Dr. Komarovsky on jaundice in newborns

Renowned pediatrician Dr. Komarovsky frequently handles common issues that new parents encounter, such as newborn jaundice. The condition known as jaundice, which causes a baby’s skin and eyes to turn yellow, can naturally worry new parents. Dr. Komarovsky provides parents with a clear understanding of why this occurs and what they can anticipate.

Dr. Komarovsky highlights in his explanations that jaundice is a common and generally harmless condition. He assists parents in comprehending the underlying reasons, such as a newborn’s immature liver function. Under his guidance, parents can feel reassured that although close observation is required, the condition often gets better on its own with the right care.

Dr. Komarovsky offers helpful guidance on when to seek medical attention and what actions parents can take at home to help them navigate this issue. His method seeks to dispel the mystery surrounding the illness and assist parents during what can be a perplexing period. Gaining insight into his viewpoint can help make treating jaundice less intimidating and more doable.

What happened?

Jaundice is a relatively common phenomenon in newborns; it affects 50–60% of full-term babies and 80% of premature babies. Treating it like a disease is not appropriate. The yellowing of the baby’s skin is entirely physiological. Normal human hemoglobin A replaces the fetal hemoglobin that was naturally present in the baby’s blood during pregnancy. The infant adjusts to its surroundings. His liver and his enzyme system are both immature. This organ is in charge of eliminating bilirubin, which is produced in all individuals as a result of the breakdown of red blood cells. The "utilization" of aging cells is necessary because these blood cells are constantly being renewed.

As normal hemoglobin replaces aging red blood cells in the postpartum period, bilirubin cannot yet be eliminated by the underdeveloped liver. The skin turns yellow when this bile pigment stays in the body. A newborn typically undergoes this kind of metamorphosis on the third day following birth.

The enzyme system advances fairly rapidly. The skin lightens, first taking on a peach tint before reverting to its normal color as the liver, having received the required enzymes, starts to function at maximum capacity and bilirubin starts to exit the body. Jaundice should totally go away after discharge in 4-5 days, or less frequently, a week, as this process is usually finished by the 7–10th day of life. Premature babies may exhibit prolonged neonatal jaundice, but medical professionals work to treat and keep an eye on them in a hospital setting.

Natural feeding-related jaundice is another form of harmless jaundice. Komarovsky claims that certain compounds in breast milk slow down the liver’s ability to bind bilirubin. Not only does the baby not need to be stopped from breastfeeding and switched to formula, but this situation is normal and does not require treatment.

How to treat?

Evgeny Komarovsky tells mothers not to worry about asking questions about how to treat neonatal jaundice because it’s a natural process. Special drugs are not used for these purposes in modern medicine. It is thought that light therapy is the most efficient approach to somewhat expedite the child’s skin’s normalizing process. To do this, the child’s skin is illuminated by a "blue" lamp. Because of this, when exposed to radiation, the pigment bilirubin degrades into materials that the newborn’s body can easily eliminate through urine and feces.

If there are no LED lamps available, Komarovsky suggests using regular "white" lamps at home because any bright light will offset the bilirubin’s toxicity.

Mother’s breast milk is a natural remedy that also works well for jaundice. It has organic ingredients that strengthen the child’s immune system. Therefore, the infant’s body will recover from physiological jaundice more quickly and easily the earlier it is breastfed and the more frequently it is fed breast milk. Providing food for these kids is a unique tale. Babies with elevated bilirubin typically exhibit increased sleepiness and may skip meals. Making sure the baby eats on schedule, waking him up when needed, and never overfeeding him are all crucial.

Taking such a baby for a walk will also be therapeutic. It is necessary to take him outside more frequently so that the youngster can interact with diffuse sunlight. A child with jaundice should be outside for the majority of the day, if the weather and season permit.

While jaundice in newborns is a common condition, parents must understand its causes and properly manage it, as Dr. Komarovsky explains in his clear insights. He says that although newborn jaundice usually goes away on its own, it frequently arises from the immaturity of the liver. He does, however, stress the significance of keeping an eye on things and getting medical advice in order to distinguish between benign and possibly dangerous cases.

Pathological situations

When a newborn baby starts to lose a lot of red blood cells—not just the aging ones that need to be replaced, but also the healthy ones—it is deemed abnormal. Here, the bilirubin level is extremely elevated, and functional jaundice is no longer an issue. Hemolytic disease of the newborn (HDN) is discussed by doctors. Children whose blood type and Rh factor differ from their mother’s may develop this pathology. In the event of an immunological conflict, the fetus’s blood cells are targeted by specific antibodies produced by the mother’s immunity.

Jaundice of this kind begins to appear within hours of the baby’s birth. The infant develops severe anemia as a result, and problems with his liver, central nervous system, and brain occur. Physicians keep a careful eye on the bilirubin level. An exchange blood transfusion is advised when specific critical blood levels of this pigment are reached. Occasionally, multiple such procedures are needed to lessen bilirubin’s harmful effects on the body as a whole. Death is possible in cases of severe hemolytic illness that progresses quickly.

Biliary atresia is linked to another pathological jaundice that is commonly observed in children. This is a congenital pathology where there is a genetic error causing these pathways to form incorrectly or not at all. Based on official medical statistics, the incidence of this disease is one in fifteen thousand newborns, making it an extremely rare occurrence. The child is given a chance at a future normal life by means of a highly complex and high-tech surgical procedure that eliminates this condition.

Other causes for a newborn’s abnormal jaundice appearance include:

• Vitamin K overdose. The drug "Vikasol" (a synthetic analogue of vitamin K) is used during labor to prevent or eliminate severe bleeding in a woman. If there is an error in dosing or an urgent need for a large amount of the drug for a woman, an overdose in the baby may occur.
• Diabetic fetopathy. A condition in which the baby"s liver and its enzyme system are insufficiently developed due to the fact that the fetus suffered during pregnancy against the background of the mother"s diabetes.
• Genetic (hereditary) liver malformations. These are some types of genetic syndromes in which structural genetic errors have arisen at the level of organ formation in the fetus.
• Intrauterine infections. Some infectious diseases that the mother suffered during pregnancy can cause pathologies in the development of the fetal liver.

Treatment of pathological jaundice

Pathological jaundice usually lasts for a long time; it does not go away in 7-8 days. In order to determine the actual cause of each type of jaundice, further testing is necessary. Only then can appropriate treatment—either conservative or surgical—be recommended.

In many cases, children who have pathological forms of jaundice are prescribed a serious medication called "phenobarbital." According to Evgeny Komarovsky, there is nothing out of the ordinary about this medication; it genuinely has the capacity to stimulate enzymes that quicken bilirubin binding in the liver. However, because "phenobarbital" has such a detrimental effect on a child’s nervous system that its other benefits become irrelevant, this medication is never used to treat small children anywhere in the world. Reliability in modern medicine has demonstrated that early exposure to "phenobarbital" invariably results in a reduction of intelligence, or the capacity to learn at a later age.

Dr. Komarovsky offers insightful information about jaundice in infants, highlighting that it’s a common ailment that’s typically not reason for concern. His guidance reassures parents that although the situation may appear worrisome, most cases eventually get better as the baby’s liver develops.

He emphasizes how crucial it is to keep an eye on the infant and communicate with medical professionals. Frequent examinations can guarantee that the jaundice is developing as expected and identify any issues early on.

All things considered, Dr. Komarovsky’s method aids parents in realizing that, although jaundice can be concerning, it is usually tolerable and transient. It can make things easier for parents and their newborns if they heed his advice.

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