Jaundice of newborns
Look in any postpartum ward, and you will find that many children have skin and eye whites that are yellowish in color. They have jaundice of newborns, which for most children is no more dangerous than a regular sweating. A certain degree of icterus develops in most of the newborns, which is caused by the accumulation in the blood of a yellow pigment called bilirubin, and the deposition of this excess bilirubin in the skin. The level of bilirubin is determined after taking a few drops of blood from the child's heel.
Normal and pathological jaundice
Newborns can develop two types of jaundice: normal( physiological) and pathological. At birth, children have more red blood cells than they need. These extra cells, similar to tiny wafers with layers of yellow pigment, called bilirubin, are destroyed by the excretory system of the child. In this case, the yellow pigment, bilirubin, is released. In our organisms this happens every day. We do not become yellow because our liver - a high-quality filter - removes excess bilirubin from the body.
The immature liver of a newborn can not cope with excess bilirubin, and as a result, this yellow pigment appears in the skin and gives it a yellow color on the third or fourth day after birth. This is normal jaundice. As soon as your child's
bilirubin withdrawal system gets stronger and the number of blood cells decreases, jaundice will pass - usually in a week or two - and will not cause any harm.
Pathological jaundice usually occurs within the first twenty-four hours after birth. This type of jaundice is caused by the destruction of too many red blood cells and too quickly. If too much bilirubin enters the circulatory system( in the medical language, "if the bilirubin level is too high"), excessive bilirubin can cause brain damage( which happens very rarely with modern preventive measures and treatment of ). Even pathological jaundice almost never harms a healthy child in time. Much more fears it causes in premature or sick children.
This pathological type of jaundice is usually caused by the incompatibility of the mother and child in the blood group. This means that the mother can have the first blood group( O), and the child has a second or third( A or B).The mother can be Rh-positive, and the baby is Rh-negative( to prevent problems related to the Rh factor incompatibility in Rh), the mothers are injected with anti-D-immunoglobulins( RhoGAM) in the last month of pregnancy andimmediately after birth).If a child's blood type is not the same as that of a mother, some of the antibodies from her mother's blood circulate in the child's bloodstream and something like a war between two opponents flares up: the red blood cells of the baby and the other's antibodies from the mother's blood of another group. As a result of this battle, many red blood cells are destroyed, bilirubin is released and jaundice appears very quickly.
Your doctor will monitor the level of jaundice according to blood tests, which determines the level of bilirubin. If the level is low - no harm, no worry. If the level is too high and quickly rises, your doctor can begin treatment by increasing your child's fluid intake in order to wash out excess bilirubin from the body and resorting to phototherapy( when the baby is placed under ultraviolet lamps) that destroys the excess yellow pigment in the skin,ensuring that it is excreted in the urine and reducing the amount of bilirubin in the blood.
If your child has jaundice - and the majority appears - be sure to ask your doctor to explain to you and try to understand what type of jaundice your child has and whether to worry. From my own experience I know that the level of anxiety in parents is always higher than the level of bilirubin in a child. In monitoring and caring for a child with jaundice
, it is important that both the level of anxiety in the parents and the level of bilirubin in the child are accurately determined and proper treatment performed.
Breastfeeding a child with jaundice
Imagine the following scenario. The child has normal( physiological) jaundice. He is healthy, born on time, and in his blood there is no clear reason for jaundice. The baby is just yellow. It is necessary for the doctor to see this "yellow flag", as a child is taken away from his mother and placed under ultraviolet lamps. Separation of the child and the mother, in addition to the fact that phototherapy makes the baby sleepy and causes partial dehydration, makes the child uninterested in breastfeeding. As a result, the amount of milk at the mother decreases during this period of greatest vulnerability, when frequent application of the baby to the breast and the constant presence of the child are necessary to stimulate the production of milk, and at a time when the child needs more calories to bilirubin.(Studies have shown that breast milk is better than bottles with water or milk formulas, it helps infants to cope with jaundice, perhaps because of the laxative effect that causes more frequent stools.)
In this scenario, events should develop as little as possible. In medical circles, there is a general belief that children with breastfeeding suffer more from jaundice. I question this. From my experience, I can say that newborn babies who are breastfed as conceived by nature are no more yellow than their counterparts who receive bottles. It is true, however, that feeding on schedule, refusal to stay together, and excommunication of the child from the mother do indeed result in the fact that jaundice appears more often in children who are breastfeeding. This situation is correctly called jaundice from breastfeeding ( not the same as jaundice from breast milk) - a situation that can be prevented and which is caused not by your milk, but by the organization of breastfeeding. Here's what you can do:
• Follow the advice on how to start breastfeeding, especially paying attention to the frequent application of the baby to the breast at the first time, the joint stay and the advice of a specialist in breastfeeding. This helps to eliminate most of the causes of jaundice. A certain amount of liquid and calories, preferably from breast milk, is necessary to help the newborn to cleanse its body of excess bilirubin.
• Consult a doctor and be sure to note what type of jaundice is. If the baby is healthy and this is normal jaundice( which I call "jaundice without problems"), do not worry - produce milk.(From the excitement, you may have less milk.)
• If the level of bilirubin alarms your doctor so much that he will prescribe phototherapy, unless the level has risen to the highest level, ask for new UV lamps that are mounted in a blanket-like device inwhich wraps the child. You can then hold the baby in your arms and breastfeed him while he receives the phototherapy. In addition, recent studies have raised the bar of a dangerous level of bilirubin in the blood.
• Do not leave a sleepy baby unattended. Jaundice sometimes causes drowsiness in children, and sleepy children suck less intensively, thereby aggravating the situation, as they close the circle.
• If your child has pathological jaundice that requires phototherapy and sometimes an intravenous infusion to wash excess bilirubin out of the body, continue to breastfeed, unless there is contraindication due to the child's health condition.
A rare type of jaundice, known as jaundice from breast milk ( this is
is not the same as jaundice from breastfeeding), is the cause of less than 1 percent of significant jelly in nursing infants. In this case, which has not yet received the proper research, breast milk can either increase the level of bilirubin in the blood, or slow its normal elimination - for biochemical reasons, is still not clear. If your doctor suspects jaundice from breast milk, you will be asked to stop breastfeeding for a period of twelve to twenty-four hours. If the level of bilirubin in the child's blood drops quickly by 20 percent, a correct diagnosis was probably made. Then in most cases the mother can resume breastfeeding after a few days without further jaundice.
Summing up all of the above, it can be said that there is rarely a need to stop breastfeeding children with jaundice. It is more true to say that breast milk is just the most suitable food for children who have jaundice.