Why is the bilirubin level in newborns high?

Newborns have just come into contact with this world and are not used to it yet, so they will have all kinds of discomforts. Newborns are also incompletely developed and are easily attacked by germs. So parents should still pay attention to some things. For example, high bilirubin in newborns is a common phenomenon. What's going on? Let's follow the experts' footsteps and learn about the reasons for high bilirubin in newborns.

High bilirubin in newborns is related to pathological jaundice and symptomatic treatment should be actively carried out.

Jaundice, also known as yellow bile or jaundice in common parlance, is a symptom of yellowing of the skin, mucous membranes, and sclera of the eye caused by increased bilirubin concentration in the human blood.

Neonatal pathological jaundice:

(1) Jaundice appears early, within 24 hours after birth; (2) Severe jaundice, with a golden yellow color or jaundice all over the body, with obvious jaundice on the palms and soles, or serum bilirubin greater than 12-15 mg/dL; (3) Persistent jaundice, with jaundice persisting or even worsening 2-3 weeks after birth, or worsening after being alleviated; (4) Accompanied by anemia or lighter stool color; (5) Patients with abnormal body temperature, poor appetite, vomiting, etc.

Pathological jaundice should be taken seriously because it is often a manifestation of disease and the cause should be sought. In addition, when the concentration of unconjugated bilirubin reaches a certain level, it will pass through the blood-brain barrier to damage brain cells (often called kernicterus), causing death or sequelae such as cerebral palsy and intellectual disability. Therefore, if you suspect your child has pathological jaundice, you should seek medical attention immediately.

1) Hemolytic jaundice: The most common cause of hemolytic jaundice is ABO hemolysis, which is caused by the incompatibility of the blood types of the mother and the fetus. The most common case is when the mother's blood type is 0 and the fetus's blood type is A or B, and the jaundice caused is more severe; other cases include when the mother's blood type is A and the fetus's blood type is B or AB; the mother's blood type is B and the fetus's blood type is A or AB, which are less common and the jaundice caused is milder. As a result, some parents will be very nervous and worry that their children will suffer from ABO hemolytic disease. In fact, one thing we need to point out is that not all newborns with ABO blood type incompatibility will suffer from hemolytic disease. The incidence of ABO incompatibility hemolytic disease in newborns was reported to be 11.9%. Neonatal hemolytic jaundice is characterized by the onset of jaundice within 24 hours after birth and its gradual worsening.

2) Infectious jaundice: Infectious jaundice is jaundice caused by damage to liver cell function due to viral infection or bacterial infection. Viral infections are mostly intrauterine infections, with cytomegalovirus and hepatitis B virus infections being the most common. Other infections including rubella virus, Epstein-Barr virus, toxoplasmosis, etc. are relatively rare. The most common bacterial infection is septicemia jaundice. The characteristic of jaundice is that physiological jaundice persists or persistent jaundice reappears after physiological jaundice disappears.

3) Obstructive jaundice: Obstructive jaundice is mostly caused by congenital bile duct malformations, with congenital biliary atresia being the most common. The characteristic of jaundice is that jaundice appears 1-2 weeks or 3-4 weeks after birth and gradually deepens. At the same time, the color of the stool gradually changes to light yellow or even white clay.

4) Breast milk jaundice: This is a special type of pathological jaundice. In a small number of breastfed newborns, the degree of jaundice exceeds normal physiological jaundice, and the reason is not very clear. The characteristics of jaundice are: after the peak of physiological jaundice, the jaundice continues to worsen, and the bilirubin can reach 10-30 mg/dl. If breastfeeding continues, the jaundice will continue at a high level for a period of time before slowly decreasing. If breastfeeding is stopped for 48 hours, the bilirubin will drop significantly by 50%. If breastfeeding resumes, the bilirubin will rise again.

Regardless of the cause, pathological jaundice can cause "kernicterus" in severe cases, which has a poor prognosis. In addition to causing damage to the nervous system, severe cases can cause death. Therefore, the focus of neonatal pathological jaundice should be on prevention, such as preventing toxoplasmosis and rubella virus infection during pregnancy, especially preventing viral infection in the early pregnancy; preventing the occurrence of sepsis after birth; and vaccinating newborns with hepatitis B vaccine at birth. Parents should closely observe changes in their children's jaundice. If any signs of pathological jaundice are found, they should be sent to the hospital for diagnosis and treatment in time.

It is recommended to check blood bilirubin, liver function, and maternal and infant blood types in order to determine the type of jaundice and actively provide symptomatic treatment. Certain liver diseases, gallbladder diseases, and blood diseases often cause symptoms of jaundice, so differential diagnosis should be performed to confirm the diagnosis.

The above are the reasons why newborns have high bilirubin. Parents should still pay attention to it. The health of children should be taken care of from an early age so that the children can grow stronger. If you experience any of the above symptoms, don't worry too much. Just undergo routine check-ups, receive timely treatment, and pay attention to your doctor's instructions.