Why are the corners of my baby's eyes yellow?

Newborn babies are most likely to have various problems because their own resistance is very weak. The baby's health is also the most concerned issue for parents. Many diseases will have some obvious symptoms, and we can use these symptoms to easily identify what disease we have. For example, some babies may have yellow color in the corners of their eyes. This symptom is likely due to jaundice. Let's learn more about this disease.

Pathological jaundice should be considered. Please judge it based on clinical manifestations and liver function tests. This situation is mostly physiological jaundice, which can be observed first and generally disappears in about two weeks. If it does not disappear, it is mostly liver and gallbladder abnormalities, which should be diagnosed and treated in time.

Distinguish between physiological jaundice and pathological jaundice in newborns:

1. Physiological jaundice

It is related to the characteristics of bilirubin metabolism in newborns, including relatively more bilirubin production; insufficient ability of hepatocytes to absorb bilirubin; poor ability of plasma albumin to bind bilirubin; defective bilirubin excretion capacity; and increased enterohepatic circulation. Therefore, 60% of full-term infants and 80% of premature infants may develop visible jaundice in the first week after birth.

2. Pathological jaundice

1. Excessive production of bilirubin

Due to excessive destruction of red blood cells and increased enterohepatic circulation, serum unconjugated bilirubin increases. Common causes include: polycythemia, extravascular hemolysis, alloimmune hemolysis, infection, increased enterohepatic circulation, erythrocyte enzyme deficiency, abnormal erythrocyte morphology, hemoglobinopathy, vitamin E deficiency and hypozincemia.

2. Hepatic bilirubin metabolism disorder

Due to the low function of liver cells to absorb and bind bilirubin, the serum unconjugated bilirubin increases. Common causes include: hypoxia and infection, Crigler-Najjar syndrome (congenital uridine diphosphate glucuronyltransferase deficiency), Gilbert syndrome (congenital non-hemolytic unconjugated bilirubinemia), Lucey-Driscoll syndrome (familial transient neonatal jaundice), drugs (such as sulfonamides, salicylates, indomethacin, lanolin, etc.), congenital hypothyroidism, hypopituitarism, trisomy 21 syndrome, etc.

3. Bile excretion disorder

Impairment in the excretion of conjugated bilirubin by hepatocytes or obstruction of the bile duct can lead to hyperconjugated bilirubinemia, but if accompanied by impaired hepatocyte function, unconjugated bilirubin may also increase. Common causes include: neonatal hepatitis, congenital metabolic defects, bile duct obstruction, Dubin-Johnson syndrome (congenital non-hemolytic conjugated bilirubinemia), etc.

treat:

1. Light therapy

It is a simple and effective method to reduce serum unconjugated bilirubin. Unconjugated bilirubin can produce conformational isomers, structural isomers and photooxidation products after exposure to light. Among them, the formation of structural isomers is the most important. It can be quickly excreted from bile and urine without being metabolized by the liver. It is the main reason why phototherapy reduces total serum bilirubin.

The most commonly used method in China is blue light irradiation. Place the newborn baby in a phototherapy box, protect both eyes with black eye masks to avoid damaging the retina, cover the perineum and anus with a diaper, and leave the rest of the body exposed. Use single-sided or double-sided light irradiation for 2 to 48 hours (generally not more than 4 days). Continuous or intermittent irradiation can be used until the bilirubin drops below 7 mg/dL and the treatment can be stopped.

2. Exchange blood therapy

Exchange transfusion can effectively reduce bilirubin, replace sensitized red blood cells and alleviate anemia. However, blood transfusion requires certain conditions and may also produce some adverse reactions, so the indications should be strictly followed and it is generally used when phototherapy fails.

3. Medication

Use drugs to reduce bilirubin production, accelerate bilirubin clearance, or inhibit bilirubin enterohepatic circulation, including supplying albumin, correcting metabolic acidosis, liver enzyme inducers (such as phenobarbital), and intravenous immunoglobulin.

4. Supportive treatment

The main thing is to actively prevent and treat hypoxia, hypercapnia, cold injury, hunger, infection, and hyperosmotic drug infusion, prevent temporary opening of the blood-brain barrier, and prevent the occurrence of bilirubin encephalopathy.