skin stimulating the destruction and elimination of bilirubin through bile, causing the jaundice and yellowish color to disappear little by little.
Learn more about how it is done and other indications for using phototherapy.
