What is the number of jaundice in a 15-day-old baby?

First of all, it depends on whether the baby's jaundice needs treatment or not

The value of jaundice is actually to monitor the level of bilirubin, bilirubin has two units, one is mg/dl and the other is umol/L, and their relationship is 1mg/dl = 17.1umol/L.

Therefore, if the baby has measured jaundice, first look at the unit behind the jaundice value, if it is mg/dl, the ordinate will look at the left side of Figure 1, if it is umol/L, the ordinate will look at the right side of Figure 1, and then compare the abscissa of Figure 1 with the age calculated in hours after birth, and see where your baby's jaundice value is.

For example, if a baby is born 24 hours after birth, the jaundice value is 13.6mg/dl, then it is in a high-risk area, and this situation needs to be actively treated, and the cause of jaundice should be looked for; So if it is a baby 60 hours after birth, and the jaundice value measured is 160umol/L, then the baby is in the low area, and there is no need for treatment, and it can be rechecked after 2 days.

If the baby's jaundice value is in a low or medium risk area, phototherapy can be considered, and it is necessary to recheck and observe the changes in jaundice in a short time; If it is in a high- to medium-risk area, phototherapy should be performed. Of course, these knowledge are simple judgments, and the specific treatment measures should also be combined with the baby's gestational age and the rate of progress of jaundice.

The bilirubin level here is the serum bilirubin level, but most of the bilirubin measured by our clinical preliminary test is percutaneous, and the difference between the two is not too big, which can be referenced.

Your baby's jaundice needs to be treated

If baby jaundice needs to be treated, phototherapy is the first choice. The most commonly used is blue light, this color of light is more easily absorbed by bilirubin on the surface of the skin, through the light irradiation can accelerate the oxidation and decomposition of fat-soluble free bilirubin into water-soluble bilirubin, so that the bilirubin deposited in the skin can be excreted as soon as possible.In addition to blue light, white light can also be used.

During phototherapy, the baby is placed naked in the phototherapy box, covered with a black cloth and the perineal area, and irradiated with one-sided or double-sided light. Because phototherapy mainly acts on the superficial tissues of the skin, it is not possible to stop phototherapy simply because jaundice has resolved, but on the basis of a decrease in serum bilirubin concentration, otherwise, jaundice will rebound.

The side effects of phototherapy are relatively few, occasionally diarrhea and rash may occur, but most of them are not serious, and will not affect the continuation of treatment, the side effects of phototherapy are much lower than the damage caused by bilirubin encephalopathy, and they can generally recover on their own after stopping phototherapy, so parents do not need to worry too much.

It is more common in clinical practice that some parents delay treatment because they are worried about the baby's guilt and the side effects of blue light. Figure 2 shows the phototherapy values for babies at different times of life, combined with gestational age and risk factors. For the same time of birth, different gestational age, and different risk factors, the value of phototherapy required for the baby is different.

For example, if the baby is born at the same time after birth, if the gestational age is small and there are risk factors, then the value of phototherapy required by him needs to be reduced.For example, 48 hours after birth, the gestational age is 35-37 weeks, and there are risk factors, bilirubin 11mg/dl will be phototherapy; > 38 weeks, bilirubin 13mg/dl for healthy babies with risk factors or 35-37 weeks, and 15mg/dl of bilirubin for healthy babies ≥ 38 weeks. Risk factors refer to whether the baby has hemolysis due to blood group incompatibility, glucose-6-phosphatase deficiency, etc.

Guidelines for phototherapy interventions for neonatal jaundice

Jaundice requiring exchange transfusion

When the degree of jaundice exceeds a certain range, blue light therapy alone is not sufficient, and exchange transfusion may be required to prevent the onset and exacerbation of bilirubin encephalopathy.

The exchange transfusion values of babies with different risk factors at different times after birth. Similarly, if a baby is born at the same time after birth, if the gestational age is small and there are risk factors, then the value of his need for exchange transfusion needs to be reduced.

Guidelines for the intervention of neonatal jaundice exchange transfusion

For example, 48 hours after birth, the gestational age is 35-37 weeks, and there are risk factors, bilirubin 17mg/dl will be exchanged transfusion; > 38 weeks, bilirubin 19mg/dl for healthy babies with risk factors or 35-37 weeks will need to be exchanged for transfusion, while ≥ healthy babies at 38 weeks, bilirubin 22mg/dl will need to be exchanged.There are certain risks associated with exchange transfusion, such as the risk of infection by blood transfusion.

Therefore, if the baby's jaundice reaches a certain value, the doctor hopes that the parents can understand and treat the blue light as soon as possible.

Otherwise, once it progresses to the point where exchange transfusion is required, not only the risk of the treatment itself, but also the risk of bilirubin encephalopathy and sequelae is greatly increased.