Baby looking yellow

Introduction Yellowing the baby's face is a clinical manifestation of neonatal jaundice. Physiological jaundice is a gradual increase in serum bilirubin from 17 to 51 mol/L (1 to 3 mg/dl) at birth to 86 mol/L (5 mg/dl) or more after 24 hours of birth. Clinically, jaundice does not occur. Other symptoms disappear within 1 to 2 weeks. Serum bilirubin in physiological jaundice does not exceed 204 mol/L (12 mg/dl), and premature infants do not exceed 255 mol/L (15 mg/dl). However, bilirubin encephalopathy can also occur in serum bilirubin of some premature infants less than 204mol/L (12mg/dl). It should be vigilant against physiological jaundice to prevent misdiagnosis or missed diagnosis of pathological jaundice.

Cause

The cause of yellowing of baby's face:

(1) Medical history:

1, the occurrence of jaundice within 24 hours of the occurrence of common sputum should first consider neonatal hemolysis, followed by CMV and other congenital infections; 2 to 3 days of physiological jaundice is the most common, ABO hemolytic should also be excluded; 4 ~ Seven days were more common with sepsis and breast milk jaundice; 7 days later, jaundice, sepsis, neonatal pneumonia, biliary atresia, and breast milk jaundice were all possible.

2, jaundice develops rapidly: neonatal hemolysis is the fastest, followed by the most sepsis, neonatal hepatitis and biliary atresia develop slowly and lasting.

3, the color of feces and urine: fecal color is very light or gray, urine color is deep, suggesting neonatal hepatitis or biliary atresia.

4, family history: family with faba disease patients should consider whether G6PD deficiency disease; parents with hepatitis should be excluded from hepatitis.

5, pregnancy history, production history (premature rupture of membranes, prolonged labor, suggesting birth-time infection), history of medication used by mother before labor.

(B) clinical symptoms:

1. Physiological jaundice is light yellow and limited to the face and neck, or affects the trunk. The sclera can also be yellow-stained. After 2 to 3 days, the skin color will disappear. On the 5th to 6th, the skin color will return to normal. The severe jaundice will also be the first and the second. It can be used throughout the body, and vomit and cerebrospinal fluid can also be yellow-stained for more than 1 week. Especially for some premature infants, it can last for 4 weeks. The feces are still yellow and there is no bilirubin in the urine.

2, the yellow color is light, the color is darker, but the skin is ruddy, the yellow is red.

3, the jaundice is more common in the trunk, sclera and proximal extremities, but the elbow and knee.

4, the general condition of the newborn is good, no anemia, liver and spleen is not swollen, liver function is normal, no jaundice occurs.

5, physiological jaundice in premature infants is more common than full-term children, can be slightly delayed 1 ~ 2d, jaundice is heavier, and the regression is later, can be extended to 2 to 4 weeks.

an examination

Related inspection

skin color

The baby's face is yellow and the diagnosis is diagnosed:

At 12 weeks of gestational age, bilirubin is present in amniotic fluid. This is unbound bilirubin secreted by the fetal trachea and bronchial tree into the amniotic fluid. The unbound bilirubin produced by the destruction of fetal red blood cells is largely removed through the placenta to the maternal circulation, so the newborn is born without jaundice. After birth, the newborn must handle the hemoglobin metabolite itself - unconjugated bilirubin. However, glucuronyl transferase is matured in 3 to 5 days in term and 5 to 7 days in immature children. In addition to the various characteristics of neonatal bilirubin metabolism already mentioned in the overview, neonatal physiological jaundice occurs.

Differential diagnosis

Symptom identification of baby's face yellowing and confusion:

1, hemolytic jaundice: the most common cause of hemolytic jaundice is ABO hemolysis, it is caused by the blood type of the mother and the fetus, with the mother's blood type is 0, the fetal blood type is A or B most common, and the resulting jaundice is heavier; Others such as the mother's blood type is A, the fetal blood type is B or AB; the mother's blood type is B, the fetal blood type is A or AB is less common, and the resulting jaundice is lighter. As a result, some parents will be very nervous, worried that the child will have ABO hemolysis, in fact, one point to note is that not all ABO system blood type incompatibility will occur in newborns. The incidence of neonatal ABO blood group incompatibility was reported to be 11.9%. Neonatal hemolytic jaundice is characterized by jaundice within 24 hours after birth and gradually worsens.

2, infectious jaundice: Infectious jaundice is caused by viral infection or bacterial infection and other causes of liver cell function damage caused by jaundice. Most of the viral infections are intrauterine infections. The most common infections are cytomegalovirus and hepatitis B virus. Other infections such as rubella virus, EB virus and toxoplasma are rare. Bacterial infection is most common with septic jaundice. Astragalus is characterized by persistent jaundice after physiological jaundice persists or physiological jaundice subsides.

3, obstructive jaundice: obstructive jaundice caused by congenital biliary malformation, congenital biliary atresia is more common, the characteristics of jaundice is 1-2 weeks or 3-4 weeks after birth, jaundice, gradually deepening, while stool The color gradually turns pale yellow, even white clay.

4, breast milk jaundice: This is a special type of pathological jaundice. A small number of breastfed newborns have a higher degree of jaundice than normal physiological jaundice, and the reasons are not yet clear. The characteristics of jaundice are: after the peak of physiological jaundice, jaundice continues to increase, bilirubin can reach 10-30 mg/dl. If you continue to breastfeed, jaundice will continue to decline slowly after a period of high level, such as stopping breastfeeding for 48 hours. The bilirubin has dropped significantly by 50%. If breastfeeding again, bilirubin rises again.

At 12 weeks of gestational age, bilirubin is present in amniotic fluid. This is unbound bilirubin secreted by the fetal trachea and bronchial tree into the amniotic fluid. The unbound bilirubin produced by the destruction of fetal red blood cells is largely removed through the placenta to the maternal circulation, so the newborn is born without jaundice.

After birth, the newborn must handle the hemoglobin metabolite itself - unconjugated bilirubin. However, glucuronyl transferase is matured in 3 to 5 days in term and 5 to 7 days in immature children. In addition to the various characteristics of neonatal bilirubin metabolism already mentioned in the overview, neonatal physiological jaundice occurs.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.