Bilirubin 300 in a newborn: causes of rejection and treatment

After birth for 2-3 days, the skin and sclera of the baby sometimes acquire a yellowish tint. This condition is called the physiological jaundice of the newborn and requires additional medical supervision. Most often, the child leaves the hospital with reduced bilirubin. If this indicator in a newborn is 300 and higher, then urgent treatment in a hospital is necessary.

The concept of bilirubin

Bilirubin is a bile pigment formed during the breakdown of proteins containing heme, in particular hemoglobin, in the body. The latter is found in the blood in red blood cells. After birth, part of the hemoglobin in the blood breaks down and bile pigment forms. In almost all newborns, bilirubin is elevated.

The newborn’s liver removes the end products of hemoglobin processing. With very high pigment indices, the baby’s internal organs cannot cope with the load and medical attention is required.

The child turns yellow as the bile pigment increases. First, the color of the face, neck, and then the whole body changes. This does not bother the baby if the indicators are increased within the age norm. If bilirubin is higher than 300 in a newborn, then there is a risk of brain intoxication and the appearance of serious consequences for the child.

Bilirubin in the blood is general, direct and indirect. The total is the sum of the last two indicators. Direct bile pigment is excreted from the body on its own, it is not dangerous and is easily soluble in water.

The medical staff pays the most attention to indirect bilirubin in the newborn. Its volume in the blood is 2/3 parts, it dissolves only in fats and requires measures to reduce it. In any case, within a month, the indicators should return to normal, and if this did not happen, then we are talking about pathological jaundice.

Norm for a newborn

After giving birth, the level of bile pigment increases. It reaches its greatest value on the third day and then decreases. The best option is to increase the total pigment within 50 μmol / L. A value of 250 μmol / L on day 3 is acceptable, but requires treatment. In premature infants, the increase reaches 170 μmol / L. Bilirubin in a newborn 300 is considered critical and requires urgent hospitalization of the child.

The norms of bilirubin in the blood, depending on age, are as follows:

• 1 day - less than 32 μmol / l;
• 2 days - up to 150 μmol / l;
• 3-5 days - no more than 200 μmol / l;
• 6 days and older - up to 21 μmol / l.

Normally, indirect bile pigment should not exceed the indicators presented in the table.

Why is bilirubin increasing

A condition in children and adults in which there is an increase in the amount of bilirubin is called hyperbilirubinemia. The breakdown of hemoglobin in the blood occurs with the appearance of bile pigment, direct and indirect. The latter must be removed from the body so that it does not accumulate in the tissues. There is albumin in the blood, which traps a toxic substance and delivers it to the liver for further disposal. After treatment with liver and glucuronic acid, indirect bilirubin becomes direct and is easily excreted in the bile and urine.

In a newborn, liver enzymes do not work as in an adult. It takes time for maturation to occur and the body to cope with bilirubin. But until this happens, indicators increase, jaundice increases. The higher the toxic values, the yellower the baby will be. Sometimes palms and feet become yellow.

If the newborn has 300 bilirubin for 5 days, then medical attention is required to exclude brain intoxication. The yellowing of the child after the hospital or the strengthening of the jaundice should alert the mother and become an occasion to contact a pediatrician. Unusual behavior of the newborn, drowsiness and lethargy require urgent hospitalization.

What tests say about jaundice

After the birth of a baby on day 1, blood will be taken from a vein in the maternity hospital for analysis. One indicator will be bile pigment. The laboratory assistant will evaluate the level of direct and indirect bilirubin.

One way to determine the level of bile pigment is blood from the umbilical cord. After 2 days, the analysis is repeated to assess how much the indicator has increased. If the indicator is within the normal range, then most likely it will not critically increase, but will decrease in the future. If bilirubin in a newborn is 300, then an experienced doctor will determine by the appearance of the child that the bile pigment is elevated and send it for analysis.

In many hospitals, a digital bilirubinometer is used to determine the level of total bilirubin. The measurement is done in the area of ​​the forehead or chest, the procedure is absolutely painless for the child and takes a few seconds.

Causes of Jaundice

The physiological jaundice of newborns increases the considered indicator within normal limits and passes on its own within 2-4 weeks. They say about pathology if it drags on for a long time or bilirubin in newborns is increased to 300. The reasons can be different:

• a conflict of Rh factors was found in the mother and child;
• consequences of genetic diseases;
• a woman during pregnancy took drugs that affected the fetus;
• albumin protein deficiency;
• congenital or acquired hepatitis;
• diseases of the liver or gall bladder;
• bowel obstruction.

Of course, bilirubin 300 in a newborn is a lot. If the baby has a bile pigment level of 200, then the reasons may be as follows:

• prematurity of the child;
• difficult birth;
• difficult pregnancy with the threat of termination;
• child hypoxia during pregnancy or childbirth;
• diabetes in the mother;
• child trauma during childbirth.

Untimely treatment of extremely high bilirubin can cause the development of encephalopathy, mental disorders of the child.

The effects of increased bilirubin

In the newborn, bilirubin 300 is considered the lower threshold of extreme value. The consequences of such an increase can be fatal. Measures to reduce it must be taken immediately.

Fat-soluble bilirubin is independently excreted for a long time. With small indicators, there is nothing terrible in this. But at high bilirubin is deposited in the cerebral cortex and leads to nuclear jaundice. Intoxication of the whole organism occurs and there is a risk of developmental abnormalities. In severe cases, death is possible.

Symptoms of nuclear jaundice:

• long incessant crying;
• yellowness of the skin and sclera;
• drowsiness, lethargy;
• the baby does not suckle well;
• the child tenses and stretches the muscles of the neck.

Signs indicating that the child has a physiological jaundice:

• the child is active;
• it sucks well;
• the pigment manifests itself from 2 days and increases by 3-4 days;
• yellowness gradually decreases and disappears within a month;
• no changes in feces and urine.

From the skin, you can determine the degree of yellowness:

1. face and neck are painted;
2. yellowness is visible to the navel;
3. the color of the upper limbs changes;
4. the skin is all yellow.

With bilirubin 300 in a newborn, how much this indicator decreases will depend on the child’s body and the therapy. It may take several days, in some cases 3-6 weeks.

Phototherapy

Phototherapy for bilirubin in a newborn 300 gives good results. The method is based on the use of safe ultraviolet radiation with a wavelength of 400-550 nm. Under the influence of a lamp, indirect pigment is able to be excreted from the body.

The child is placed under a lamp, his eyes and genitals are closed with special glasses. The child only gets to eat. With a pronounced jaundice, the child is kept under the lamp around the clock, it is possible to place the lamp over the mother’s bed and carry out treatment even while feeding. Periodically, the child should be turned on the back and on the stomach so that bilirubin breaks down on all sides.

Breastfeeding positively affects the elimination of toxic substances from the body. It should be noted that with phototherapy, the need for fluid in the baby increases by 10-20% and the number of attachments to the breast may increase. Finish treatment with a decrease in the total level of bilirubin in the blood.

Is bilirubin dangerous in a newborn 300? Reviews of mothers say that it is dangerous, but only in the absence of treatment. When phototherapy is started on time, the prognosis is favorable.

Drug treatment

Drug treatment is prescribed for prolonged jaundice, with identified pathologies in the gastrointestinal tract.

If the disease is caused by bowel obstruction, then surgical intervention is required. With stagnation of bile, choleretic drugs are used that are allowed for newborns. They can use Hofitol, Ursofalk, Ursodez and others. These drugs improve the metabolism in infants and improve appetite.

Additionally, sorbents are used to help bind and remove bilirubin from the intestines. You can use activated carbon, Enterosgel or Polysorb. In addition, the doctor in the hospital prescribes an enema so that harmful substances do not remain in the body.

Folk remedies and preparations that the pediatrician did not prescribe are contraindicated for infants. You can not give choleretic herbal preparations, castor oil and laxatives.

Infusion therapy

With the infusion method of treatment, medications are administered intravenously to the child's body. The therapy is carried out only in a hospital under the supervision of doctors. It is prescribed if it is impossible to fully finish the child during phototherapy, with weight loss, with vomiting, constant spitting up or other conditions in which the child loses fluid.

In women, when they see droppers, the question arises: "Is bilirubin dangerous in a newborn 300?" It is dangerous if pathology is not treated in a timely manner. And if the doctor decided on the appointment of intravenous infusions, then they must be passed.

To reduce intoxication and accelerate the excretion of indirect bilirubin, a glucose solution and sodium chloride are added to the dropper. In some cases, albumin protein may be administered.

How much bilirubin is reduced

Nobody will say for sure how much bilirubin 300 will decrease in a newborn. Usually, within a week, the indicator becomes non-hazardous and gradually decreases to the level of the norm. But the exact period will depend on the cause of the pigment increase. If the level of bilirubin has reached indicators of more than 400 μmol / l, then the therapy will be lengthy. With mechanical jaundice, the level may not decrease until the cause is eliminated.

Prevention of jaundice

Prevention should begin in preparation for pregnancy. But even during the bearing of the child, it is not always possible to secure and prevent an increase in bilirubin. Subject to the following rules, increases the chance to reduce the manifestation of jaundice:

• identification of the conflict of the Rhesus factor in the mother and child;
• timely donate blood to determine the genetic deficiency of enzymes;
• avoid alcohol, tobacco, drugs and chemicals;
• move away from stressful situations;
• reduce the use of medications during pregnancy and childbirth;
• start breastfeeding while still in the delivery room;
• feed the baby on demand, establish lactation;
• if possible, take the child out to the sun, observing precautions against heat and sunstroke.

Prevention of jaundice is not always able to reduce the manifestations of the disease. In case of yellowing of the skin of the child, it is necessary to show the pediatrician.